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This might be a "problem where every instance is bespoke". Another would be nuclear a weapon detonation or a major hurricane. You can plan for it and run simulations all you want, but your resource constraints aren't known until after the event. ICU rooms contain patients teetering at the edge of death, who might take months to heal or die. They might be "almost out" and suddenly crash into a totally different crisis than the one they were wired up for an hour ago (cardiac patient has a stroke, stroke patient has an MI, bariatric surgery patient throws a pulmonary embolus, etc). Ventilation, gastric tube, rectal tube, urinary catheter, 10 central venous drips, an arterial line, and a 5-lead EKG and pulse ox, all on in a patient who's on a pneumatic mattress that is constantly rocking the patient to prevent bedsores, is not uncommon. And there are three vendors attached to every device. For example, Masimo has the pulse ox device, but the leads are from Cardinal Health under license (no doubt produced under subcontract in China, with soy-based insulation) and the sensor sticker is held on with a second layer of generic silk tape because that's what the nurse had at the time. If you really wanted to do this, you'd have to have the entire suite designed by a single engineering firm with an obsessive focus on supply chain management. You'd need the Boeing or Airbus of ICUs. But doctors are generally convinced they don't need engineers, so good luck with that. |