1. Developing Metrics for Patient Capacity and Capability Michael C. Vojtasko, CHE Emergency Management Strategic Healthcare Group Veterans Health Administration Department of Veterans Affairs

2. Part I Background

3. What is a Metric? Relating to Measurement

4. What is a Metric? Relating to Measurement Comes from meter which is defined as a measure.

5. What Is the Current Measure? Beds by category

6. What is the Current Measure? Beds by Category – Medical/Surgical – Burns – Critical Care – Psychiatry – Pediatrics

7. Capability vs. Capacity Capacity: Available Beds Capability: Medical Specialties

8. Why Beds? Best measure at the time.

9. Why Beds? Best measure at the time. 25 years ago most acute care and follow-up was provided on an inpatient basis.

10. Why Beds? Best measure at the time. 25 years ago most acute care and follow-up was provided on an inpatient basis. Focus was on trauma.

11. Why Beds? Best measure at the time. 25 years ago most acute care and follow-up was provided on an inpatient basis. Focus was on trauma. Easy to measure and report.

12. Is There A Problem? Depends on who you talk to; but lets look at some of the arguments for change:

13. Is There A Problem? Depends on who you talk to; but lets look at some of the arguments for change: - Decrease in Length of Stay (LOS)

14. Is There A Problem? Depends on who you talk to; but lets look at some of the arguments for change: - Decrease in Length of Stay (LOS) - Shift to ambulatory care

15. Is There A Problem? Depends on who you talk to; but lets look at some of the arguments for change: - Decrease in Length of Stay (LOS) - Shift to ambulatory care - Decrease in number of beds in the U.S.

16. Is There A Problem? Depends on who you talk to; but lets look at some of the arguments for change: - Decrease in Length of Stay (LOS) - Shift to ambulatory care - Decrease of the number of beds in the U.S. - Experiences from Operation Iraq Freedom

17. THIS IS AN EXPERIMENT!

18. Part II Workgroup Sessions

19. Process Break out into groups. Designate a leader and scribe. Three sessions of 20 minutes each. Each session followed by a group summary by the leader--and discussion as time allows. Scribe turns in key points.

20. Session 1 Is there a problem with the current measure (i.e. beds) and, if so, describe why? If not, why not? Develop a problem statement for a workgroup to address.

21. Session 2 It has been suggested that patient care capacity (i.e., number of patients that can be treated by category) be reported by NDMS Patient Reception Areas rather than beds available.

22. Session 2 Question #1 Assuming this suggestion would be adopted, what are some of the issues that would need to be addressed in the development and reporting of such a measure?

23. Session 2 Question #2 What other measures could be developed for reporting the patient capacity and capability of an NDMS Patient Reception Area?

24. Session 3 Question # 1 Who are the customers that would/could use a measure of patient capacity?

25. Session 3 Question # 2 What authorities (agencies, organizations, etc.) would have to approve a new measure?

26. Session 3 Question # 3 What are the obstacles, problems and issues that would need to be overcome in implementing a new measure?

27. Where Do We Go From Here?

28. CONTACT Michael C. Vojtasko. CHE Director, EMSHG Operations & VHA Emergency Planner (304) 264-4805/4835 michael.vojtasko@med.va.gov