Learn how leaders in healthcare innovation are tackling the industry’s most challenging problems.
For many decades traditional health care facilities delivering acute care have struggled with the challenge of meeting variable demand with fixed resources. Historically, these facilities have “managed to the mean”. Leaders examine historical arrival patterns and build facility and staffing models based on average demand.
Unfortunately, in acute care settings patient census may vary by as much as 50% from the mean expected arrivals for any given day. On busy days, the number of rooms available and number of staff on duty are insufficient, in which case throughput performance and patient safety suffer, and on slow days they are excessive, in which case significant resources and associated costs are wasted.
Classical teaching in emergency medicine suggests staffing at the 75th or 80th percentile is the best approach.
Emergency patient census varies as much as 50% from the mean while staffing remains fixed, leading to waste in low demand situations and pain on high volume days.
This graph demonstrates how, despite best efforts of providers, many days the facility is under-staffed, and on many other days it is over-staffed and costs are excessive.
A variety of methods have been developed to help with this core problem. Examples include float pools of nurses, cross training, on-call staff that are called in to help when the system is stressed with high patient numbers, sending some staff home early when activities slow, expanding the size of the ED, opening zones during high demand, and rare event planning for new approaches in the event of disasters. While these methods may assist with improving metrics, they fall far short of solving the core problem and add cost to the system.