bed occupancy rates
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2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 65-66
Author(s):  
Janine de Snoo-Trimp ◽  
◽  
Laura Hartman ◽  
Bert Molewijk ◽  
◽  
...  

"Background: Allocating admitted patients to their wards is increasingly put under pressure due to high bed occupancy rates. Consequently, allocation becomes morally challenging as it is confronted with potentially conflicting values like protecting teams’ workload, solidarity between wards and quality of care. Furthermore, there is a continuous uncertainty regarding expected intake, discharge, available beds and personnel. An integrative ethics support project was started to help to better deal with these challenges. After identifying core moral challenges, the aim of the current project was to co-create a map of values and norms for the daily allocation meetings. Methods: This qualitative study included observations of allocation meetings and 13 interviews. Subsequently, in five working group sessions a map of relevant values and norms was co-created with a selection of involved professionals. Results: Findings revealed moral challenges in three so-called ‘moral circles’: 1) one’s own team; 2) the hospital and 3) the hospital’s region. A map was developed including important and agreed upon values with 14 norms for the daily allocation meetings. Additionally, formal policies were updated and a conversation method was introduced to guide discussions when there are moral challenges. Conclusion: The joint development of the map led to a shared and practical product for both discussions and decisions regarding bed allocation. Its development already contributed to increased awareness of and openness about moral challenges. Using the map in daily allocation meetings may further stimulate moral reflection on these challenges to support these healthcare professionals in making well-considered and value-based decisions. "


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eunju Suh ◽  
Mahdi Alhaery

PurposeWhile United States is among countries with the world’s highest coronavirus infections, its approaches and policies to reopen the economy vary by state. A lack of objective criteria and monitoring toward satisfying the criteria can lead to another COVID-19 outbreak and business closures. Considering the pressing need to return to normalcy without a rebound of COVID-19 infections and deaths, an index that provides a data-driven and objective insight is urgently needed. Hence, a method was devised to assess the severity of the COVID-19 pandemic and determine the degree of progress any state has made in containing the spread of COVID-19.Design/methodology/approachUsing measures such as the weekly averages of daily new deaths, ICU bed occupancy rates, positive cases and test positivity rates, two indexes were developed: COVID-19 reopening readiness and severity.FindingsA clear difference in the pandemic severity trends can be observed between states, which is possibly due to the disparity in the state’s response to coronavirus. A sharp upward trend in index values requires caution prior to moving to the next phase of reopening.Originality/valueThe composite indexes advanced in this study will provide a universal, standardized and unbiased view of each state’s readiness to reopen and allow comparisons between states. This in turn can help governments and health-care agencies take counter measures if needed as to the anticipated demand for future health-care services and minimize adverse consequences of opening.


2021 ◽  
Author(s):  
Shabbir Syed Abdul ◽  
Meghna Ramaswamy ◽  
Luis Fernandez-Luque ◽  
Oommen John ◽  
Thejkiran Pitti ◽  
...  

UNSTRUCTURED The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly known as COVID-19 is causing widespread fear and stress. In India alone, there were more than 410,000 new cases and 4,000 deaths reported as of 6th May 2021. The COVID-19 pandemic has affected everyone, everywhere, and created systemic inequities leaving no one behind. People from lower and middle socio-economic classes are among the worst affected, thus exacerbating populations into extreme poverty. In many Indian cities, hospital bed occupancy rates cross over 200%. However, this is just the tip of the iceberg. The critical shortages of beds, medical supplies, and equipment such as oxygen cylinders for patient care have led to a state of public health emergency and have led to a surge in patients being treated in ambulances and delivery vehicles. The dire snapshot of the COVID-19 crisis in India reflects underinvestment in both its healthcare and public health system. In addition, misinformation circulating in social media is driving panic at a pace and scale never imagined before. Nevertheless, the citizen groups and civil society in India contended this issue through the spirit of social solidarity and creativity by developing digital communications measures through social networking platforms to interconnect and overcome the COVID-19 crisis. Through this article, we propose the pivotal role of digital solutions and public participation to reestablish our society and describe how the Sustainable Development Goals (SDGs) can support eHealth initiatives, and mitigate infodemics.


