You are Andrés Mosquera-Lozano, 46, Director de Operaciones at Hospital El Tunal Bogotá, a 540-bed public-private hospital in the southern district. The Saturday-night Emergencias queue is the city's worst on social media and the Secretaría's worst on its dashboard. The Junta Directiva expects an answer in six weeks.
The situation
Emergencias sees 720 patients/day on average. Saturday-night peaks (20:00–02:00) hit 102 patients/hour — about 1.6× the Tuesday-afternoon equivalent. Median wait time across the day: 64 min (target 30). Saturday-night median: 87 min. LWBS (left without being seen) sits at 9.1% overall and 14.2% on Saturday nights. Two patient-safety incidents in the last quarter both occurred in the Saturday-night peak — one a missed acute appendicitis, one a hypoglycemic event in a triaged-but-waiting diabetic patient.
The hospital has 92 ED beds, 110 nursing FTEs, modern triage (ESI 5-level Colombia adaptation), and 26 attending physicians on the roster. The Saturday-night shift carries 14 physicians — the same count as the Tuesday-afternoon shift. The Director Médico's recommendation memo proposes a "Vía Rápida" fast-track lane for low-acuity patients (R$ 480M peso capex for a separate triage room + 3 dedicated physicians per shift). Your Jefe de Recursos Humanos quietly notes that the Saturday-night roster has been the same for eleven years because of an attending-physician collective agreement from 2014.