Improving the health-care delivery process at hospital emergency services by a better use of inpatient bed information

Shen, Xisheng; Wang, Xiaofang

doi:10.1016/j.elerap.2014.10.008

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…Bed availability contributed to the prolonged LOS. Findings from other studies showed that the lack of inpatient beds in relevant units reduced output and exit block contributing to crowding and prolonged LOS in the ED [ 25 , 33 , [47] , [48] , [49] , [50] , [51] ]. Our study showed that mean overall time (LOS) from when patients reported to reception to being transferred or discharged from the ED was 73 h 49 min which is equivalent to 3.04 days.…”

Section: Discussionmentioning

confidence: 99%

Areas of delay related to prolonged length of stay in an emergency department of an academic hospital in South Africa

Mashao

Heyns

White

2021

African Journal of Emergency Medicine

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Introduction Globally, length of stay of patients in emergency departments remains a challenge. Remaining in the emergency department for >12 h increases health care costs, morbidity and mortality rates and leads to crowding and lower patient satisfaction. The aim of this research was to describe the areas of delay related to prolonged length of stay in the emergency department of an academic hospital. Methods A quantitative retrospective study was done. The Input-Throughput-Output model was used to identify the areas of patients' journey through the emergency department. The possible areas of delay where then described. Using systematic sampling, a total of 100 patient files managed in an emergency department of an academic hospital in South Africa were audited over a period of 3 months. Descriptive statistics and regression analysis was used to analyse data. Results The mean length of stay of patients in the emergency department was 73 h 49 min. The length of stay per phase was: input (3 h 17 min), throughput (16 h 25 min) and output (54 h 7 min). A strong significant relationship found between the length of stay and the time taken between disposition decision (throughput phase) disposition decision to admission or discharge of patients from the ED (output phase) (p < 0.05). Conclusion The output phase was identified as the longest area of delay in this study, with the time taken between disposition decision to admission or discharge of patients from the ED (patients waiting for inpatient beds) as the main significant area of delay.

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Section: Discussionmentioning

confidence: 99%

Areas of delay related to prolonged length of stay in an emergency department of an academic hospital in South Africa

Mashao

Heyns

White

2021

African Journal of Emergency Medicine

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“…, 2017; Mehrolhasani et al. , 2016; Shen and Wang, 2015) and according to the complexity of cases in specialties wards or intensive care units (ICUs) (Kembe et al. , 2014; Long and Mathews, 2018; Long and Mathews, 2018; Mathews and Long, 2015).…”

Section: Theoretical Backgroundmentioning

confidence: 99%

“…, 2014; Mathews and Long, 2015) and optimization of the use of beds (Mathews and Long, 2015; Qiu et al. , 2015; Shen and Wang, 2015). The second form of using ICTs is through technologies for supporting current bed management operations (Richardson, 2017) and the integration of resources (Lovett et al.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

“…In a hospital, beds usually are allocated according to specific specialties such as orthopedic, pediatric and heart diseases (Lambton et al, 2017;Mehrolhasani et al, 2016;Shen and Wang, 2015) and according to the complexity of cases in specialties wards or intensive care units (ICUs) (Kembe et al, 2014;Long and Mathews, 2018;Long and Mathews, 2018;Mathews and Long, 2015). Indeed, despite the general management of beds in a hospital, it is also necessary to consider that the existence of different types of beds (Liu, 2003) requires the monitoring of beds according to their specificities to balance the capacity of a hospital in its several health services.…”

Section: Hospital Bed Managementmentioning

confidence: 99%

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Managing inpatient bed setup: an action-research approach using lean technical practices and lean social practices

