Pulse — Hospital Orchestration Command Center

Coordinate the processes that make a hospital run — alert caregivers, connect to hospital systems, and continuously optimize operations — so the building runs smoothly with far less administrative overhead.

Pulse is an interactive ops command center for a hospital. It fuses patient flow, beds, staffing, and care coordination into one live operating picture, and runs a transparent optimization "brain" that turns the current state of the hospital into ranked, justified, one-tap actions — placing a boarder, backfilling a sick call, expediting a discharge — instead of the phone-tag, whiteboards, and stale 7am bed huddles hospitals run on today.

This repository is a working, clickable prototype driven by a deterministic simulation of a ~186-bed hospital. No real EHR/PHI is involved; the data model and store contract are designed so that "going live" means swapping the simulation tick for a real HL7/FHIR feed — the UI, selectors, and optimization brain stay unchanged.

Built with Next.js 15 · React 19 · TypeScript · Tailwind v4 · Zustand · Recharts

Quickstart

pnpm install
pnpm dev          # http://localhost:3750  → redirects to /command

Standalone static pages (served by the app, also openable as files):

URL	Page
http://localhost:3750/concept.html	Concept explainer — who it's for, problems solved, benefits
http://localhost:3750/diagram.html	How it works — architecture & orchestration-loop diagram
http://localhost:3750/mockup.html	Interactive single-file mockup of the command center

Other scripts: pnpm build, pnpm start, pnpm typecheck.

In the top status ribbon you can play/pause the simulation clock, change speed (1× / 4× / 16×), switch scenarios (Calm Tuesday → Friday ED Surge → Flu Season + Sick Calls → Code Influx) to watch the brain react in real time, and reset the world. Demos are reproducible and shareable via ?seed=42&scenario=friday-surge.

The command center (flagship modules)

Route	Module	What it does
`/command`	Mission Control	Census & surge gauge, the brain's ranked Action Queue, anomaly Watchtower, closed-loop impact ledger, and the live command feed — the single operating picture.
`/flow`	ER & Patient Flow	Per-patient & per-acuity predictive wait / door-to-provider forecasts (p50/p90), a deterioration watchlist with threshold auto-escalation, and an ED-boarding forecast.
`/beds`	Beds & EVS Turnover	Constraint-aware ranked bed placement with one-tap assign, a live 186-bed board (single source of truth), and EVS smart-dispatch Kanban. Accepting a placement fans out EVS + transport + a receiving-unit alert.
`/staffing`	Sick-Call Backfill	Auto-detected coverage gaps run a cost-and-fit-ranked, fatigue-aware open-shift cascade (same-unit → float → OT → agency) with one-tap fill, plus live acuity-weighted ratio-compliance gauges.
`/feed`	Command Feed	Every alert and recommendation lifecycle event as one closed-loop stream — owner routing, SLA timers, acknowledgment, and auto-escalation ladders.

Roadmap modules (scaffolded, wired to the same stores): Discharge & Barriers, Perioperative, Diagnostics/TAT, Safety & Quality, Transport & Assets, Revenue & Prior-Auth. The full 27-module catalog and dozens of additional ideas live in docs/CONCEPT.md.

How it works (architecture in one breath)

deterministic sim engine ──tick──▶ Zustand store ──selectors──▶ React command center
        │                              ▲                              │
        └── optimization "brain" ──────┘   user actions (accept/override/assign) ──┘
            (predictors + solvers → Recommendations + Alerts)

Simulation (src/lib/sim/) — a seeded clock fires stochastic events (arrivals, admits, discharges, sick calls, deterioration, EVS completion), applies them as reducers, and appends to an immutable event log (the canonical "event bus").
Brain (src/lib/brain/) — transparent, explainable predictors (admit probability, quantile wait forecast, deterioration, accept-likelihood) and solvers (bed placement, backfill cascade, capacity/surge index, boarding forecast). Every recommendation ships a scoreBreakdown so the UI can render factor × weight = contribution. Nothing auto-executes.
Store & selectors (src/lib/store.ts, src/lib/selectors.ts) — one live snapshot; the store contract mirrors what an SSE/WebSocket/FHIR-Subscription bridge would push.
Design system (src/app/globals.css, src/components/ui/) — dark, density-first, with a single shared urgency color language (ok · watch · urgent · critical) every board speaks.

Full detail: docs/ARCHITECTURE.md.

Project layout

src/
  app/                 # routes: /command /flow /beds /staffing /feed + roadmap stubs
  components/
    layout/            # nav rail, status ribbon, command shell
    ui/                # design-system primitives (card, badge, gauge, data-table, sheet…)
    command/ flow/ beds/ staffing/ feed/   # feature components by domain
    shared/            # recommendation drawer, score breakdown, module shelf
  lib/
    types.ts           # canonical domain model
    sim/               # seed, engine, scenarios, actions, rng
    brain/             # predictors, solvers, orchestration
    store.ts selectors.ts ui.ts utils.ts
docs/
  CONCEPT.md           # the product concept + full idea catalog
  ARCHITECTURE.md      # technical architecture
  ideation/            # raw multi-agent ideation synthesis (JSON)

⚕️ Disclaimer. Prototype with simulated data only. Not a medical device; no clinical decisions should be made from it. Real deployment would require EHR integration, clinical validation, bias/fairness governance, and regulatory review — see the governance notes in docs/CONCEPT.md.

Project README

Pulse — Hospital Orchestration Command Center

Quickstart

The command center (flagship modules)

How it works (architecture in one breath)

Project layout