There's a general rule of thumb that I have about any business: if it "looks busy" and people are running around, yelling into phones, unavailable for questions, etc., it's probably either understaffed or ineffectively organized. A workplace where things aren't visibly moving is one that is ready to make plans and respond to events smoothly. The productivity rate is somewhat independent of the "busyness rate" since there are a huge number of ways to stop work from needing to be done in the first place.

However, this seems to be unsatisfying to modern management styles. Apparently if you aren't running the employees into the ground like an Amazon warehouse, you're "leaving something on the table".

>I think talking about micro-optimizations like this misses the forest through the trees.

It may be different in practice than you are imagining. It's been years so I don't have the exact numbers, but something on the order of 10-20% increased patient throughput in radiology of a major metropolitan hospital that provides for an underserved community. (Keep in mind, it's not just nurses who have to traverse hospitals but patients. Many of them are old or lack mobility, so the changes are compounded.) I don't consider that "micro" but you may have different expectations. As a comparison, I don't think nurses would think a 20% increase in staffing is trivial, but my preference is to measure at the patient level, because that is the outcome I'm most concerned with.

>Showing that they were better than modern day automated shift planning.

Can you explain? I'm not following this statement. I was involved because it wasn't working.

>you want surge capacity in healthcare.

I agree. But like all complicated systems, you rarely get something for nothing. The trope in healthcare is you can choose between quality, cost, and access, but you only get to choose two. Lots of slack in the provider supply side is great for surge capacity, but it generally comes at the expense of cost. That's difficult when many of the same people who complain about the lack of providers also like to point out the cost of healthcare. I would prefer to take system-level view so we aren't essentially just shifting the waste around in the system and instead work to cut it out completely. In this case, excess capacity isn't waste but a desired measure of resilience. But I do think it needs to be measured and managed. My experience has been that nurse managers will just constantly increase the slack in the system rather than address the other issues.

And I absolutely agree there are issues, across many industries, where JIT thought-processes are short-sighted. COVID, and prior to that, Fukashima, has demonstrated this error. There are certain critical systems that we do not want operating at maximum input/output efficiency. If the staffing issues I've referenced were consciously framed in that sort of pragmatic, data-driven argument, I would be the first to stand behind it. But often they were really coming from a "we're-overwhelmed-and-don't-know-what-else-to-do-so-just-hire-more-people" perspective.