H1N1




		A Little Less Art and a Lot More Science


	Focus your Performance Improvement Efforts Through Process Simulation

H1N1 Scenario

Assume:

Additional 235 patients present daily with potential H1N1 symptoms.
Construction of an H1N1 “tent” on hospital grounds dedicated to potential H1N1 patients thereby minimizing probable cross-infection
15% of patients from the “tent” are admitted to the ED for further treatment

Q1. What physician staffing level will provide adequate patient wait times in the “tent”

Q2. What will be the effect on the “main” hospital emergency department

A1. “Time to see a Physician” is selected as the metric driving the staffing decision. Simulation shows the following results at varying staffing levels:

Number of Physicians
First shift	Second Shift	Third Shift	Time to see a Physician
3	3	3	00:03:43
3	2	3	00:05:42
2	2	3	00:09:01
2	2	2	00:17:06
2	1	2	01:37:41
1	1	2	04:52:12

Seven, eight, or nine physicians provide a sub-ten minute “Time to see a Physician” metric.

A2. Two metrics are examined: “Time to see a Physician” and “Patient Throughput”. Simulation shows the following result:

Time to see a physician	Acuity
	1	2	3	4	5
Base case	00:03:43	00:00:56	00:05:09	00:03:11	00:03:46
with addition of 15% H1N1 patients	00:03:06	00:01:36	00:10:13	0006:12	00:08:30

Average Patient Throughput
Base case	01:54:41
with addition of 15% H1N1 patients	01:49:27


	While the time to see a physician has increased slightly, the average throughput has decreased slightly presumably due to the prescreening of H1N1 patients.


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