Batch 01 · ER triage
Priority queue collapse during flu season
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System failure identification
During flu season the triage queue stops behaving as a priority queue. High-acuity arrivals are seen promptly, but mid-acuity patients wait indefinitely as each new arrival outranks them. The queue is still ordered correctly at every individual step, which is what makes it hard to see.
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Data pipeline diagnostics
Dashboards report median wait, which the promptly seen high-acuity cases hold down. Starvation in the middle of the queue lives entirely in the upper tail, where no metric looks. A metric built around the centre of a distribution cannot describe its tail.
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Predictive computational model
Track the 90th percentile wait per acuity band, and the age of the oldest unseen patient in each band. A rising oldest-waiting age is the signal that queue ordering has stopped being fair. Both figures are computable from data the department already records at triage.
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Workflow integration
Bind the oldest-waiting age to the existing queue display rather than a new alert. Charge nurses already read that screen, and adding a column changes behaviour where a pager would not. The measure has to sit where the reordering decision is actually made.