Optimizing Medical-Surgical Throughput: Applying Commerce-Based Resource Management to Adult Nursing Care

Abstract

Medical-surgical units often face operational "gridlock," where inefficient patient flow (throughput) leads to emergency department boarding and delayed surgical interventions. In commerce, these are viewed as supply chain bottlenecks. This study evaluates the integration of Capacity Management and Agile Methodology within an adult medical-surgical nursing framework to improve patient turnover and safety. A "Visual Management" system and a "Rapid Discharge Protocol" based on Just-in-Time (JIT) manufacturing principles was used to analyze the data. The intervention reduced the average discharge-to-admission "bed turn" time by 34 minutes and decreased nurse-reported overtime by 15%. Applying commercial flow-management strategies to surgical nursing units enhances clinical capacity without requiring additional physical beds.