Abstract of Dissertation

Agency : Admission Process, Discharge Process, Delivery of Health Services, Patient Care

Objective : Not Available

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Recommendations : an admission, an inpatient period and a final stage with the discharge process. An inefficient bed management in any of the three stages of the hospitalization can cause a mismatch between demand and capacity. It has been proved that when bed demand exceeds capacity, patient admissions and scheduled surgical procedures can be delayed or cancelled. Traditionally, it has been assumed that the variability in the demand comes from the inflow of patients in emergency departments. Interventions focused primarily on emergency departments have had limited success. However, repeated case studies have shown that elective admissions are often the major cause of variation as they are more unpredictable than the emergency admissions. In addition, the greatest variation is typically in the number of discharges. To have information about planned discharges 24-h in advance would allow a higher planning and an optimal bed assignment. Moreover, the discharge process should start at the point of admission in the case of planned admissions, as in some cases the estimated length of stay without a medical complication is known. Discharge planning allows for 79 a better and quicker bed assignment in hospitals and the development of nurses and other staff working in discharge coordinator roles. In this sense, it has been proved that multidisciplinary teams can improve the delivery of health services and patient care. All admissions and discharges of the hospital should be centrally managed and planned, as singledepartment solutions may create or worsen bottlenecks in other areas. During the hospitalization process, patient flow is a strategic aim for the healthcare enterprise. Hospitals can combine process management with information technology to redesign patient flow for maximum efficiency and clinical outcomes.

Hospitals face an increasing demand for hospitalization. For medical staff due to the introduction of innovative technology in diagnostic and therapeutic procedures higher standards in clinical safety and, finally, an increasing patient demand for better quality services poses challenges for quality management. Optimal bed management is a strategic aim in any hospital as the provision of an inpatient bed, together with the staff and supplies involved, accounts for much of its most complex and expensive activity. The way beds are managed affects the way other hospital departments perform since many are dependent on bed availability, such as emergency services, operating theatres, etc. At the same time, these other hospital departments have an impact on bed usage. Therefore, it is essential to have an efficient and correct bed management in order to improve service delivery.