Managing capacity and demand across the patient journey.
Bed availability remains the main operational focus for managers and clinicians on a day-to-day basis within the NHS. There is now published research that establishes a lack of bed stock is too simplistic an explanation of the situation. Other reasons for bed shortage include the daily and weekly lack of synchronisation of admissions and discharges, the large variation in bed occupancy over time, the downtime during weekends and holiday periods, wasted time during inpatient stays and the variation in patient length of stay. So far most of what little work has been done has focused on the front end of the process, to 'buffer' unplanned admissions through the use of short-stay facilities, such as medical assessment units, as a short-term solution. This paper reviews the evidence for the hypothesis that bed availability problems can be solved by actions other than the addition of more beds to the system.
Allder
Steven
S
Department of Neurology, Plymouth Hospitals Trust.
Silvester
Kate
K
Walley
Paul
P
D003695:Delivery of Health Care / Q000458:organization & administration*; D006742:Hospital Bed Capacity; D006760:Hospitalization; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D010507:Periodicity; D006113:United Kingdom
J Public Health (Oxf). 2007 Sep;29(3):281-7
17650527
J Public Health (Oxf). 2005 Sep;27(3):263-9
15964977
Aust Health Rev. 2007 Feb;31(1):50-62
17266488
Emerg Med J. 2004 Sep;21(5):575-6
15333534
Eur J Public Health. 2001 Jun;11(2):166-70
11420803
Emerg Med J. 2003 Mar;20(2):149-55
12642528
BMJ. 2003 Nov 29;327(7426):1257
14644968
BMJ. 2001 Mar 24;322(7288):735
11293419
J Healthc Manag. 2006 Sep-Oct;51(5):309-20; discussion 320-2
17039690
Health Serv Manage Res. 2003 Nov;16(4):268-75
14613624
BMJ. 1999 Jul 17;319(7203):155-8
10406748
BMJ. 2004 Mar 13;328(7440):605
15016691
Health Care Manag Sci. 2007 Jun;10(2):125-37
17608054
J Healthc Manag. 2003 Mar-Apr;48(2):82-97; discussion 97-8
12698610
BMJ. 2002 Feb 2;324(7332):280-2
11823362
BMJ. 2004 Mar 6;328(7439):582-3; author reply 584
15001516
J Manag Med. 1999;13(4-5):234-50
10787495