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The emergency department report tabs

With the lens on, the Output Report shows six tabs of the department’s own in place of the general ones: Front Door, Flow, Getting Out, Crowding, Team and Spaces and Money. They sit in one row under the Rules strip, and a tab shows only when the run holds its rows. This article takes the first five. Money has its own article, Cost per patient.

Each time table has a row for All patients and one for each acuity level (ESI 1 to ESI 5 in the pictures), the patients in the row (N) and the times P50, P85, P90 and P95. Each chart has a Show as table button.

Front Door

Section titled “Front Door”
The Front Door tab under the headline and Rules strips: the table Acuity mix with a row for All patients and each of ESI 1 to 5, then Door to triage, a space and a provider with three tables, Door to triage, Door to space and Door to provider, each with the columns Acuity, N, P50, P85, P90 and P95, and the chart Patients waiting, by hour of day, with the line Busiest at 21:00, 1.7 waiting and a Show as table button.
Figure 1. The top of Front Door: the acuity mix, the three door tables and the patients waiting by hour.

Front Door is about the wait before care begins. Acuity mix gives the visits at each acuity and their share. Door to triage, a space and a provider gives three tables by acuity: Door to triage ends when a nurse starts sorting patients by how sick they are, Door to space when they are given a treatment space, and Door to provider when a doctor or practitioner first sees them. Patients waiting, by hour of day charts the average patients in the Waiting Room in each hour.

Front Door scrolled to Why patients waited for a space: the Rooming needs line B. A space and a nurse (the default) with the note From the model, and five tiles, Mean rooming wait, No space free, No nurse with room, No provider with room, which reads Not checked under B, and More than one.
Figure 2. Why patients waited for a space, with the Rooming needs line.

Further down, Why patients waited for a space breaks the wait down by what was missing. Every minute a patient waited to be roomed is charged to the one missing piece, or to more than one when several were missing at once, “so one shortage never hides another.” The Rooming needs line reads the choice made on the Room step, with the note From the model. The tiles give the Mean rooming wait and the share of the waiting minutes held by No space free, No nurse with room, No provider with room and More than one. A piece the choice does not check reads “Not checked under B”, with the letter of the choice. See Settings for an emergency department model.

Flow

Section titled “Flow”
The Flow tab: tables by acuity for Provider to decision, Lab order to result, Imaging order to result and Length of stay, the last with the columns Over 4 hours and Over 8 hours and a second table By how the visit ended, then the table Time by care step with the columns Step, Kind of step, Patients through the step, Average time in the step and Average wait before the step.
Figure 3. The Flow tab: the time tables and Time by care step.

Flow times the parts of a visit once care has begun: Provider to decision, from the first provider exam to the decision on where the patient goes next; Lab order to result and Imaging order to result, from the request until the result is back; and Length of stay, from arrival at the door until the patient leaves. Length of stay adds a column for each line set under Report rules, Over 4 hours and Over 8 hours in the picture, and a second table, By how the visit ended, with a row for each way a visit ended.

Time by care step lists every step with its Kind of step, the Patients through the step, the Average time in the step and the Average wait before the step.

Getting Out

Section titled “Getting Out”
The Getting Out tab: the table How visits ended with the rows All visits, Discharged, Admitted and LWBS, the tables Boarding and Bed request to assigned by acuity, the chart Patients boarding, by hour of day, and the tile Boarding patient-hours a day.
Figure 4. The Getting Out tab: how visits ended and what admitted patients waited for.

Getting Out is about how visits end and what admitted patients wait for. How visits ended gives each way a visit ended with its visits and share: All visits, Discharged, Admitted and LWBS in the picture. Boarding times how long admitted patients are held in the department from the admit order until they leave for a ward, with an Over 4 hours column. Bed request to assigned times the wait from asking the ward for a bed until one is assigned.

Patients boarding, by hour of day charts the average admitted patients waiting for a ward bed in each hour, and says “Every hour of the day reads 0” when no one boarded. Boarding patient-hours a day adds those hours over one day.

Crowding

Section titled “Crowding”
The Crowding tab: three charts by hour of day, Patients in the ED, Patients in the Waiting Room and Spaces in use, each with its busiest hour and a Show as table button, then the card The busiest hour and the table Patients in the ED, by weekday, from Monday to Sunday.
Figure 5. The Crowding tab: the hourly charts, the busiest hour and the weekday table.

Crowding shows how full the department was. Patients and spaces, by hour of day holds three charts, Patients in the ED, Patients in the Waiting Room and Spaces in use, each naming its busiest hour. Spaces in use is a share of all space units. The busiest hour gives the clock hour of the run with the most patients in the department on average, and the most at any one moment in it. Patients in the ED, by weekday gives the average patients on each weekday.

Team and Spaces

Section titled “Team and Spaces”
The Team and Spaces tab: the table Staff with the columns Resource, Units, Utilization, Average caseload weight, Peak caseload weight, Time over the caseload limit and Cases handed off, the table Treatment spaces, the charts Staff in use and Spaces in use by hour of day, and the tile Visits per space a year.
Figure 6. The Team and Spaces tab: staff, treatment spaces and their use by hour.

Team and Spaces reads how busy the staff and the spaces were. Staff lists each staff resource with its Units and its Utilization, the share of the time the units were in use, and, where it keeps a caseload, Average caseload weight, Peak caseload weight, Time over the caseload limit and Cases handed off. Treatment spaces gives each space resource its units, its utilization and Most in use at once. Staff and spaces in use, by hour of day charts the share of all units in use in each hour. Visits per space a year is “The visits a day in this run times 365, over the treatment space units.”