COVID-19: CReST Support for developing COVID-19 services

Whilst the CREST appointment/bed modelling tool has been developed for use with Children and Young Peoples’ Mental Health Services it may also have value in assisting with the planning of new COVID-19 services.

The CREST Tool enables an assessment of the level of resources required to properly manage a flow of patients through a service – whether in a clinic (outpatient) or bed-based (inpatient) setting. The tool is particularly appropriate where a queue for a service is time-sensitive – i.e. no-one should wait longer than 20 minutes, or 7 days, or 18 weeks to receive the service.

The Inpatient module of the modelling tool is designed to model numbers of beds required to meet demand. Combining together

  • Numbers of patients requiring beds
  • Average Length-of-Stay expected
  • Maximum wait-time for beds

The model will calculate the numbers of beds required to maintain a flow of patients without developing extended waiting times.

So, for example, if a Trust is expecting 100 COVID-19 patients a week over the next several weeks how much bed capacity do they need to unlock, in order to admit people within 1 day?

Our modelling is set up for annual demand, so we would multiply the 100 expected patients by 52 for an annual demand of 5,200.

Research into COVID-19 in China has suggested an average length-of-stay of 12.8 days for those hospitalised (https://www.nejm.org/doi/full/10.1056/NEJMoa2002032).

We’re aiming to manage admissions so that no patients wait longer than 1 day to be admitted, once their need for a bed has been identified.

We enter those key figures into the model, as shown below.

Then click ‘Run Model’

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Our bed model tells us that we will have an ongoing bed-requirement of 203 beds for these COVID-19 patients.


Beds made available

Average Wait (Days)

Breaches per Month

% Breaches

% Utilisation

183

88.4

390.4

97.6

99.9

184

10.1

329.3

82.3

99.4

185

4.9

277

69.3

98.8

186

3

232.6

58.1

98.3

187

2.1

194.8

48.7

97.8

188

1.5

162.7

40.7

97.3

189

1.1

135.6

33.9

96.7

190

0.9

112.7

28.2

96.2

191

0.7

93.4

23.4

95.7

192

0.6

77.2

19.3

95.2

193

0.4

63.7

15.9

94.7

194

0.4

52.4

13.1

94.3

195

0.3

42.9

10.7

93.8

196

0.2

35.1

8.8

93.3

197

0.2

28.6

7.1

92.8

198

0.2

23.2

5.8

92.4

199

0.1

18.8

4.7

91.9

200

0.1

15.2

3.8

91.4

201

0.1

12.2

3.1

91

202

0.1

9.8

2.5

90.5

203

0.1

7.8

2

90.1

204

0

6.3

1.6

89.6

205

0

5

1.2

89.2

206

0

3.9

1

88.8

207

0

3.1

0.8

88.3

208

0

2.4

0.6

87.9

209

0

1.9

0.5

87.5

210

0

1.5

0.4

87.1

211

0

1.2

0.3

86.7

212

0

0.9

0.2

86.3

213

0

0.7

0.2

85.8

214

0

0.5

0.1

85.4

215

0

0.4

0.1

85

216

0

0.3

0.1

84.7

217

0

0.2

0.1

84.3

218

0

0.2

0

83.9

219

0

0.1

0

83.5

220

0

0.1

0

83.1

corona2__1156x566.png