This staffing calculator determines the number of providers (including physicians and non-physician practitioners), nurses, and technicians needed per shift to adequately staff comprehensive emergency departments (EDs), freestanding emergency departments (FEDs), and immediate care centers (ICs). It is based on four inputs and several configurable assumptions. The default inputs calculate the staffing requirements for an evening shift in a 40K annual volume ED to achieve high performance regarding patient and staff experience.

1. Adjust the site volume as either the daily or the annual number of cases.
‍
2. Set the department's PX/SX (Patient and Staff Experience) requirement to High, Average, or Low using the drop-down list. Click the arrow to the right of the 'PX/SX' field to display the available options.
‍
3. Enter the shift of interest, Day, Evening, or Night using the drop-down list.
‍
4. Enter the site type, ED, FED, or IC using the drop-down list.

The table displays recommended staffing levels for each 8-hour shift, days, evenings, and nights. Providers (physician and non-physician practitioner) staffing is listed in tenths, allowing for a more precise allocation through shift overlaps. For example, a requirement of 2.5 providers can be met by deploying two providers plus a third provider for the peak four hours. Note that the recommendations assume only hours of docs/PAs actively picking up charts (not finishing up cases).

The staffing level outputs are derived from several assumptions integrated into the background calculations. These assumptions, highlighted in pink, are adjustable. Clicking the RESTORE DEFAULTS button resets these assumptions to their original values. For ED and FED shifts, each is assumed to span eight hours. Patient arrival patterns are expected to be distributed as follows: one-third during the day, one-half in the evening, and one-sixth overnight. The day and evening shift proportions are configurable, while the night shift percentage is fixed to ensure a total of 100%. For Immediate Care Centers (ICs), a uniform 12-hour daily shift is assumed, with patient volume evenly distributed.

The model adheres strictly to the Emergency Severity Index (ESI), a triage classification system dividing patients into five acuity levels. Admission and transfer rates by ESI act as indicators of proper classification, preventing under- or over-triage. Expected admission rates are 45% for emergent cases (ESI 1 and 2), 20% for urgent cases (ESI 3), and 1% for non-urgent cases (ESI 4 and 5). The ESI "weighted average" score reflects patient acuity, with lower scores indicating higher acuity. Standard benchmarks are 2.9 for EDs, 3.3 for FEDs, and 3.8 for ICs. These values are configurable.

Workload units (WLU) quantify the effort required to care for a patient based on the assigned ESI. A one-year analysis at a Chicago-area hospital system, verified by an academic hospital in North Carolina, demonstrated that emergent cases have a workload of 1.4, urgent cases 1.0, and non-urgent cases 0.7. For example, an ESI 2 case requires the same effort as two ESI 4 cases. These values are configurable.

The maximum workload per hour (WLH) providers can manage is tied to PX/SX goals. WLH > 2 adversely impacts PX/SX, and WLH > 3 jeopardizes patient safety. These thresholds are configurable. Staffing requirements for providers, nurses, and technicians are calculated based on setting-specific ratios, with a fixed nurse-to-technician ratio of 2:1. All these values remain adjustable.

© 2025 Auscura