Bed management
Encyclopedia
Bed management is the allocation and provision of bed
s, especially in a hospital
where beds in specialist wards are a scarce resource. The "bed" in this context represents not simply a place for the patient to sleep, but the services that go with being cared for by the medical facility: admission processing, physician time, nursing care, necessary diagnostic work, appropriate treatment, and so forth.
In the UK, acute hospital bed management is usually performed by a dedicated team and may form part of a larger process of Patient flow management.
, there is naturally pressure to ensure high occupancy rates and therefore a minimal buffer of empty beds. However, because the volume of emergency admissions is unpredictable, hospitals with average occupancy levels above 85 per cent "can expect to have regular bed shortages and periodic bed crises."
Shortage of beds can result in cancellations of admissions for planned (elective) surgery, admission to inappropriate wards (medical vs surgical, male vs female etc), delay admitting emergency
patients, and transfers of existing inpatients between wards, which "may add a day to a patients length of stay".
These can be politically sensitive issues in publicly funded heathcare
systems. In the UK
there has been concern over inaccurate and sometimes fraudulently manipulated waiting list statistics, and claims that "the current A&E target is simply not achievable without the employment of dubious management tactics."
and DMD.
It is possible for healthcare organisations to customise an 'off-the-shelf' product or solution to improve patient flow management in a hospital, which is the primary role of a bed management system. Some healthcare organisations may require a unique solution which is unlikely to exist as an off-the-shelf product.
The most recent requirement is for mobile apps for heathcare applications which can run on leading mobile platforms, such as IPhone
, and Android (operating system).
Typical software products for the healthcare sector include In-Patient Management Systems to help ward staff manage patient traffic and bed allocation within a hospital. Such systems make the daily process of patient and bed management easier, improves staff efficiency by saving time and helps management meet hospital performance targets.
A Bed Request & Management System is designed to help hospital staff deliver high levels of care to patients by providing real-time information to bed managers, ward staff, doctors etc., so optimising communication efficiency between all staff. Typical features of such a system can include:
A&E Patient Monitoring Systems are based on an electronic whiteboard which allows staff to track patients in real-time as they are moved around the hospital.
System customisations can include the production of department performance statistics, storage and recall of patient details, the creation of electronic discharge letters which allows health personnel to produce patient discharge letters that can be automatically printed and sent, and a prescription system which efficiently and securely handles the prescription of controlled drugs using an electronic TTO in adherence and compliance with legislation. Ward flow is a further system customisation for handling patient arrivals or transfer to or from a ward bed, and for priority planning.
Bed
A bed is a large piece of furniture used as a place to sleep, relax, or engage in sexual relations.Most modern beds consist of a mattress on a bed frame, with the mattress resting either on a solid base, often wooden slats, or a sprung base...
s, especially in a hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
where beds in specialist wards are a scarce resource. The "bed" in this context represents not simply a place for the patient to sleep, but the services that go with being cared for by the medical facility: admission processing, physician time, nursing care, necessary diagnostic work, appropriate treatment, and so forth.
In the UK, acute hospital bed management is usually performed by a dedicated team and may form part of a larger process of Patient flow management.
Importance of bed management
Because hospital beds are economically scarce resourcesScarcity
Scarcity is the fundamental economic problem of having humans who have unlimited wants and needs in a world of limited resources. It states that society has insufficient productive resources to fulfill all human wants and needs. Alternatively, scarcity implies that not all of society's goals can be...
, there is naturally pressure to ensure high occupancy rates and therefore a minimal buffer of empty beds. However, because the volume of emergency admissions is unpredictable, hospitals with average occupancy levels above 85 per cent "can expect to have regular bed shortages and periodic bed crises."
Shortage of beds can result in cancellations of admissions for planned (elective) surgery, admission to inappropriate wards (medical vs surgical, male vs female etc), delay admitting emergency
Emergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...
patients, and transfers of existing inpatients between wards, which "may add a day to a patients length of stay".
