1. Ruraltownville ED – Pat Sat/Value
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2. Ruraltownville ED – Geography
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3. Ruraltownville ED – Part 1
20,000 annual visits
11% LWOBS rate, peaks at 25% in the evenings
Poor reputation in the community…and your own leadership, “You have the worst performing ED in the Province!”
You have a boarding problem, only 8 treatment spaces and a very poor physical layout.
1 doc, 1 NP, 3 nurses and 1 triage nurse at peak times
20 minute group exercise – min brainstorming, 5-10 min report out
Problem Identification
Approach – considerations, data, information, diagnostics
Potential Solutions
Brief report out from 3 randomly selected teams
Print handout of this page and geography page
Exercise: How would YOU approach this problem if it were YOUR ED?

5. Ruraltownville ED – Part 2

6. CTAS Distribution

7. Ruraltownville ED Acuity by HOD
© 2011, Jody Crane, MD, MBA

8. Key Metrics Ruraltownville ED
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9. Ruraltownville ED Capacity

10. Exercise – Ruraltownville ED
During peak hours
What is the triage nurse utilization if each patient takes 7.5 minutes to triage? (assume all patients are triaged)
What is the Nurse Practitioner Productivity in patients per hour if the nurse practitioner is able to see all of the low acuity patients (CTAS 4 and 5)? Give some reasons for the actual productivity of the NP being only 1.4 patients per hr.
Calculate the NP utilization in #2 above if he/she spends 20 minutes working on each patient.
If the door to bed time was 20 minutes and all patients occupied a bed until they were discharged, calculate the bed utilization based on the current T&R LOS of 200 minutes (assume all patients are discharged)
Kevin can go through the answers here

11. 1. Triage Nurse Utilization – 1 RN
2. Nurse Practitioner Productivity

12. 3. NP Utilization
4. Bed Utilization

13. Nurse, MLP and Physician
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14. © 2012, X32 Healthcare, LLC, All Rights Reserved

15. Any Thoughts?
Would you change any of your recommendations from your group exercise?