Our Story

The St. Francis clinical and administrative team, in conjunction with Progressive Emergency Physicians’ Central Administration, have been successful in addressing significant staffing challenges associated with a decrease and subsequent increase in patient volume and acuity at St. Francis Hospital. This unique challenge was addressed through constant data collection and analytics, open and transparent communication with all clinicians, and adjustments of patient flow predicated on the nature of their presenting medical problem and acuity, specifically the utilization of a COVID tent to expedite patient testing thus allowing for a PPH which under normal acuity and flow circumstances would not be appropriate for that site. PEP’s ability to staff-up to such historically high patient volumes is predicated on a strong network of cross-credentialed physician partners who were willing and able to assist at St. Francis, in addition to conventional recruiting and onboarding efforts for new providers. However, the internal network is what allowed us to respond in parallel with the volume increasing in real time.

Our Problem

St. Francis Hospital experienced a significant decrease in Emergency Department patient volume commensurate with the prevalence of COVID in 2019, to see that volume increase beyond pre-COVID baseline, and subsequently explode as of January 2021. This significant increase in volume has largely been associated with patients seeking COVID testing and antibody therapy, resulting in unique staffing challenges.

Our Journey

  • Pre-COVID volume at St. Francis was as high as 91 patients/day
  • COVID-19 onset became most prevalent and detrimental to volume at the site in May 2020
  • Schedule completely adjusted to meet clinical volume and acuity needs
  • Volume began to return in Q3 2020, exploding in January 2021 due to COVID testing and antibody therapy
  • Volume trends monitored constantly to refine staffing and ensure appropriate PPH
    • High PPH in Q1 2021 associated with significant increase in low-acuity ED presentations (testing) which provided a safe and appropriate environment to staff to a PPH above what normal conditions would dictate (i.e. admission percentage in January 2020 was 45.45% with a total monthly patient volume of 2,816 vs. January 2021 with an admission percentage of 20.97% with a total monthly patient volume of 5,593)
  • Throughput metrics and LWBS remained well below goals, despite volume increasing exponentially on a relatively short period of time

Our Data

Average Daily Volume Statistics

2020

20-Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

AVERAGE

SFH

91

86

76

77

58

69

75

79

79

80

81

110

78

2021

21-Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

AVERAGE

SFH

181

157

165

158

 

 

 

 

 

 

 

 

165

PPH Statistics below:

2020

Mar

April

May

June

July

Aug

Sept

Oct

Nov

Dec

AVG

SFH

1.43

1.72

1.59

1.80

1.86

1.80

1.81

1.74

1.85

2.11

1.77

2021

21-Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sept

Oct

AVG

SFH

2.44

2.29

2.45

2.37

 

 

 

 

 

 

2.39

LWBS Statistics:

2020

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

MED

LWOBS

0.50%

0.20%

0.29%

0.43%

0.22%

0.24%

0.38%

0.24%

0.54%

0.32%

0.16%

0.26%

0.28%

2021

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

MED

LWOBS

0.29%

0.39%

0.48%

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