These can be politically sensitive issues in publicly funded heathcare
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
systems. In the UK
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
there has been concern over inaccurate and sometimes fraudulently manipulated waiting list statistics, and claims that "the current A&E target is simply not achievable without the employment of dubious management tactics."
Specific problems
- Shortage of beds due to lack of other options. Hospitals in developed countries cannot force a patient to leave if the patient's home is reasonably believed to be unsafe. For example, if a frail, elderly patient has recovered from an acute illness, but is unable to dress himself and prepare simple meals on his own, then the hospital must ensure that the patient will have sufficient assistance with these necessary activities of daily livingActivities of daily livingActivities of Daily Living is a term used in healthcare to refer to daily self-care activities within an individual's place of residence, in outdoor environments, or both...
, or the patient must remain in the hospital. In places with a shortage of skilled nursing facilities, home health care workers, and related support organizations, beds may be unavailable for new, acutely sick patients because of the continued presence of the previous patients. This is sometimes known as a "bed blocking". - False appearance or unnecessary creation of a bed shortage. "Bed hiding", as it is sometimes called, is the practice of delaying admissions due to a falsely claimed lack of beds in the appropriate department. Bed hiding has several causes, including scheduling so many elective procedures that there are inadequate beds left for emergency admissions; frequent changes from ward to ward; inadequate communication, so that cleaning staff don't know when a bed has become available and needs cleaning; misalignment of tasks, so that skilled nurses are expected to take time away from direct patient care to clean beds; too few nurses scheduled for a shift; and overworked staff, who may be inclined to mis-report a bed as full, especially at the end of a shift, in an effort to shift the workload to another person. Bed hiding can be significantly reduced by careful tracking of bed status, making cleaning after discharge the top priority for cleaning staff, and even by physically moving patients to the ward as soon as they are ready for admission rather than boarding them in the emergency department. Reducing bed hiding in regular wards can reduce wait times in the emergency department.
Bed management systems
Bed management systems are developed by software development companies specialising in the health sector to technical healthcare standards, such as HL7, ICD-10ICD-10
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
and DMD.
It is possible for healthcare organisations to customise an 'off-the-shelf' product or solution to improve patient flow management in a hospital, which is the primary role of a bed management system. Some healthcare organisations may require a unique solution which is unlikely to exist as an off-the-shelf product.
The most recent requirement is for mobile apps for heathcare applications which can run on leading mobile platforms, such as IPhone
IPhone
The iPhone is a line of Internet and multimedia-enabled smartphones marketed by Apple Inc. The first iPhone was unveiled by Steve Jobs, then CEO of Apple, on January 9, 2007, and released on June 29, 2007...
, and Android (operating system).
Typical software products for the healthcare sector include In-Patient Management Systems to help ward staff manage patient traffic and bed allocation within a hospital. Such systems make the daily process of patient and bed management easier, improves staff efficiency by saving time and helps management meet hospital performance targets.
A Bed Request & Management System is designed to help hospital staff deliver high levels of care to patients by providing real-time information to bed managers, ward staff, doctors etc., so optimising communication efficiency between all staff. Typical features of such a system can include:
- Categorised bed requests for urgent beds, repats, electives etc., so reducing wait times.
- A view of the current state of beds in all wards.
- Direct transfer to certain wards as needed.
- Queuing patients for beds to improve patient care.
A&E Patient Monitoring Systems are based on an electronic whiteboard which allows staff to track patients in real-time as they are moved around the hospital.
System customisations can include the production of department performance statistics, storage and recall of patient details, the creation of electronic discharge letters which allows health personnel to produce patient discharge letters that can be automatically printed and sent, and a prescription system which efficiently and securely handles the prescription of controlled drugs using an electronic TTO in adherence and compliance with legislation. Ward flow is a further system customisation for handling patient arrivals or transfer to or from a ward bed, and for priority planning.