MOD 6, CT 1 - Michelle Miguel

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School

Colorado State University, Global Campus *

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Course

410

Subject

Health Science

Date

Jan 9, 2024

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docx

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Uploaded by mmiguel3

1 Capacity Management Memo Michelle C. Miguel Colorado State University – Global Campus HCM410: Healthcare Operations Management Todd Kane April 25, 2021

2 TO: John Smith, CEO FROM: Michelle Miguel, ER Department Manager DATE: April 25, 2021 SUBJECT: Capacity Management for the ED Overcrowding in an emergency department (ED) has always been an issue. Some reasons for overcrowding include, but are not limited to, low-income or uninsured individuals lacking primary care, unnecessary visits such as seasonal illnesses, and not having proper scheduling for mandatory surgeries (Salway et al., 2017). The ER medical director has an idea to build a 10-bed addition to the hospital to fix this issue. As it may seem to be a helpful idea, adding more beds is not the best solution to keep emergency departments from being overcrowded. It costs about $1,000,000 to build a hospital bed, and another $600,000 to $800,000 to provide staff to cover just one bed (Salway et al., 2017). This alternative would be a major financial burden to the hospital. Studies also show that increasing the number of beds in an ED increased the number of patients, which does not keep the overcrowding sustained (Salway et al., 2017). Alternative Solutions Capacity management allows an organization to adjust its capacity to meet fluctuating demand (McLaughlin & Olsen, 2017). According to Mandavia & Samaniego (2016) and Salway et al. (2017), the following are alternatives that would help decrease the issue of overcrowding in the ED, without having to spend on more hospital beds:  Optimizing staffing  Triage alternatives

3  “Results waiting” area for test results  Hire a hospitalist Knowing when the busiest and non-busy hours are in the ED will help with optimizing staffing to ensure it is appropriately resourced when needed (Salway et al, 2017). Distributing current staff rather than hiring more will save on cost in the long run. If hiring more staff is absolutely needed, a hospitalist could be used to focus on bed management to decrease the throughput time for admissions (Salway et al., 2017). Creating an area for patients to wait for test results would help free up beds. Usually, patients occupy a bed until they are discharged, leaving less of them open for newer admissions. By creating a “results waiting” area, those who do not need to be in a bed or need constant monitoring can wait for test results in this area (Mandavia & Samaniego, 2016). Triage alternatives could reduce wait time for admitted patients. A traditional triage may take over an hour for a patient to see a nurse. Patient pivoting and direct bedding are other ways to triage. With patient pivoting, a nurse sees all patients upon arrival, does a quick assessment of everyone's chief complaint, and depending on their complaint, puts them as a “fast track” or directly to an open bed (Mandavia & Samaniego, 2016). With direct bedding, everyone entering the ED goes directly to a bed. From there, a nurse will complete their registration at bedside and prepare them for a physician to get seen and discharged quicker (Mandavia & Samaniego, 2016). Conclusion An overcrowded emergency room creates challenges for efficient workflow and patient flow. The mentioned alternative solutions let the hospital use and optimize resources that are already available, from current number of beds to the staff. “Adding beds to the ER does not

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