Overview
    These calculators are intended to demonstrate how improving the performance of various KPIs within emergency department operations, or areas directly affected by those operations, can impact an organization's financial position. The cells shaded yellow can be changed to reflect the circumstances of a specific situation. Typical default values have been provided, but values that are realistic for a particular organization will provide more meaningful insights. Cells shaded green reflect the results of the calculations.
    Instructions          
    Fill in the orange-shaded boxes with values that reflect your organization's current performance levels and future targets.
    Key            
    Editable Cell
    Intermediate Calculation
    Opportunity Calculation Result
     Abbreviations   
     ED   Emergency Department   
     HPPV   (Nursing staff) hours per ED patient visit   
     IP   Inpatient admissions (from the ED)   
     LWBS   Left without being seen   
     OP   Outpatient visits   
     OT   Overtime   
     Oppty $   Value of improvement opportunity in dollars   
     T&R   Treat & release ED patient departures   
  Calculator: LWBS (left with being seen) Improvement
                 
  Premise: When emergency departments are overcrowded, wait times increase and in extreme cases hospitals go on diversion. In both instances patients will go elsewhere for their healthcare when possible. The impact is both an immediately quantifiable loss of opportunity as well as damage to reputation which can discourage future patient loyalty. Reducing LWBS rates can recapture lost revenue immediately as well as increase longer term prospects from increased loyalty.
  Opportunity: Decrease the LWBS rate by improving workflow efficiencies, operational processes, and interdepartmental coordination.
  Annual ED Visit Volume LWBS % LWBS Departures % Admissions Lost Admits Oppty $ / IP IP $ Lost  
        % T&R Departs Lost T&R Departs Oppty $ / OP OP $ Lost   
  Current Scenario              
   
         
                 
  Future Scenario              
   
         
                 
   Value of Improvement          
  Current Lost Opportunity           
  Future Lost Opportunity           
  Value of Gain           
  Calculator: Average Length of Stay (ALOS) Reduction
  Premise: Hospital workflow is impacted significantly by how quickly patients can be appropriately discharged from inpatient units.  The emergency department plays a integral role in a hospital's overall patient flow. Patients boarded in the ED have been shown to have longer lengths of stay. Also, optimizing hospital discharge processes frees up capacity for patients to be admitted to inpatient units sooner. Among the benefits of optimizing patient flow is the incremental value of an increased  number of elective inpatient procedures which require beds for pre and post-operative care during peak occupancy periods. This value can be estimated by computing the number of additional elective hospital visits that would be possible by improving patient flow and multiplying that by the value (based on DRG payments) of typical elective procedures.  
  Opportunity: Improve ALOS from current level to one that reflects efficient discharge processes that still ensure the appropriate standard of care.
  Staffed Bed Capacity % Capacity Avg Occupancy Avg Days/Year Bed Days/Year ALOS Inpatients Visits/Year    
  Current Scenario                
     
  Future Scenario                
     
  Value of Improvement                 
   Gain in # of Potential Inpatient Visits           
   Percent of Capacity Gain Used for Elective Procedures           
   Additional Elective Procedures           
   Value of Typical Inpatient Elective Procedure*           
   Additional Value of Capacity Gain           
  * Examples of Common Medicare MS-DRG Facility Payments for Elective Surgical Procedures (2020)    
  Hospital Base Rate:              
  % of Discharges DRG Weight DRG Payment   MS-DRG
    470-MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC
    247-PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC
    469-MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACEMENT
    467-REVISION OF HIP OR KNEE REPLACEMENT W CC
    462-BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC
          enter additional DRG information if appropriate
                 
Typical Elective Procedure Value            
  Calculator: Overtime Premium Pay Reduction & Staff Efficiency Improvement
  Premise: The combination of efficient emergency department processes and more precise staff planning holds the potential to reduce overtime and other premium pay. Understanding various patterns in emergency department volumes provides  opportunities to create more accurate staff forecasts and avoid last minute staffing changes that may come with expensive premium compensation. 
  Scenario: Reduce the percentage of emergency department nursing staff hours with overtime pay & increase staff efficiency.
  Annual ED Visit Volume Nursing HPPV* Required Staff Hrs OT Hrs % OT  $s / Hr Value of OT  
  Current Scenario            
   
  Future Scenario            
   
  Value of Improvement             
   Cost of Current Overtime Expenses         
   Cost of Future Overtime Expenses         
   Cost Savings from Reducing Overtime         
  Note: Estimates of nursing staff efficiency (HPPV) can also be changed in conjunction with altering overtime hours percentage.
  * HPPV: nursing hours per patient emergency department patient visit  
  ** Reference:  Using Predictive Analytics to Align ED Staffing Resources with Patient Demand, Skinner, et al, hfma, January 2018 
   
  Summary of Potential Annual Financial Benefits Possible through Improvements in Hospital Workflow Efficiency including Emergency Department Operations
Improving Left Without Being Seen Rate:    
Reducing Inpatient Average Length of Stay:    
Mimimizing Staff Overtime:    
Total: