Quantitative Methods in Health Care Management

Quantitative Methods in Health Care Management


To prepare for this Discussion:

•Read the scenario about Memorial Hospital Emergency Department Committee's Hospital-Based Emergency Care: At the Breaking Point.

Memorial Hospital Emergency Department (SCENARIO)



Memorial Hospital, a large, urban medical center and level I trauma center, has an emergency department (ED) designed to hold 40 acute patients. It is operating well over capacity, with more than 80 patients actively undergoing care, 30 of whom lie on wheeled stretchers in hallways. Of these 80 patients, 24 are waiting to be admitted to inpatient beds; 4 have been waiting 7–10 hours, 1 for 20 hours, and 1 for over 24 hours. The hospital has been on EMS diversion for 5 hours, but with other nearby hospitals also on diversion, it is still receiving a steady stream of patients. Doctors and nurses used to the high stress of emergency care are maintaining relative order, although they have been operating at full tilt for most of the shift. The risk of errors from fatigue, stress, and hurry grows steadily higher. An EMS crew that has been waiting to offload a patient into the busy ED for more than 35 minutes stands by impatiently. The waiting room is crowded with more than 50 people—34 patients, family, and friends—including children, adults, and elderly. Some are in pain, at least one is bleeding, while others appear to have cold or flu symptoms.

A call from the dispatch center notifies the ED that five patients will soon arrive from a car crash on the nearby interstate, with injuries of varying severity. One is coming by helicopter, and the trauma team is mobilized. The ED director does her best to clear



•Describe 2–3 capacity management issues facing the ED in this scenario, and identify likely causes for them.





•Discuss two specific kinds of forecasts or other methods involving capacity planning that managers at Memorial Hospital's ED might have conducted to help avert the problems it faced in this scenario. What are possible implications for managers and staff from these kinds of forecasts or capacity planning?