Bed usage in a Dublin teaching hospital: a prospective audit

Area of Science:

• Healthcare Management
• Hospital Operations
• Health Services Research

Background:

• Acute hospital beds are a finite and expensive resource.
• Delayed discharge due to lack of step-down facilities contributes to bed shortages.
• Inefficient bed utilization impacts patient flow and access to care.

Purpose of the Study:

• To audit inpatient bed use and identify factors contributing to prolonged stays.
• To quantify the impact of delayed discharges on hospital capacity.
• To evaluate the necessity of step-down facilities for efficient patient flow.

Main Methods:

• Prospective audit of inpatient bed occupancy over three months.
• Analysis of patient discharge data, including reasons for delayed discharge.
• Calculation of occupied bed days by patients awaiting transfer.

Main Results:

• 30% of medically discharged patients remained in hospital awaiting step-down facilities.
• These patients occupied 486 bed days.
• This bed occupancy could have accommodated 54% more patients, preventing procedure cancellations and trolley wait times.

Conclusions:

• Acute hospital bed use is highly inefficient.
• There is a clear need for dedicated step-down facilities.
• Optimizing existing hospital bed use is paramount for patient care and resource efficiency before constructing new facilities.