5 ms·

Now apply this same reasoning to, say, hospital capacity. Some things need to optimize for the ability to absorb peak load, not steady-state operating costs.

cmilton 4y ago
How is peak load defined in a hospital? (I assume you mean patients. I apologize if that is incorrect.)
- kuhewa 4y ago
  There will be different definitions for related concepts but I reckon the parent comment is referring to "surge capacity"
- SECProto 4y ago
  > How is peak load defined in a hospital? Same as everywhere else - largest demand on resources. For a hospital, the resources are staffing and equipment (rather than cpu/storage/ram). An MRI machine is cheapest when you have as many scans as possible for a given level of staffing - reducing the time per scan from 6mins to 5mins means that you can get 20 extra patients scanned per 8 hour shift (with one machine). In support of the initial commenter's point ("Some things need to optimize for the ability to absorb peak load, not steady-state operating costs"), for hospitals, you need look no further than covid - horrendous health outcomes for routine things, because the capacity was soaked up dealing with respiratory virus. And if you disagree with that (you're wrong), look no further than a strong flu season - staffing capacity that is totally fine for a random august is nowhere near adequate. Or look at Saturday night in any Emerg - there's a huge peak in emergency medical situations from drunk people doing stupid things.
- quickthrower2 4y ago
  For a public health system you run the stats, using the $ cost of a life (or equivalent for a well life vs. sick life). Sounds sinister but ultimately they have so many $ and need to decide how to optimise that money.
  - bumby 4y ago
    >optimise that money Perhaps the problem is defining a hospitals utility function as “optimizing money” rather than “optimizing a patient outcome”. I agree that money is definitely a constraint, but I’m not sure it’s what should be optimized.
  - LastTrain 4y ago
    You do that for a non-public health system too, but you also figure in margins.
kqr 4y ago
Even hospitals make that trade-off. Every hundred years there are at least a few events that overload steady-state hospitals. The important part is not building the capacity in, it's remaining flexible and adapting to what happens.
- omginternets 4y ago
  >The important part is not building the capacity in, it's remaining flexible and adapting to what happens. At some point, flexibility requires extra capacity. You can't improvise when you're spending 100% of your resources on operations.

cmilton 4y ago

How is peak load defined in a hospital? (I assume you mean patients. I apologize if that is incorrect.)

kuhewa 4y ago
There will be different definitions for related concepts but I reckon the parent comment is referring to "surge capacity"
SECProto 4y ago
> How is peak load defined in a hospital? Same as everywhere else - largest demand on resources. For a hospital, the resources are staffing and equipment (rather than cpu/storage/ram). An MRI machine is cheapest when you have as many scans as possible for a given level of staffing - reducing the time per scan from 6mins to 5mins means that you can get 20 extra patients scanned per 8 hour shift (with one machine). In support of the initial commenter's point ("Some things need to optimize for the ability to absorb peak load, not steady-state operating costs"), for hospitals, you need look no further than covid - horrendous health outcomes for routine things, because the capacity was soaked up dealing with respiratory virus. And if you disagree with that (you're wrong), look no further than a strong flu season - staffing capacity that is totally fine for a random august is nowhere near adequate. Or look at Saturday night in any Emerg - there's a huge peak in emergency medical situations from drunk people doing stupid things.
quickthrower2 4y ago
For a public health system you run the stats, using the $ cost of a life (or equivalent for a well life vs. sick life). Sounds sinister but ultimately they have so many $ and need to decide how to optimise that money.
- bumby 4y ago
  >optimise that money Perhaps the problem is defining a hospitals utility function as “optimizing money” rather than “optimizing a patient outcome”. I agree that money is definitely a constraint, but I’m not sure it’s what should be optimized.
- LastTrain 4y ago
  You do that for a non-public health system too, but you also figure in margins.

kqr 4y ago

Even hospitals make that trade-off. Every hundred years there are at least a few events that overload steady-state hospitals. The important part is not building the capacity in, it's remaining flexible and adapting to what happens.

omginternets 4y ago
>The important part is not building the capacity in, it's remaining flexible and adapting to what happens. At some point, flexibility requires extra capacity. You can't improvise when you're spending 100% of your resources on operations.