forecasting and capacity management
Order Instructions: Memorial Hospital Emergency Department
Tuesday, 3:00 PM
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.
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