In March 2020, the leadership team at Toronto General Hospital (TGH) needs to plan resources to accommodate the new influx of COVID-19 ICU patients. Key resources for ICU capacity include beds, physicians, nurses, and PPE. The current demand coming from two streams of patients (elective surgeries & emergencies) is expected to overwhelm the ICU capacity, but by slowing down elective surgeries, TGH can mitigate the situation. The optimal proportion of COVID to total ICU patients must be analyzed considering the impact on physicians, nurses, patients awaiting elective surgeries, and PPE. The case allows students to take the role of a hospital leader deciding on allocating capacity across resource pools and recommend an ICU action plan.
The Vancouver Coastal Health Authority (VCHA), with guidance from the British Colombia (BC) Provincial Health Services Authority, had been responsible for organizing and executing an effective COVID-19 response. Its approach for testing capacity and supply chain management had been influenced by several factors: lack of supply, lack of labour, lack of testing expertise, and provincial government mandates. Although these factors had constrained the VCHA’s ability to control the virus, BC’s projected case increases posed serious concerns within the current management. The head of the VCHA wondered how she could better position the VCHA to combat COVID-19 in the long term while securing enough supplies. As she was concerned that COVID-19 cases would continue to surge, she knew this strategy had to be effective and time-sensitive.