Reis

Fernandes

Silva

et al. 2023

JHOM

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PurposeThis article aims to introduce a guide to improving hospital bed setup by combining lean technical practices (LTPs), such as kaizen and value stream mapping (VSM) and lean social practices (LSPs), such as employee empowerment.Design/methodology/approachAction research approach was employed to analyze the process of reconfiguration of bed setup management in a Brazilian public hospital.FindingsThe study introduces three contributions: (1) presents the use of VSM focused specifically on bed setup, while the current literature presents studies mainly focused on patient flow management, (2) combines the use of LSPs and LTPs in the context of bed management, expanding current studies that are focused either on mathematical models or on social and human aspects of work, (3) introduces a practical guide based on six steps that combine LSPs and LSPs to improve bed setup management.Research limitations/implicationsThe research focused on the analysis of patient beds. Surgical beds, delivery, emergency care and intensive care unit (ICU) were not considered in this study. In addition, the process indicators analyzed after the implementation of the improvements did not contemplate the moment of the COVID-19 pandemic. Finally, this research focused on the implementation of the improvement in the context of only one Brazilian public hospital.Practical implicationsThe combined use of LSPs and LTPs can generate considerable gains in bed setup efficiency and consequently increase the capacity of a hospital to admit new patients, without the ampliation of the physical space and workforce.Social implicationsThe improvement of bed setup has an important social character, whereas it can generate important social benefits such as the improvement of the admission service to patients, reducing the waiting time, reducing hospitalization costs and improving the hospital capacity without additional physical resources. All these results are crucial for populations, their countries and regions.Originality/valueWhile the current literature on bed management is more focused on formal models or pure human and social perspectives, this article brings these two perspectives together in a single, holistic framework. As a result, this article points out that the complex bed management problem can be efficiently solved by combining LSPs and LTPs to present theoretical and practical contributions to the important social problem of hospital bed management.

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“…Of these, 40% are hospitalized after the initial admission ( 9 ). As the main gate and source of outpatients in a hospital, the emergency department experiences an annual increase in the number of visits; therefore, it is always crowded, a condition that causes service quality deterioration ( 10 ). On the other hand, the emergency department plays a particularly sensitive role as a stressful working environment ( 11 ) due to the fact that its staff has to perform quick, high quality, and effective processes ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Quality of Emergency Service in Iran’s Military Hospitals: A Qualitative Study

Zaboli¹,

Shokri²,

Javadi³

et al. 2016

Electron physician

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IntroductionQuality is a key factor for the success of any organization. Moreover, accessing quality in the emergency department is highly significant due to the sensitive and complex role of this department in hospitals as well as the healthcare and medical treatment system. This study aimed to identify, from the perspective of medical experts and nurses serving in the military health and medical treatment system, the factors that affect the quality of emergency service provided in selected military hospitals in Iran.MethodsThis qualitative research was performed in Valiaser Hospital of Tehran (Iran) in 2015, using the framework analysis method. The purposive sampling technique was used for data collection. A total of 14 participants included two emergency medicine specialists, four general physicians, two senior nurses (holding M.Sc. degrees), and six nurses (holding B.Sc. degree). Data were collected through semistructured interviews. Sampling continued until data saturation occurred. The Atlas/Ti software was employed for data analysis.ResultsFour basic themes emerged as the effective factors on the quality of emergency services, namely, structural themes, process/performance themes, outcome themes, and environmental/contextual themes. Moreover, through a framework analysis, 47 subthemes were specified and summarized as indicators of the different aspects of the main themes.ConclusionThe factors affecting the quality of emergency services in Iran’s selected military hospitals are especially complicated due to the diversity of the missions involved; thus, different factors can influence this quality. Therefore, an effort should be made to tackle the existing obstacles, facilitate the identification of these effective factors, and promotion of the quality of healthcare services.

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Improving the health-care delivery process at hospital emergency services by a better use of inpatient bed information

Cited by 11 publications

References 24 publications

Areas of delay related to prolonged length of stay in an emergency department of an academic hospital in South Africa

Areas of delay related to prolonged length of stay in an emergency department of an academic hospital in South Africa

Managing inpatient bed setup: an action-research approach using lean technical practices and lean social practices

Factors Affecting Quality of Emergency Service in Iran’s Military Hospitals: A Qualitative Study

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