How many hospital beds do you need and where do you need them?
How simulation can help solve the challenges of bed planning and capacity improvement
Planning for hospital and community beds is one such example. Demand for hospital beds comes both from emergency demand and elective scheduling and can be impacted by:
- Busy EDs needing to avoid long waits
- Staff and specifically decision-making medical staff availability
- Fluctuating specialty requirements
- Transferring between wards
- Discharging patients
For the best patient outcomes and the lowest length of stay, it needs to be the right bed in the right specialty too.
Talk to the heroic staff in control rooms and on the wards and they are constantly managing a crisis situation – and doing a great job. Ask them what would help and they can’t see how the situation could change. From a day to day perspective, there is very little room for flex.
Stand back a bit and talk to the planners. Their job is to ensure that the right number of beds for each specialty are in place on an annual basis, and that there is sufficient capacity to cope in times of higher demand, particularly during the winter. Their constraints are cost, space and staff and commissioner’s expectations. Can they make the planning decisions that reduce the day to day crisis management?
How Isle of Wight gained an extra 17% capacity for medical inpatients within their existing bed base using simulation
The Isle of Wight used simulation to create a replica of emergency and elective demand and bed capacity by specialty on an hourly basis over a year. Their results revealed that in some specialties they were over capacity for elective demand and under for emergency. As they demonstrated their results to staff and commissioners, they were able to get buy in for changing the use of beds which gained 17% additional capacity for medical inpatients within their existing bed base. They used the same simulation to test the impact of discharges, and reduced length of stay scenarios on community bed requirements to help inform commissioning decisions on beds.