Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

Staffing an ED Appropriately and Efficiently

By ACEP Now | on August 1, 2009 | 0 Comment
From the College
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

Having the right mix of physicians, nurses, midlevel providers, and support staff in the emergency department can help ensure emergency department efficiency, patient satisfaction, cost-effective care, and medical-legal safety. But just how do you know that you are staffing your emergency department appropriately and efficiently?

You Might Also Like
  • Emergency Department Benchmarking Alliance Releases 2014 Data on Staffing, Physician Productivity
  • Physician Staffing Model at Texas Health ED Helps Maintain Top Clinical, Operational Metrics
  • More Advanced Practice Providers Working in Emergency Departments
Explore This Issue
ACEP News: Vol 28 – No 08 – August 2009

“When it comes to ED staffing, there are strategic drivers and tactical drivers. The strategic drivers are quality of care, patient safety, and the level of service you want to deliver. The tactical drivers are patient volume, acuity, patient length of stay, admit holds, physician capabilities, and non-physician staffing,” said Kirk B. Jensen, M.D., MBA, who is chief medical officer for BestPractices, Inc. Dr. Jensen also is a faculty member of the Institute for Healthcare Improvement (IHI) in Boston, and chair of IHI’s collaborative on Improving Flow in the Acute Care Setting and Operational and Clinical Improvement in the ED.

Many EDs vary 40% between their slowest and busiest days, so peak load crises are inevitable. but how many are tolerable?

“The ED by its nature is often either overstaffed or understaffed because patient volume is not evenly distributed. Many smaller EDs have as much as a 40% variation between their slowest and busiest days, so peak load crises are inevitable. The real question is how many are tolerable? How far do you bend before you break?” Dr. Jensen said.

What are the best ways to reconfigure staffing models as volume increases, and how do you identify the critical inflection points at which another attending physician is required?

“First and foremost, you’ve got to deal with the fact that there are 8,760 hours in a year and the ED is open every one of those hours,” Dr. Jensen said. “You have to decide what a reasonable workload is for your facility and your physicians, and once you exceed that workload, then you need to add coverage.”

“In the past, the numbers often quoted were 2.3 to 2.8 patients per hour. We are now living the new reality of patient complexity, acuity, customer service expectations, skilled workforce shortages, crowding, boarders, and risk management,” he said. “To the extent that a range can be established, it would be 1.8 to 2.8 patients per provider per hour.”

In matching your staffing capabilities or capacity to demand, you reach an inflection point. “If, on average, your doctors can see 2 patients an hour, and your department is averaging anywhere from 1.5 to 2 patients an hour, you’re fine. But somewhere around 2.1 or 2.2 patients per hour, you reach an inflection point at which you have to beef up staffing,” Dr. Jensen said.

Pages: 1 2 3 | Single Page

Topics: Care TeamOperations

Related

  • Scripps Mercy Hospital San Diego’s Unique ED Culture Breeds Innovation

    July 3, 2025 - 0 Comment
  • Opinion: Demand Up, Beds Down—The Emergency Dept. Crowding Crisis

    June 17, 2025 - 0 Comment
  • A Behavioral Health Intake-Process Model

    May 2, 2023 - 0 Comment

Current Issue

ACEP Now: July 2025

Download PDF

Read More

About the Author

ACEP Now

View this author's posts »

No Responses to “Staffing an ED Appropriately and Efficiently”

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*

Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603