GRACE is a real-time surge capacity platform for Labor & Delivery. Four color-coded levels—Green through Black—pair weighted acuity scoring with AI analysis, predictive alerting, and EHR integration—so every charge nurse, every shift, has a shared picture and a playbook before the unit goes underwater.
Labor & Delivery has never had its own structured surge model. A controllable day can spin into crisis; staffing becomes a wing-and-a-prayer; on-call and low-census processes are under-used until it is too late. A census surge in L&D backs up every unit in the Women’s division.
Originating in leadership work at a leading hospital in Texas, the framework defines four operational color bands for L&D: staff acuity tool, indicators and actions per band, resources across the division and hospital—and phased placement when beds disappear. GRACE turns that framework into live software with AI-assisted analysis, real-time collaboration, and integration with existing hospital systems.
GRACE packages the surge story developed with Amy Poso, RN, BSN, for leadership at a leading hospital in Texas: built so frontline leaders can plan before chaos—then scale activation across divisional units, external departments, and hospital-wide support.
GRACE uses four operational bands—Green through Black—each with its own definitions, key indicators, immediate actions, and resources that ratchet up by level. The approach draws on evidence-based overcrowding research, adapted specifically for the realities of Labor & Delivery.
Staffing is appropriate for volume and acuity per AWHONN standards. Census on all units is below maximum capacity.
Staffing responsibilities are maximized for volume and acuity per AWHONN standards. Census on one or more units is near or at maximum capacity.
Staffing responsibility exceeds AWHONN standards for safe care because of volume and/or acuity. Census on one or more units is at or beyond maximum capacity.
Staffing is maximized, yet acuity and volume exceed the ability to honor scheduled work—induction and cesarean delays mount and patient flow for appropriate care is disrupted.
GRACE goes beyond the surge matrix. Real-time collaboration, AI analysis, EHR integration, and historical trending turn every shift into actionable data.
Every user sees the same live unit state. Room occupancy, acuity scores, surge level, and staffing sync automatically across all connected sessions with no manual save required.
Anthropic Claude interprets the feel of the unit, summarizes room activity, generates structured shift debriefs, and forecasts surge-level changes 2 hours ahead.
A heuristic prediction engine analyzes current acuity trends and room velocity to forecast where the unit will be in 2 hours. Optional email alerts fire when escalation is predicted.
Connect GRACE to Epic, TeleTracking, and other hospital systems via HL7 v2 ADT messages, FHIR R4 resources, or generic REST APIs. Inbound data automatically updates room state and census.
Unit-wide and per-room dashboards show surge-level distribution, acuity heatmaps, nurse-to-acuity ratio trends, and room activity timelines for continuous improvement.
Every room change is logged: admissions, discharges, factor changes, nursing level shifts, and color transitions. A sparkline chart shows each room’s score trajectory over time.
Three roles control access: admins manage team, integrations, and system settings; charge nurses operate the dashboard and run AI tools; viewers observe read-only.
System-wide and per-user notification preferences. Alerts fire on surge-level changes, critical rooms, shift debriefs, prediction escalations, and new team members.
Color-coded surge levels, weighted acuity scoring, real-time collaboration, AI analysis, EHR integration, and historical trending—so levels reflect what is happening on the floor right now.
Definitions, key indicators, immediate actions, and resources to activate—escalating from steady-state Green through Yellow, Red, and Black, with Phase I–III patient-placement scripts as capacity tightens.
The acuity matrix assigns base weights and level multipliers by clinical factor; summed per-room scores drive color-coded tiles and feed total unit load so you can compare against AWHONN-style capacity in real time.
Every user sees the same live unit state—room occupancy, acuity scores, surge level, and staffing sync automatically across all connected sessions with no manual save required.
Claude interprets the “feel of the unit,” summarizes room activity, generates structured shift debriefs for handoffs, and forecasts surge-level changes 2 hours ahead.
Connect to Epic, TeleTracking, and other hospital systems via HL7 v2 ADT messages, FHIR R4 resources, or REST APIs. Inbound data automatically updates room state, acuity factors, and census.
Unit-wide and per-room dashboards show surge-level distribution, acuity heatmaps, nurse-to-acuity ratio trends, and detailed room activity timelines for continuous improvement.
Three roles (admin, charge nurse, viewer) control access. Configurable email notifications fire on surge-level changes, critical rooms, shift debriefs, predictions, and new team members.
Indicators reflect not only census but flow: patients held in L&D when postpartum, antepartum, or triage back up—mirroring the real constraints that steal beds and magnify risk.
Register your hospital, add your team, and go live in minutes. Real-time dashboard, AI shift intelligence, and EHR integration included.
