77. UTILIZATION OF HEAT-MAPPING SOFTWARE TO MATCH A RESIDENT STAFFING TEMPLATE TO ED ARRIVAL PATTERNS

Abstract

Background Academic institutions rely on resident physicians to adequately staff emergency departments while residency programs need a steady flow of patients in order to provide trainees with a good clinical experience. Feedback from end-of-rotation evaluations suggest that residents feel competition for patients during some shifts and overworked during others. To investigate this, we utilized heat-mapping software to determine the degree of over- and under-staffing by hour of the day in the ED. Objective Utilize heat-mapping to develop an evenly-distributed staffing model in the ED at a tertiary care children's hospital Design/Methods Heat-mapping software within Excel (Microsoft Corp, Seattle, WA) was utilized to overlay ED patient arrival patterns from June 2017-May 2018 on top of the potential patients per hour based on national estimates for trainees. Time-frames for under- and over-staffing were identified. A new schedule matrix was implemented in October 2018 and the same heat-mapping process was used to determine appropriateness of the staffing matrix. Given the visual nature of the study, results are presented descriptively. Results Analysis of the heat-map revealed that the current schedule matrix significantly under-staffed in the morning between 7-11am and over-staffed the rest of the day. A heat map representing usual staffing from October to December 2017 is shown in figure 1 and highlights the mismatch. Changes were made to the staffing matrix informed by the findings which resulted in more appropriate staffing during morning hours and evening hours for the months of October to December 2018 (figure 2). Conclusion(s) Novel use of heat-mapping software has the potential to successfully match ED patient arrival patterns to an appropriate resident staffing matrix. Future directions include incorporation of variable productivity to account for fatigue as the shift progresses.