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Optimising acute stroke pathways through flexible use of bed capacity: a computer modelling study.
Richard M Wood1,2, Simon J Moss3, Ben J Murch3
1Bristol, North Somerset and South Gloucestershire ICB, National Health Service, South Plaza, Marlborough St, BS1 3NX, Bristol, United Kingdom. richard.wood16@nhs.net.
BMC Health Services Research
|August 20, 2022
Summary
To optimize hospital bed capacity, this study reveals that "flex capacity" is crucial. Incorporating variability beyond average patient flow estimates is essential for efficient healthcare resource allocation and improved patient outcomes.
Area of Science:
- Healthcare Management
- Operations Research
- Health Systems Engineering
Background:
- Optimizing clinical pathway capacity is vital for patient outcomes and financial sustainability.
- Average-based capacity planning often underestimates required resources.
- This study assesses 'flex capacity' needs during peak demand.
Purpose of the Study:
- To investigate the necessity of 'flex capacity' in addition to average-based estimates.
- To quantify additional bed requirements for stroke pathways.
- To improve healthcare capacity planning accuracy.
Main Methods:
- A computer simulation modeled patient flow on a centralized stroke pathway.
- Variability in patient arrivals, length of stay, and transfer times were accounted for.
- Flex capacity utilization was the primary outcome measure.
Main Results:
- 45% flex capacity needed for hyper-acute and acute units; 36% for rehabilitation units to minimize waiting.
- Flex capacity was required 30% (hyper-acute), 20% (acute), and 18% (rehabilitation) of the time.
- These figures ensure minimal delays for stroke presentations.
Conclusions:
- Accurately capturing variability in capacity plans is critical.
- A practical, economical approach complements traditional averages-based methods.
- Study findings directly influenced stroke service reconfiguration.
