UOH – University of Ottawa Heart Institute Academic Medical Organization
UOH-21-001 – Cardiac surgery triaging tools to reduce mortality while maximizing intensive care resources during the COVID-19 crisis
We developed, validated and digitally implemented the “CardiOttawa”, a family of data-driven tools to manage wait time while optimizing intensive care unit (ICU) and hospital capacity (https://cardiottawa.ottawaheart.ca/; available with free sign-up). These high performance tools were derived and validated on high quality, population-based data in Ontario, using a combination of statistical and machine learning techniques. These tools were practically designed by cardiovascular clinicians to bridge existing knowledge gaps and was specifically tailored to the cardiac surgery workflow. For instance, we produced a bimodal set of algorithms to predict the probability of short (≤ 2 days; c-statistic 0.78) and prolonged ICU length of stay (LOS) (≥ 7 days; c-statistic 0.85). Our hospital LOS algorithm also consisted of a pair of models to predict top-tier resource users (LOS ≥ 35 days; c-statistic 0.92), as well as the exact LOS in days. In addition, the accuracy of our waitlist management tool is evident in the near-equal number of observed and predicted deaths on the waitlist. Since April 2020, the CardiOttawa has been used to triage all cardiac surgery referrals at the University of Ottawa Heart Institute (UOHI) with great clinical success. Daily use of these tools has enabled the UOHI to achieve > 95% of its usual annual procedure volume during the pandemic fiscal year (April 2020 – March 2021), while other Ontario centres on average had to reduce their cardiac surgery volumes by 30%. This was achieved while preserving staffing cost and bed capacity for patients with COVID-19. We are currently discussing with CorHealth Ontario, strategies to systematically implement these tools across the province, to improve patient outcomes and optimize health care resource allocation during the pandemic and beyond.
Public Health Measures and Society
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