A Systematic Review of Demand-Based Capacity Planning in the Emergency Department of the Hospital

Authors

  • Khushboo Khatri
  • Ramakanta Prusty

Keywords:

N\A

Abstract

The emergency department (ED) is an important entry point for healthcare systems that often function under strong pressure due to unpredictable patient volumes. The requested capacity plan is intended to coordinate resources with patient requirements in real time to ensure a timely, safe and effective supply. This review examines demand-based capacity planning from   healthcare leaders, managers, and professionals perspective and examines strategies, challenges, tools and future directions for effective resource management in EDs.

The ED is a dynamic and high-stakes environment that operates at the threshold of chaos, demanding continuous adaptability, strategic foresight, and leadership excellence. As healthcare systems confront growing patient volumes, limited resources, and unpredictable case mixes, demand-based capacity planning has emerged as a vital tool to optimize care delivery and ensure operational resilience.

Healthcare managers in the ED serve as key drivers of system performance, balancing clinical urgency with resource allocation. The review highlights how senior ED leadership must engage in continuous planning, simulation, and strategic adjustment to maintain patient flow, mitigate overcrowding, and enhance care quality especially during surges in demand.

Furthermore, this paper explores the intersection of people, systems, and physical environments as critical components in capacity planning. Managers must be agile in change management, aligning operational innovations with team values to embed improvements at all levels. Ultimately, the success of demand-based capacity planning hinges not only on data-driven models but also on the leadership capacity to transform challenges into coordinated responses. The findings underscore that the effectiveness of ED services is inextricably linked to the quality of its leadership and the strength of its organizational framework.

 

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References

Choo EK, Garro AC, Ranney ML, et al. The ED as a complex adaptive system. Ann Emerg Med. 2014;63(1):13-19.

Wears RL, Perry SJ, Wilson S, Galliers J. Emergency department status boards: user-evolved artefacts for inter- and intra-group coordination. Cogn Tech Work. 2007;9(3):163–170.

Coiera E. Communication systems in healthcare. Clin Biochem Rev. 2006;27(2):89–98.

Hoot NR, Aronsky D. Systematic review of emergency department crowding: causes, effects, and solutions. Ann Emerg Med. 2008;52(2):126-136.e1.

Fairbanks RJ, Bisantz AM, Sunm M. Emergency department communication and situational awareness. BMJ Qual Saf. 2007;16(2):109–113.

Croskerry P. Cognitive forcing strategies in clinical decision making. Ann Emerg Med. 2003;41(1):110–120.

Wolf L, Delao AM, Perhats C, Moon MD, Zavotsky KE. Leadership roles in the ED: a qualitative study. J Emerg Nurs. 2018;44(3):246–252.

Asplin BR, Magid DJ, Rhodes KV, Solberg LI, Lurie N, Camargo CA. A conceptual model of ED crowding. Ann Emerg Med. 2003;42(2):173–180.

Sun BC, Hsia RY, Weiss RE, et al. Effect of emergency department crowding on outcomes of admitted patients. Ann Emerg Med. 2013;61(6):605–611.e6.

Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: a review of causes, consequences and solutions. Healthcare. 2018;6(1):1-9.

Schweigler LM, Desmond JS, McCarthy ML, Bukowski K, Ionides EL, Higdon D, et al. Forecasting models of emergency department crowding. Acad Emerg Med. 2009;16(4):301–308.

de Bruin AM, Bekker R, van Zanten L, Koole GM. Dimensioning hospital wards using the Erlang loss model. Ann Oper Res. 2010;178(1):23–43.

Pines JM, Hilton JA, Weber EJ, et al. International perspectives on emergency department crowding. Acad Emerg Med. 2011;18(12):1358–1370.

Sethuraman U, Kannikeswaran N, Chen X, Mahajan P. Effect of a rapid assessment program on total length of stay in a pediatric emergency department. Pediatr Emerg Care. 2011;27(4):295–300. PMID: 21490544

Reducing patient waiting time and length of stay in an Acute Care Pediatric Emergency Department. Quality improvement project using PRAM with CTAS. PMCID: PMC5522973. Published 2017. PMID: 28824805

Li X, Lin H, Gao R, Chen X, Zhang Y, Liu J, et al. Optimizing emergency department length of stay using Six Sigma methodology. BMC Health Serv Res. 2020;20(1):554. doi:10.1186/s12913-020-05412-w. PMID: 32600344

Abir M, O’Neil JA, Davis MM, Wong AC, Goldstick JE, Cohen A, et al. A systematic review of interventions to reduce emergency department consultation-to-admission decision time. Health Serv Res. 2017 Oct;52(5):1221–1243. doi:10.1111/1475-6773.12538. PMID: 27860151

18. F.K. Korley, M.J. Morton, P.M. Hill, et al.

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Published

2025-09-22

How to Cite

1.
Khatri K, Prusty R. A Systematic Review of Demand-Based Capacity Planning in the Emergency Department of the Hospital. J Neonatal Surg [Internet]. 2025Sep.22 [cited 2025Oct.14];14(32S):8528-35. Available from: https://jneonatalsurg.com/index.php/jns/article/view/9184

Issue

Vol. 14 No. 32S (2025): Journal of Neonatal Surgery

Section

Original Article

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