Estimating the time involved in managing the 'unoccupied bed:' a time and motion study

Area of Science:

• Healthcare Management
• Nursing Resource Allocation
• Health Economics

Background:

• Occupied bed days are a standard metric for calculating nursing requirements.
• Current calculations often overlook the nursing time dedicated to unoccupied beds.
• This oversight can lead to underestimation of nursing workload and potential compromises in care safety.

Purpose of the Study:

• To quantify the nursing time and associated costs of unoccupied beds.
• To evaluate the impact of unoccupied bed management on overall nursing resource allocation.
• To advocate for a more comprehensive approach to calculating nursing needs.

Main Methods:

• Direct observation using time-and-motion techniques.
• Measurement of nursing activities related to bed turnover (transfers, discharges, admissions).
• Estimation of salary costs based on observed nursing time.

Main Results:

• Internal transfers averaged 8.65 minutes of nursing time per unoccupied bed.
• Patient discharges averaged 26.27 minutes.
• Patient admissions averaged 37.7 minutes.
• Estimated daily nursing salary cost for unoccupied bed activities was approximately $386 (AUD).

Conclusions:

• Unoccupied beds are not resource-neutral and incur significant nursing time and costs.
• Current nurse staffing models that ignore unoccupied bed time are incomplete.
• Accurate nursing requirement calculations must incorporate the time and resources dedicated to managing unoccupied beds to ensure safe patient care.