Addressing overestimation and insensitivity in the 85% target for average bed occupancy

Area of Science:

• Healthcare Operations Research
• Hospital Bed Management
• Health Systems Engineering

Background:

• The traditional 85% average bed occupancy target for acute hospital wards is widely accepted but may not be universally applicable.
• Concerns exist regarding the generic application of this target, potentially leading to inefficient resource allocation or capacity breaches.
• Limited research has explored alternative occupancy targets that better reflect diverse clinical settings.

Purpose of the Study:

• To develop a range of average occupancy targets for acute hospital settings.
• To provide a data-driven framework for optimizing hospital bed capacity.
• To inform more sensitive bed occupancy assessments for hospital planners.

Main Methods:

• Utilized computer simulation to model patient admissions and discharges.
• Assumed random patient arrivals, independent of each other.
• Employed patient-level length of stay data from across England for distribution fitting.

Main Results:

• Optimal average occupancy targets vary significantly with ward size, from 45-79% (15-bed) to 64-84% (50-bed).
• Ward specialty influences targets, with Gynaecology at 57-58% and Adult Mental Health at 67-74% for a 25-bed ward.
• Relaxing capacity breach tolerance from 2% to 5% increases targets, e.g., Adult Mental Health rising to 75-82%.

Conclusions:

• The 85% occupancy target is an overestimate for most practical hospital settings.
• Hospital planners must consider ward size, specialty, and breach tolerance for accurate bed capacity assessment.
• This study offers a reliable method for assessing operational performance and calculating optimal bed requirements.