Operations & Performance Improvement
Before you build a tower or add FTEs, we find the capacity trapped in your discharge process, your OR block, your ED front end and your length of stay. Most organizations are running a 78% hospital as though it were full.
The expensive answer is usually the second-best one
of an admitted patient’s time in the emergency department is spent boarding after the decision to admit
Industry figure, not an Adelo Consulting result. Source: Emergency Department Benchmarking Alliance 2022 survey, reported by ACEP.
Capacity constraints almost always present as a building problem or a staffing problem. Underneath, they are usually a flow problem: discharges that cluster after 3 p.m., OR blocks held by surgeons who no longer use them, boarding that starts in the ED but originates on 6 West, and an observation population nobody owns.
We measure the system as it actually runs, not as the policy describes it — then rebuild the operating rhythm that holds the gain after we leave.
Capacity you already own, released.
Capabilities in operations & performance.
Patient flow and throughput
Discharge process redesign, care progression rounds, escalation pathways, and the daily operating cadence that makes them stick.
Length of stay and capacity management
Avoidable-day analysis, barrier tracking, geographic cohorting, and observation and status management.
Perioperative and procedural performance
Block utilization and release policy, first-case on-time starts, turnover, prime-time capacity, and surgeon scheduling behavior.
Emergency department operations
Front-end redesign, split flow, boarding root cause, left-without-being-seen and door-to-provider performance.
Labor productivity and cost
Productivity standards, span of control, premium labor and agency reduction, and non-labor spend where it is genuinely available.
Command center and capacity governance
The structures — daily huddle, capacity escalation, transfer center — that turn one-time improvement into a permanent operating rhythm.
Outcomes we scope engagements against.
These are the results we design toward and measure. We commit to targets in writing at the start of an engagement, and we report against them honestly — including when we miss.
We do not publish client results we cannot substantiate or attribute. Targets on this page describe engagement design, not guaranteed outcomes.
- Discharge order and departure times moved earlier in the day
- Boarding hours and left-without-being-seen reduced
- Prime-time OR capacity released without new rooms
- Premium and agency labor spend structurally reduced
- An operating cadence that holds the result after we leave
Three ways to start.
Diagnostic2–4 weeks
A focused assessment with a written finding and a ranked set of actions. Fixed fee, defined scope. Most relationships start here because it is a low-risk way to find out whether we are useful.
Sprint8–16 weeks
A defined improvement engagement against a named target — throughput, denials, turnover, survey readiness. We work alongside your team rather than around them, and we transfer the method as we go.
Embedded6–18 months
Interim leadership or sustained transformation support. Our leader carries real accountability in your operating structure, with a written mandate and measurable commitments.
Engagements rarely stay in one service line.
Talk to us about operations & performance.
Start with a short diagnostic. Fixed fee, a written finding, and a ranked set of actions you own whether or not you work with us again.