Staffing and Scheduling Emergency Rooms in Two Public Hospitals: A Case Study

Abstract

Emergency Rooms (ER) in hospitals are considered as an integral part of the health care system. The number of patients arriving to the ER constitutes a significant percentage of the total patients who demand health services from a hospital.  Therefore insuring the ER services around the hour is very crucial to maximize patients' care. In addition, the efficient allocation and utilization of nurses and physicians is one of the most important issues facing ER administrators.  Although demand on ER services in hospitals at Baghdad increases dramatically at certain incidents, we observed that the ERs, where we conducted the study, are overstaffed with nurses and physicians around the day. However, it is, always, desirable to operate any emergency room with minimum staff, while maintaining the quality of patient care.  This paper simulates the patients' arrivals to determine the adequate number of nurses and physicians, required, over 24 hours, at the ERs of two large public hospitals at the city of Baghdad. The simulation results were adjusted and used to determine the number of physicians and nurses in each ER for one week, 3-shift working day.  The analysis conducted in this paper revealed that it is possible to downsize the current number of physicians by an average of 28%, and the number of nurses by about 55% while maintaining emergency services around the hour. The results could be translated into lower operating expenses of the ER, and better utilization of staff resources in other parts of the hospital.