1 · What this is — and why a template
Unlike public health systems, the VA does not publish real-time operational strain. Bed occupancy, ED boarding and staffing live inside internal VHA systems (bed-management/VSSC). Public VA data is limited to lagged access and quality measures (Access-to-Care wait times, SAIL star ratings, the Facilities API). So this console is built as an operator template: realistic demo data you can see working immediately, plus a clean hook to push your facility's real internal numbers in (Section 9) — no code changes required.
2 · Reading it at a glance
The header pill shows the facility tier (Normal / Watch / Critical) and the strain index. The banner restates that this is a template on demo data. Everywhere a number appears it carries a DEMO flag so no one mistakes it for live telemetry. Once you wire real feeds (Section 9), the demo flags fall away for the fields you supply.
3 · Facility strain index DEMO
A 0–100 composite of the unit-level pressure below — occupancy relative to capacity, staffing shortfall, and ED boarding. It is weighted toward the worst unit and the busiest top-four, so a single overwhelmed department lifts the facility signal rather than being averaged away. On the demo baseline it reads Normal (~49) with the Emergency Department as the clear hotspot — illustrating the design intent: most of the building is coping while one unit is under real pressure, and the index points you straight at it.
4 · Unit strain ranking DEMO
Every unit (ED, ICU, med-surg wards, mental health, community living center, OR), worst first, with its occupancy and the driver of its strain. This is the triage-of-attention view: where is pressure concentrating right now? Each unit's score blends occupancy, staffing and — for the ED — boarding load.
5 · ED & patient flow DEMO
The emergency department in detail: admitted patients boarding for want of an inpatient bed, walkouts (left without being seen), and diversion status. ED boarding is the canonical sign that the whole hospital is full — it is an inpatient-flow problem showing up in the ED, which is why it weighs on the facility index.
6 · Mental-health access DEMO
A VA-specific priority: new-patient wait, same-day demand vs capacity, and inpatient psychiatry occupancy. Mental-health access is a core VA performance and safety concern, so it gets its own panel rather than being buried in general capacity.
7 · Staffing coverage DEMO
RN actual-vs-target by unit. Staffing is the lever that turns physical capacity into usable capacity — a bed without a nurse is not a bed — so the strain score treats a staffing shortfall as a driver of pressure, not just an HR statistic.
8 · Surge scenario sandbox
Pressure-test the response plan against four what-ifs: flu surge, mass-casualty incident, staffing shortage, and boarding crisis. Each adjusts the inputs and recomputes the index and ranking — clearly labelled as rehearsals, not forecasts. Use them to ask "if X happens tonight, where do we break first, and is the escalation plan ready?"
9 · Wiring your live feeds — the operator hook
This is the key to making the console real. A global STATUS_OVERRIDE object, keyed by unit id, lets you push live values in from any source (a scheduled job, a dashboard embed, a paste from your bed-management export) without editing the console code. Any field you supply overrides the demo; the rest stays as-is. To force a tier, set tier.
// keys: ED, ICU, 3W, 4E, MH, CLC, OR
STATUS_OVERRIDE['ICU'] = { census: 18, cap: 16, rnAct: 7, rnTgt: 8, tier: 'alert' };
STATUS_OVERRIDE['ED'] = { census: 41, cap: 30, board: 19 };
render(); // repaint with your live numbers
Wire it to your real systems by setting these fields from:
- Census / capacity / boarding → your VISN or facility bed-management / capacity-management feed (the internal equivalent of a live census export).
- RN actual vs target → the staffing/scheduling system (e.g. nurse-staffing methodology targets vs actual assignments).
- Mental-health access → the scheduling/clinic feed for new-patient and same-day demand.
- Public anchors (lagged) → VA Access-to-Care wait times and the VA Facilities API (needs a free developer key) for facility metadata and published wait times.
The simplest production pattern: a scheduled job pulls your internal numbers, writes a small JSON, and the page reads it and calls render() on a timer. Because the override is field-level, you can wire one feed at a time and the rest stays on demo until you're ready.
10 · Honest limits & appropriate use
- Demo until wired. Out of the box the numbers are illustrative; only fields you push via the hook are real.
- Decision-support, not autopilot. The index focuses attention; clinical and command staff decide.
- Not a patient-level tool. It reads unit and facility pressure, not individual triage.
- Public VA data is lagged. Access-to-Care and SAIL are useful anchors but are not real-time strain.