ED Flow Workshop - ACEP...Jody Crane, MD, MBA, FACEP Chief Medical Officer, TeamHealth Karen...
Transcript of ED Flow Workshop - ACEP...Jody Crane, MD, MBA, FACEP Chief Medical Officer, TeamHealth Karen...
ED Flow WorkshopJody Crane, MD, MBA, FACEP
Chief Medical Officer, TeamHealth
Karen Murrell, MD, MBA
Physician Lead-Emergency Medicine, Kaiser Northern California
EDDA, 2019
Please Estimate the Following
Annual Volume ___________
% LBTC ___________
% Admit ___________
# of ED Treatment Spaces ___________
ESI % 4,5 ___________
% Vertical 3 ___________
Door to Doc ___________
LOS ___________
Dispo to Depart Admitted ___________
# Providers at Peak ___________
# RN at Peak ___________
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% LBTC by Volume
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LOS and Admit Rate by Volume
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Door to Doc by Volume
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LOS and Boarding Time
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Median LOS by Volume
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Median LOS and Boarding Time by
Volume
Exercises – Calculate the Following:
1. Peak Arrival Rate
2. Peak Arrivals Low Acuity
3. Peak Arrivals Vertical 3
4. ED Bed Ratio
5. Target MD service rate
6. Target RN service rate
7. Target bed LOS and overall LOS
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Peak Arrival Rate
Annual Visits
_____________
5,000
=
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Peak Arrivals Low Acuity
Annual Visits
_____________ X % ESI 4,5
5,000
=
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Peak Arrivals Vertical 3
Annual Visits
_____________ X
5,000
= % Vertical 3 X
(100% - % ESI 4,5 - % admit)
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Do you Have Enough Beds?
Annual Visit : ED Bed Ratio
Annual Visits
___________
# ED Treatment Spaces
=
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Annual ED Visits per Treatment
Space by Volume
EDBA 2017 Summary Staffing Data
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ED Docs - Target Service Rate (pts/hr)
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4 docs
(Y)
Waiting10 pts/hr
(X)
? min/pt(Z)
Peak arrival rate (X) = 10 pts/hr
Takt Time (Z) = 60 min/10 pts/hr = 6 min/pt
For multiple docs, multiply Z by Y = 6 * 4 = 24 min
Peak Target Service Rate = 60 min/24 min = 2.5 pph
Peak arrival rate (X) = ____
Takt Time (Z) = 60 min/X pts/hr = ____
For multiple docs, multiply Z * Y = ____
Peak Target Service Rate = 60 min/ (Z * Y) = ____
What is Your Doc Expected Cycle Time and Service Rate?
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Y docs
Waiting
X pts/hr
Z min/pt
Peak arrival rate (X) = 10 pts/hr
Takt Time (Z) = 60 min/10 pts/hr = 6 min/pt
For multiple RNs, multiply Z by Y = 4.8 * 15 = 72 min
Peak Target Service Rate = 60 min/19.2 min = .83pph
ED RNs - Target Service Rate (pts/hr)
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15 RNs
(Y)
Waiting10 pts/hr
(X)
? min/pt(Z)
Peak arrival rate (X) = ____
Takt Time (Z) = 60 min/X pts/hr = ____
For multiple RNs, multiply Z * Y = ____
Peak Target Service Rate = 60 min/ (Z * Y) = ____
What is Your RN Expected Cycle Time and Service Rate?
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Y RNs
Waiting
X pts/hr
Z min/pt
Peak arrival rate (X) = 10 pts/hr
Takt Time (Z) = 60 min/10 pts/hr = 6 min/pt
Multiply by Y to get in-bed LOS = 6 * 25 = 150 min
Total LOS = in-bed LOS + door to doc = 180 min
Beds - Expected LOS (bed cycle time)
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25 beds
(Y)
Waiting10 pts/hr
(X)
? min/pt(Z)
Peak arrival rate (X) = ____
Takt Time (Z) = 60 min/X = ____
Multiply Z * Y to get in-bed LOS = ____
Total LOS = Z * Y + door to doc = ____
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Y beds
Waiting
X pts/hr
Z min/pt
What is Your Expected LOS?
Thank You!
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