Use of a Novel Patient-Flow Model to Optimize Hospital Bed Capacity for Medical Patients. 2021

Yue Hu, and Jing Dong, and Ohad Perry, and Rachel M Cyrus, and Stephanie Gravenor, and Michael J Schmidt

There is no known method for determining the minimum number of beds in hospital inpatient units (IPs) to achieve patient waiting-time targets. This study aims to determine the relationship between patient waiting time-related performance measures and bed utilization, so as to optimize IP capacity decisions. The researchers simulated a novel queueing model specifically developed for the IPs. The model takes into account salient features of patient-flow dynamics and was validated against hospital census data. The team used the model to evaluate inpatient capacity decisions against multiple waiting time outcomes: (1) daily average, peak-hour average, and daily maximum waiting times; and (2) proportion of patients waiting strictly more than 0, 1, and 2 hours. The results were published in a simple Microsoft Excel toolbox to allow administrators to conduct sensitivity analysis. To achieve the hospital's goal of rooming patients within 30 to 60 minutes of IP bed requests, the model predicted that the optimal daily average occupancy levels should be 89%-92% (182-188 beds) in the Medicine cohort, 74%-79% (41-43 beds) in the Cardiology cohort, and 72%-78% (23-25 beds) in the Observation cohort. Larger IP cohorts can achieve the same queueing-related performance measure as smaller ones, while tolerating a higher occupancy level. Moreover, patient waiting time increases rapidly as the occupancy level approaches 100%. No universal optimal IP occupancy level exists. Capacity decisions should therefore be made on a cohort-by-cohort basis, incorporating the comprehensive patient-flow characteristics of each cohort. To this end, patient-flow queueing models tailored to the IPs are needed.

UI MeSH Term Description Entries
D007297 Inpatients Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. Inpatient
D006742 Hospital Bed Capacity The number of beds which a hospital has been designed and constructed to contain. It may also refer to the number of beds set up and staffed for use. Bed Capacity, Hospital,Bed Size, Hospital,Bed Capacities, Hospital,Bed Size,Bed Sizes,Bed Sizes, Hospital,Capacities, Hospital Bed,Capacity, Hospital Bed,Hospital Bed Size,Hospital Bed Sizes,Size, Bed,Size, Hospital Bed,Sizes, Bed,Sizes, Hospital Bed,Hospital Bed Capacities
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001509 Bed Occupancy A measure of inpatient health facility use based upon the average number or proportion of beds occupied for a given period of time. Bed Occupancies,Occupancies, Bed,Occupancy, Bed

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