2. Peak unscheduled patient arrivals period from noon to 2pm
New model matches staffing to peak expected patient arrivals

3. Proposed staffing levels of new team based PAS model to match expected patient arrivals:
Source: Mary Marran (VP of Brain & Behavioral Health Integration, Director of Informatics)

4. Inpatient Evaluation No Yes No Yes RN Triage: Pharmacy Med. Recon.
Team Social Worker completes inpatient psychiatric evaluation No
Ambulatory SW assists with OP disposition
Yes No
Team MD reviews IPE, med. recon. or completes Med Recon.
Team MD reviews or completes Med Recon.
Admit
Yes
Care teams- concept, how impact care
Hand off communication
System integration (inpt units)
Med and psych + total comprehensive eval
Surge response
Physical Exam
PA available
Team Nurse admission with IC, monitors patient in milieu, and completes nursing report to unit.
Unit staff arrives for PAT search & escort.
Precertification

5. PAS New Team Based Staffing Plan Detail
Move to a team based care throughput model from a traditionally psychiatrist centered model, estimated skill mix savings of ~$514,000 with psychiatrist reduction of 7.50 to 5.5 FTEs , reduced moonlighting costs, and elimination of on call costs.
Current State
Current Level
Intake Coordinator
14.96
Asst. Nurse Manager (Staff RN)
5.0
PAS Social Services Clinician
2.25
Social Services Clinician II
1.5
Clinical Access Specialist
0.5
Clinical Care Director
1.0
Nurse Manager
2.0
PAS Director
PAS Operations Coordinator
Total
28.71
Future Model
Future Level
Intake Coordinator
13.6
Unit Clerk
1.5
Asst. Nurse Manager (Charge)
1.4
Staff RN
4.20
PAS Social Services Clinician
8.45
Clinical Nurse Specialist
0.8
Nurse Manager
1.0
PAS Director
PAS Operations Coordinator
Total
32.95
Bottom line changes –adding FTE’s to direct care functions. Reducing physician costs driven by need to reduce costs and physician recruitment challenges—hard to find doctors, off shift work is not popular.