Hospital Capacity Management: Insights and Strategies

Robbin Dick, MD, FACP started his career in 1988 working in the Emergency Department and trained in Internal Medicine. This role served him well in developing concepts and principles around efficiency and process improvement. Robbin developed the first recognized observation unit in NY State to improve ED efficiency in 1996 which started him on the journey of observation medicine and hospital capacity management. In 2003, he joined the University of Rochester Emergency Department and implemented and managed a 36-bed observation unit. In 2009, he had the opportunity to focus on the use of Lean-Six-Sigma concepts in hospital capacity management. As Vice President of Clinical Efficiency, Dr. Dick developed new models of care delivery and integration. His professional work career includes being Director of Observation Services managing the Observation Service line for Medical Emergency Professionals across the state of Maryland. In 2016, his company joined USACS (US Acute Care Solutions) where Robbin served as Chief of Observation Services for the organization until October, 2018. During his time with USACS, he developed a National Observation Service Line which included well-defined protocols, a robust teaching module based off a MKSAP (Medical Knowledge Self-Assessment Program), testing guidelines, a peer-review process, electronic I-PAD patient satisfaction program and national oversite of the Observation Programs operational development. USACS currently has over 15 Observation units with over 70,000 encounters yearly and is the largest Observation program in the United States. Currently, Robbin’s focus is on consultative services in Observation Medicine and Hospital Capacity Management. Robert Agness, BA is an experienced professional in operational management. He received Lean Sigma training under Shingo Ztisu trainers at Eastman Kodak’s Lean Institute early in his career. His role at Kodak involved the application of Lean Sigma principles restructuring and redesigning internal processes and facilities. Robert spent his last years at Eastman Kodak implementing a lean factory as Operations Manager of its Digital Graphics manufacturing site. Robert brought his expertise in Lean Six Sigma methodologies and implementation to Rochester General Health Systems in 2007. There he educated the leadership, developed a Lean Sigma Black Belt program equivalent, and facilitated the redesign of patient flow in the Emergency Department, Radiology, Peri-op and Inpatient Care Units. He also has designed and implemented the system’s Central Bed Management Department, effecting greater efficiency across numerous departments. He managed patient flow and capacity management for two of the system’s hospitals, totaling 600 beds. Robert is currently semi-retired and works part-time as a consultant in Hospital Capacity Management providing recommendations and assistance utilizing Lean Sigma training.