[Keywords: Bed Utilization Model; Departmental Bed Utilization
The bed utilization rate and turnover times are important indicators of hospital efficiency and management quality. Now we use the "bed utilization model" [1] to evaluate the utilization of departmental beds and provide a basis for decision-making in hospital management.
1 Source of information
The information was obtained from the statistical reports of our hospital from 2000 to 2003, see Table 1. Table 1 Bed utilization and turnover of each department from 2000 to 2003
2 Methods and results
2.1 Relevant formulas
Standardized bed utilization = actual bed utilization/bed utilization. Standardized bed occupancy rate = actual bed occupancy rate / standardized bed occupancy rate.
Standardized bed turnover rate = actual bed turnover number/standard bed turnover number.
According to the National Ministry of Health standards, the hospital-wide annual bed utilization rate upper limit is 93%, the lower limit is 85%, and the standard value is 89%; the annual bed turnover times upper limit is 23 times, the lower limit is 18 times, and the standard value is 21 times. However, this paper is for the use of beds in the department, so there is no standardized conversion.
2.2 Drawing the four-quadrant coordinate chart With "bed utilization rate" as the vertical coordinate and "bed turnover times" as the horizontal coordinate, the hospital-wide "bed utilization rate" in Table 1 is 63.7% of the annual average and the annual average of 63.7% of the annual average of 63.7% of the annual average of 63.7% of the annual average of 63.7% of the annual average of 63.7% of the hospital-wide "bed utilization rate" in Table 1 is the horizontal coordinate. The 4-year average of "bed utilization rate" in Table 1 is 63.7% and the 4-year average of "bed turnover times" is 24.8 times as the quadrant standard, and the 4-year average of the coordinate points of each department is put on the coordinate chart, and the coordinate points correspondingly fall in the Ⅰ, Ⅱ, Ⅲ and Ⅳ quadrants, which indicates the static type of bed utilization of that department. Figure 1 Static situation of bed utilization of each department is also based on the 4-year average of the hospital as the quadrant standard. The 4-year average of each department is also taken as the quadrant standard, and the coordinate points of the 4-year data of each department in Table 1 are marked on the coordinate chart to form the dynamic curve of bed utilization of each department, see Fig. 2. Fig. 2 Dynamic curve of bed utilization of each department from 2000 to 2003
3 Analysis
3.1 Static analysis See Fig. 1.
3.1.1 Quadrant Ⅰ Quadrant I of the coordinate chart represents the "bed efficiency type", which is the "bed efficiency type", and is the "bed efficiency type". In the first quadrant of the coordinate graph, there are "bed efficiency departments", such as cardiothoracic surgery, general surgery, ophthalmology, digestive oncology, etc. Compared with the average level of the whole hospital, they are more efficient. Compared with the average level of the whole hospital, the bed utilization rate of the department is higher, the turnover number is faster, and the utilization of beds is reasonable. Because of the composition of its disease types are mostly common and frequent diseases, we can consider to increase the investment of human and material resources in this kind of department in order to achieve better social and economic benefits.
3.1.2 Quadrant Ⅱ In quadrant Ⅱ of the coordinate diagram is the "bed turnover type department", such as maternal and pediatrics. The department's bed utilization rate is low, but the turnover rate is fast, and the average length of stay of patients is shorter, indicating that the type of disease is relatively light. Due to the fierce competition in the medical market, such departments can appropriately relax the conditions of admission, increase the number of admitted diseases, improve the bed utilization rate, to achieve the purpose of more income and fast treatment.
3.1.3 Quadrant Ⅲ In quadrant Ⅲ of the coordinate chart is the "bed idle department", such as infectious tuberculosis department. This type of department has a low bed utilization rate, slow turnover, and underutilized beds. Therefore, in terms of management, we should form specialty characteristics, expand visibility, focus on the quality of diagnosis and treatment, improve service attitude, and give full play to the role of idle beds.
