Nelson, B. (2012). Appropriate Patient Census: Hospital Medicine’s Holy Grail. The Hospitalist. Retrieved from http://www.the-hospitalist.org/details/article/1453425/Appropriate_Patient_Census_Hospital_Medicines_Holy_Grail.html.
This article examines the impact of workload imbalance on healthcare providers. Specifically, it looks at the “repercussions of a patient census that is either too high or too low for a hospitalist service.” Further, “Ellis Knight, MD, MBA, FHM, senior vice president for physician and clinical integration at Palmetto Health in Columbia, S.C., recalls conducting root cause analyses after every serious adverse event when he was vice president for medical affairs at a large teaching hospital. ‘For every one of them—it was just like a broken record—every one of them, the nursing staff or the physicians involved would start the recount by saying, ‘It was a very, very busy day; we had a very high census,’’ Dr. Knight says. ‘When that happens, when you get those, what I call tsunami waves of patients coming into a unit or being admitted at one time, it can really wreak havoc and it can make even the best clinicians get rushed, take shortcuts, and make mistakes.'”