PubMed · 10157224
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J Sorenson. 1996. Multi-phased bed modelling.. https://doi.org/10.1177/095148489600900107
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There is no standard optimum occupancy rate for hospitals. Bed occupancy rates must be considered in relation to the number of beds in a hospital. In general, a large hospital operating the same occupancy rate as a small one will have to turn away fewer patients. The bed needs of each trust need to be analysed in greater detail than has previously been the case.
There is considerable evidence that the distribution of the length of time that a patient occupies a bed in a hospital department is best described by a sum of two or three exponential terms, because of the presence of acute care, rehabilitation, and possibly long term care patients in the department. The patient flow models implied by these mixed exponential distributions are presented and fitting them to observed data when the admission rate fluctuates is discussed. Unlike single exponential distributions, mixed exponential distributions imply that the average length of stay of patients currently resident in the department is much longer than the average length of stay of a group of patients discharged over a period of time, so that the latter way of measuring will not correctly indicate what portion of the resources are being used by rehabilitation and long term care patients. Also, the expected additional length of stay increases dramatically with the time already spent in the department. Applications to predicting the effects of policy changes and to long term monitoring of hospital departments are presented. Two American hospitals are analyzed. The occupancy times in the government supported hospital follow a mixed exponential distribution similar to those found in the United Kingdom, but in the private hospital they fit a single exponential distribution, indicating markedly different management practices.
Pressure is increasing on hospitals to do more with fewer resources. The appropriate management of hospital beds is crucial. The author's practical experience of applying the Harrison and Millard Flow Model (BOMPS) and Sorensen's multi-phased bed model to aspects of the public hospital system in South Australia are detailed. These techniques can provide decision makers with improved bed management information. Modelling enables the effects of decisions to be analyzed before implementation. Further development of these tools, together with other modelling approaches, cannot be ignored as a means of improving the strategic management of hospital beds.