Utilization of heat-mapping tools to match a resident staffing template to emergency department arrival patterns. AEM Educ Train 2021 Jul;5(3):e10633
Date
09/03/2021Pubmed ID
34471790Pubmed Central ID
PMC8325434DOI
10.1002/aet2.10633Scopus ID
2-s2.0-85111647805 (requires institutional sign-in at Scopus site)Abstract
OBJECTIVES: Academic emergency departments (ED) rely on a steady flow of patients to provide residents with good clinical training. Understanding institutional volume patterns allows training directors to create a schedule that maximizes learning opportunities while also adequately staffing the ED. Our primary objective of this study was to utilize heat-mapping software to optimize resident staffing in an academic ED.
METHODS: Heat-mapping tools within Microsoft Excel were utilized to overlay ED patient arrival patterns on top of the potential patients per hour based on published productivity data for trainees and historical averages for advanced practice providers at our institution. Time frames for under- and overstaffing were identified and color-coded. This analysis informed a revised schedule template and the same heat-mapping process was used to determine the appropriateness of the revised staffing template.
RESULTS: The heat map for the original schedule template revealed understaffing in the morning and overstaffing the rest of the day. Informed by these findings, schedule adjustments were made. There was no net increase in the number of resident or advanced practice provider coverage hours. Prior to implementation, the ED was understaffed by 5% or more during 18.4% of operating hours. Following changes to the staffing template, only 5.9% of operating hours were understaffed (p < 0.001). Furthermore, significant understaffing (20% or more) decreased from 16.6% to 3.1% (p < 0.001).
CONCLUSIONS: Novel use of heat-mapping software has the potential to successfully match ED patient arrival patterns to an optimal resident staffing template. Future directions include incorporation of variable resident productivity to account for fatigue as the shift progresses.
Author List
Schuh AM, Nimmer M, Drendel ALAuthors
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of WisconsinAbigail M. Schuh MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
