Simulations of Deliveries of SARS-CoV-2 Positive Pregnant Women and Their Newborn Babies: Plan to Implement a Complex and Ever-Changing Protocol

Management of severe acute respiratory Syndrome corona virus-2 (SARS-CoV-2) infected pregnant women at time of delivery presents a unique challenge. The variability in the timing and the method of delivery, ranging from normal vaginal delivery to an emergent cesarean section, adds complexity to the role of the health care providers in the medical care of the patient and in the interactions, they have with other providers. These variations are further influenced by the availability of isolation rooms in the facility and adequacy of personal protective equipment. The protocols already set in place can be further challenged when the facility reaches its capacity to manage the patients.To fulfill the goal of providing adequate management to the SARS-CoV-2 infected pregnant women and their infants, avoid variation from suggested guidelines, and decrease risk of exposure of the health care workers, the health care provider team needs to review the variations regularly. While familiarity can be achieved by reviewing the guidelines, clinical case simulations provide a more hands-on approach.Using case-based simulations and current guidance from the Center for Disease Control, American Academy of Pediatrics, and recent reviews, we discuss a management guideline developed at our institution to facilitate provision of care to SARS-CoV-2 infected pregnant women during delivery and to their infants, while protecting health care providers from exposure, and in keeping with the local facility logistics. Key Points

Equipment Layout Improvement for Large-Scale Hot Cell Facility Logistics

This study presents approaches to equipment layout improvement for a large-scale hot cell facility. First, the original facility layout and target process are introduced, including the basic information and specifications. Second, the flow of process materials is analyzed and the relationships are evaluated in detail using a “from-to chart” and a “relationship chart” for the original layout, and the logistics are simulated using the selected discrete event simulator to calculate the traveling distances of process materials handled by teleoperated material handling systems. Third, the original layout is modified using the total closeness rating (TCR), and the efficiency and usage of the material handling system are calculated and compared with the original case to evaluate the efficiency improvement of the modified layout. This modification process, which included load reduction, enabled those aspects of the material handling system that would need to be changed to be identified; these changes were suggested by a quantitative analysis of the logistics between each pair of stations and intuitive rearrangement based on charts and figures. These approaches could be an initial step in the large-scale hot cell design process, with future work to follow.

Research on Optimization Technology of Facility Layout Based on Improved Differential Evolution Method

The facility layout design is the key problem in manufacturing system. Based on the constraints such as the cost of facility logistics and the space of equipment, this paper sets up a Quadratic Assignment Problem model of facility layout. The model is solved using Differential Evolution algorithm according to the features of facility layout, which is combined with Random Key technology. The test results performed on the liner and circular layout show the proposed approach can solve effectively the facility layout design problem.