Abstract

Different hospitals use different definitions for hospitalists’ workloads, some define it as the number of encounters per shift, and others define it as the daily census or relative value units (RVUs) generated. Thus, this research paper investigates the impact of different assignment policies on the variation of hospitalists’ workloads and ED boarding time when patient acuity is considered. This paper also proposes a new policy that minimizes variation in hospitalists’ workloads, with consideration of the trade-offs between hospitalists’ workloads and ED boarding time. Assigning patients to hospitalists based only on the number of patients results in a workload variation (WLV) that is equivalent to about 5.5 patients. Assigning patients to hospitalists based on patient acuity helps to reduce the variation in acuity workload among the hospitalists. Since policy 2 allows anywhere patient assignment, the WLV in policy 2 is lower than the WLV in policy 3 as result of having flexibility in the number of patients that can be assigned to each hospitalist. Policy 2 has the best hospitalist workload balance among all three policies with WLVs of 7.03, 7.04, and 6.98 for bed capacities of 95%, 97.5%, and 100%, respectively.