Acute Care Surgery · Workforce Planning Instrument

Staffing Adequacy & Financial Justification

Convert a division's clinical coverage into standardized work-periods, weigh it against surgeon supply and safe patient load, and translate the gap into value — sorted by how defensibly each dollar can be shown to administration.

Enter your division's coverage and roster below.

1 Clinical Demand

All coverage the division must provide, in work-periods. Daytime line = days/wk × 52 × teams × duration weight (>14h = 2 WP, ≤14h = 1). Call line = # positions × annual count × duration weight × intensity. # Positions = simultaneous coverage slots (usually 1; set 2 if two surgeons cover the same period).

Daytime service line / teamDays/wkTeamsDur (h)
Call coverage lineScopeDur hIntensity#
Total clinical demand0 work-periods
Clinical cFTEs required0.0

2 Surgeon Supply

Define what 1.0 cFTE means for this division, then enter the roster.

Clinical work-periods available0 work-periods
Volume cross-check (optional)

Independent estimate from trauma volume (≈1.0 cFTE per 285 admissions). A sanity check against coverage-derived need; large divergence is worth a conversation, not an alarm.

Volume-implied cFTEs

3 Team Census & Benchmarks

How do your teams stack up? Enter the average census per attending for each team and see how it compares to national benchmarks from Beyond Capacity. Use this to decide when to split into 2 or more teams. Acuity matters more than raw count — treat this as a flag for discussion. Teams mirror the service lines in Step 1.

ServiceAvg / attendingTeamType

4 Value Inputs

Grouped by defensibility. Tier 1 is auditable; Tier 2 needs local cost accounting; Tier 3 is risk-adjusted. Defaults are seeded from the literature — overwrite with local data.

Tier 1 — Direct & auditable
Tier 2 — Modelable from local data

A bed-day is worth its variable cost if beds are available (~$1.5–2.5K), or a backfilled admission's full margin if capacity-constrained.

Tier 3 — Risk-adjusted (expected value)

5 The Gap & The Value Stack

Staffing Gap

cFTE shortfall0.0
Annual work-period gap0
Extra work-periods per current 1.0 cFTE0
Cost to hire the gap$0

Team Census vs. Benchmarks

Enter average census in Step 3 to compare against the perceived safe maxima.

VALUE

Most defensible at the top. Build the case so the floor stands on Tier 1 alone.

Tier 1 · Direct & auditable

Professional fees$0
Locum / overage replaced$0
Activation readiness$0

Tier 2 · Modelable

Throughput / LOS$0
Downstream margin$0

Tier 3 · Risk-adjusted

Avoided turnover$0

Net Position

Conservative floor

Tier 1 only − hire cost.

Net / year$0

Full infrastructure case

Tiers 1–3 − hire cost.

Net / year$0

Framing

Cost per work-period of coveragethe price of readiness
Hidden cost of inaction (turnover today)$0

6 Visual Summary

The value waterfall, the work-period gap, and patient load against safe ceilings.

Value Stack — Waterfall

Demand vs. Supply

Census vs. Safe Ceiling