Peak unscheduled patient arrivals period from noon to 2pm New model matches staffing to peak expected patient arrivals

Proposed staffing levels of new team based PAS model to match expected patient arrivals: Source: Mary Marran (VP of Brain & Behavioral Health Integration, Director of Informatics)

Inpatient Evaluation No Yes No Yes RN Triage: Pharmacy Med. Recon. Team Social Worker completes inpatient psychiatric evaluation No Ambulatory SW assists with OP disposition Yes No Team MD reviews IPE, med. recon. or completes Med Recon. Team MD reviews or completes Med Recon. Admit Yes Care teams- concept, how impact care Hand off communication System integration (inpt units) Med and psych + total comprehensive eval Surge response Physical Exam PA available Team Nurse admission with IC, monitors patient in milieu, and completes nursing report to unit. Unit staff arrives for PAT search & escort. Precertification

PAS New Team Based Staffing Plan Detail Move to a team based care throughput model from a traditionally psychiatrist centered model, estimated skill mix savings of ~$514,000 with psychiatrist reduction of 7.50 to 5.5 FTEs , reduced moonlighting costs, and elimination of on call costs. Current State Current Level Intake Coordinator 14.96 Asst. Nurse Manager (Staff RN) 5.0 PAS Social Services Clinician 2.25 Social Services Clinician II 1.5 Clinical Access Specialist 0.5 Clinical Care Director 1.0 Nurse Manager 2.0 PAS Director PAS Operations Coordinator Total 28.71 Future Model Future Level Intake Coordinator 13.6 Unit Clerk 1.5 Asst. Nurse Manager (Charge) 1.4 Staff RN 4.20 PAS Social Services Clinician 8.45 Clinical Nurse Specialist 0.8 Nurse Manager 1.0 PAS Director PAS Operations Coordinator Total 32.95 Bottom line changes –adding FTE’s to direct care functions. Reducing physician costs driven by need to reduce costs and physician recruitment challenges—hard to find doctors, off shift work is not popular.