3.1.4 Quadrant Ⅳ Quadrant Ⅳ of the coordinate chart is the "bed-pressure type departments", such as cadre wards, orthopedics. This type of department's bed utilization rate is generally higher, but the turnover of beds is slower, the patient's hospitalization time is relatively long, indicating that the admission and treatment of difficult, critical, special diseases. In the work, the internal medicine should pay attention to the application of new therapies, surgery should focus on the development of new technologies, strive to shorten the waiting time, pay attention to the preoperative preparations, reduce the ineffective recovery days, pay attention to grasp the standard of healing, improvement, reduce the pressure on the bed, so as to accelerate the turnover of beds, so that the beds can be better utilized.
Although the burn unit and cardiovascular respiratory belong to the idle type of department, renal neurology belongs to the turnover type of department, but are close to the average level of the hospital, has a certain development potential, can also consider increasing the three departments of human and material input.
3.2 Dynamic analysis Because the bed utilization rate and turnover times of the departments can not be standardized, and the types of diseases admitted and the degree of criticality are different, so the bed utilization between departments is generally not comparable. Intra-departmental comparison for 4 years reflects the dynamics of bed utilization in this department, as seen in the dynamic curve in Figure 2: Cardiothoracic general surgery basically fluctuates within the efficiency type, and bed utilization has been relatively reasonable. Pentacenter and digestive oncology were in the turnover type in 2000, and then shifted to the efficiency type in the last three years, with obvious progress.
Cadre wards, orthopedics has been fluctuating in the pressurized bed type, infectious tuberculosis has been fluctuating in the idle type, you can consider reducing the number of beds in infectious diseases, increase the number of beds in cadre wards, orthopedics. Facts have also proved that in the past three years, the army retired cadres bed utilization rate increased significantly, orthopedics also often add beds admitted.
Renal neurology from idle type to efficiency type change, progress is obvious. Neurosurgery from the pressure of bed type to idle type change, and the end of 2000 renal specialty from the neurosurgery department to the renal neurology department has a certain relationship, but the neurosurgery dynamic curve is the biggest change, especially need to redouble their efforts, or else can also be considered to reduce the number of beds and the number of personnel and so on. The burn unit bed utilization curve is closest to the hospital-wide average but the low bed occupancy rate is noteworthy.
3.3 Calculate the average occupancy of each department and the hospital as a whole using the Bed Utilization Index (BUI)
BUI (average number of patients admitted per bed per year) =
(bed occupancy × number of bed turnovers).
As needed, the average number of admissions can be calculated using the number of beds in each department and for the hospital as a whole. For example, the hospital-wide 4-year average bed utilization index is 63.7% × 24.8 = 15.80, that is to say, in these 4 years, the hospital-wide average annual intake of 15.80 patients per bed, according to the 4-year average unfolding of 450 beds × 1/4 + 500 beds × 3/4 = 487.5, the average annual intake of 15.80 × 487.5 ≈ 7,703 patients in the 4-year average.
4 Discussion
The analysis and evaluation using the "bed utilization model" objectively reflects the efficiency of the departmental beds, we should take effective measures to optimize the number of beds in the relevant departments according to the specific situation, so that the use of beds and the turnover of beds to maintain an appropriate ratio, which can prevent us from working only on the beds. Not only can we avoid pursuing only the bed utilization rate in our work and neglecting the improvement of the number of turnover times, but also fully tap the potential of those unused beds.
This paper analyzes the utilization of beds in various departments and provides a basis for the comprehensive regulation of hospital beds. Throughout the sections and the whole hospital, the bed utilization rate is too low, and the standard value of 89% of the bed utilization rate stipulated by the Ministry of Health of the country is far away. The medical system has long been reformed, we should keep abreast of the situation, understand the social health care needs, recognize the changes in health care needs, outpatient clinics and wards should be closely coordinated, rational deployment of medical layout, and actively treating patients, so that the limited health resources can be more greatly utilized.
References
[1] Zhu Shijun, ed. Hospital Management and Information Utilization [M]. Beijing: People's Army Medical Publishing House, 2001. 238.
(PLA No. 97 Hospital Information Department Xuzhou, Jiangsu 221004)
(This article is edited by Tao Liu)