Hospital occupancy and discharge strategies: a simulation-based study.

Area of Science:

• Healthcare Management
• Operations Research
• Hospital Administration

Background:

• Rising emergency department (ED) arrivals and admissions lead to hospital congestion and patient dissatisfaction.
• Cost constraints limit hospital bed expansion, necessitating alternative solutions for patient flow.
• Hospital overcrowding impacts patient experience and operational efficiency.

Purpose of the Study:

• To evaluate the effectiveness of various patient discharge strategies in reducing hospital occupancy rates.
• To improve patient flow and minimize the frequency and duration of hospital congestion episodes.
• To identify optimal discharge protocols for enhancing hospital resource utilization.

Main Methods:

• Utilized the HESMAD (Hospital Event Simulation Model: Arrivals to Discharge) simulation model.
• Conducted simulation experiments with diverse discharge strategy scenarios.
• Analyzed and compared results using standard hospital occupancy indicators.

Main Results:

• Significantly reduced the number of days hospitals operate above base bed capacity.
• Achieved a reduction from 281.5 to 22.8 days in the best-case scenario.
• Demonstrated potential for substantial reductions in hospital overcrowding across multiple scenarios.

Conclusions:

• Simple strategies, including 24-hour discharge and relocating long-stay patients, effectively reduce overcrowding.
• Discharge and relocation strategies show a greater impact on occupancy rates than process shortening.
• Implementation of targeted discharge protocols can significantly improve hospital occupancy and patient flow.