Hospital occupancy and discharge strategies: a simulation‐based study

• DOI: 10.1111/imj.13485
• Publication Date: 2017-05-09T14:42:49Z
• Authors: Shaowen Qin; Campbell Thompson; Tim Bogomolov; Dale Ward; Paul Hakendorf
• Keywords: Overcrowding; Occupancy

Increasing demand for hospital services has resulted in more arrivals to emergency department (ED), increased admissions, and, quite often, access block and ED congestion, along with patients' dissatisfaction. Cost constraints limit an increase the number of beds, so alternative solutions need be explored.To propose test different discharge strategies, which, potentially, could reduce occupancy rates hospital, thereby improving patient flow minimising frequency duration congestion episodes.We used a simulation approach using HESMAD (Hospital Event Simulation Model: Arrivals Discharge) - sophisticated model capturing through large Australian from arrival at discharge. A set experiments range proposed strategies was carried out. The results were tabulated, analysed compared common indicators.Simulation demonstrated that it is possible significantly days when runs above its base bed capacity. In our case study, this reduction 281.5 22.8 best scenario, reductions within under other scenarios considered.Some relatively simple such as 24-h or discharge/relocation long-staying patients, can overcrowding improve rates. Shortening administrative and/or some treatment processes have smaller effect, although latter easier implement.