Capacity Audit Tool: identifying inpatient delays to maximise service improvement

This case study describes the development of a process and tool, the 'Capacity Audit', to quantify key inpatient delays in an acute care tertiary hospital setting.

The Capacity Audit Tool is an adaption of an existing Wasted Capacity Audit Tool supported by a systematic process to assess and quantify the status of patients in a cohort of inpatient beds. This paper reports on the application of the tool for all inpatient beds in an acute tertiary hospital assessed twice a day for a 15-day period.

In total, 820 surveys were completed. This represents 9126 beds assessed in the morning shift and 9261 in the afternoon shift over the 15-day period. The simplicity of the Capacity Audit Tool and the process to collect data resulted in a 95% compliance rate. The audit revealed that 76% of beds audited were being used appropriately for acute care. The top three delays were patients awaiting a post-acute care, the bed being empty and awaiting a patient to be allocated, and patients awaiting discharge transport.

The Capacity Audit Tool facilitates a high level of compliance, providing a comprehensive understanding of the use of hospital bed stock and bed capacity. In addition, the process reveals key inpatient delays to target critical improvement strategies.