Ocean View General Hospital operates five cardiac catheterization labs. The hours of operation are ideally 7:00 A.M.to 4:30 P.M., but because of the nature of the work, the day doesn't end until all scheduled cases are completed. Patients are scheduled in the labs in ninety - minute time slots. Although each cardiologist performs at his or her own rate, the average time requirement for a diagnostic study is sixty minutes, and an interventional case including a stent requires about ninety minutes.

Patients are rarely scheduled more than three to four days in advance, and most are scheduled about forty - eight hours before the procedure. The patient mix is 60 percent outpatient and 40 percent inpatient. Outpatients are asked to arrive two hours in advance of their scheduled time, in order to prepare them for the catheterization lab, but also to provide flexibility in the schedule if a physician finishes early and cases can be moved up.

The hardest part of managing this area is the unpredictable nature of the schedule. Emergency patients with an acute myocardial infarction have priority and are immediately taken into the lab, bumping scheduled patients. Each lab is staffed with a team of three or four members, who are responsible for the care of the patient during the procedure and also for room turnover. They are not responsible for recovery of the patient or for the line - extraction process. This system enables them to turn the room over for the next patient in fifteen to twenty minutes postprocedure, increasing lab throughput.

The recovery room has fourteen staff assigned to cardiac catheterization patients. The lab performs 8,052 procedures per year and is open for 234 days a year. Catheterization labs are open for six hours of operations. Patients stop arriving two hours before the last scheduled case. The average procedure time is 87 minutes. The following costs are associated with catheterization lab:

1. Cost of the catheterization team idle: the four - member team of Registered Cardiovascular Invasive Specialists with an hourly rate of $ 22.00/hour. Total: $ 88.00/hour.

2. Cost of waiting: the cost of care provided in the preprocedure area. A two - person team of an RN and an EMT are able to care for six preprocedure patients waiting to go to the catheterization lab. Hourly salaries: RN: $ 28.00 and EMT: $ 12.00. Total: $ 6.66/hour.

3. Cost of customers being served: the average cost of performing a cardiac catheterization procedure is $ 800.00. Using Excel queuing template, determine the optimum capacity for the Ocean View General Hospital ' s catheterization labs.