Author(s):  
Richard M Wood

As the second wave of COVID-19 continues to push healthcare services to their limits, rapid and strategic planning has never been more important. Richard M Wood explains how statistical ‘nowcasting’ can be used to predict bed occupancy rates and help leaders to better manage acute capacity during this ongoing crisis.


2020 ◽  
pp. 000313482095028
Author(s):  
Abby Wong ◽  
Meghan Prin ◽  
Laura N. Purcell ◽  
Clement Kadyaudzu ◽  
Anthony Charles

Introduction In high-income countries (HICs), the intensive care unit (ICU) bed density is approximately 20-32 beds/100 000 population compared with countries in sub-Saharan Africa, like Malawi, with an ICU bed density of 0.1 beds/100 000 population. We hypothesize that the ICU bed utilization in Malawi will be high. Methods This is an observational study at a tertiary care center in Malawi from August 2016 to May 2018. Variables used to evaluate ICU bed utilization include ICU length of stay (LOS), bed occupancy rates (average daily ICU census/number of ICU beds), bed turnover (total number of admissions/number of ICU beds), and turnover intervals (number of ICU bed days/total number of admissions – average ICU LOS). Results 494 patients were admitted to the ICU during the study period. The average LOS during the study period was 4.8 ± 6.0 days. Traumatic brain injury patients had the most extended LOS (8.7 ± 6.8 days) with a 49.5% ICU mortality. The bed occupancy rate per year was 74.7%. The calculated bed turnover was 56.5 persons treated per bed per year. The average turnover interval, defined as the number of days for a vacant bed to be occupied by the successive patient admission, was 1.63 days. Conclusion Despite the high burden of critical illness, the bed occupancy rates, turn over days, and turnover interval reveal significant underutilization of the available ICU beds. ICU bed underutilization may be attributable to the absence of an admission and discharge protocols. A lack of brain death policy further impedes appropriate ICU utilization.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jane Holl ◽  
Andy Cai ◽  
Lauren Ha ◽  
Alin Hulli ◽  
Melina Paan ◽  
...  

Introduction: Given the time-sensitive benefits of acute stroke (AS) treatments, stroke systems of care must balance reducing door-in-door-out (DIDO) time at primary stroke centers (PSCs) with capacity limits at comprehensive stroke centers (CSCs). For example transferring more AS patients earlier in the process (e.g., prior vascular imaging for large vessel occlusion) from PSCs would result in more inappropriate transfers to CSCs that could overburden these centers.We conducted a simulation to estimate the balance between increased AS transfers from PSCs to CSCs and the percent of CSC time on “bypass” (inability to accept transfers to neuro-ICU). Methods: Clinicians from 3 Chicago-area CSCs and 3 affiliated PSCs and the Chicago Emergency Medical Services (EMS) created a PSC DIDO process map. We assumed CSC time on bypass is affected by AS and non-AS admissions from the CSC and from the affiliated PSCs. Input data were obtained fromtheChicago region registry (e.g., # PSC to CSC transfers), peer reviewed literature (US average transfer rate of AS patients to CSCs), EMS (PSC-CSC affiliations), and CSCs (e.g., average bed occupancy rates). CSC size was estimated by #neuro-ICU beds: small (12 beds), medium (23 beds), and large (28 beds). The simulation output was % time of CSC on “bypass”. Results: Table shows % time of CSC on bypass by varying PSC AS transfer rates for each category of CSC size. Larger increases in PSC transfer rates resulted in modest increases in CSC bypass rates, particularly for medium and large CSCs. Validation with data from one CSC showed < 4% overestimate of CSC % time on bypass. Conclusion: CSCs with more beds have efficiencies of scale leading to lower % time on bypass, even with increases in PSC AS transfer rates proportionate to CSC size. This model allows stroke systems of care to compute regional CSCs’ % time on bypass based on actual PSCs’ transfer rates and CSC size.


2019 ◽  
Vol 11 (13) ◽  
pp. 77
Author(s):  
Sandu Siyoto ◽  
Albert Ronald Tule

The purpose of the study was to describe service procedures, doctor services, nurse services, facilities and infrastructure, and Bed Occupancy Rate (BOR) and to determine the effect of service procedures, doctor services, nurse services, facilities and infrastructure on bed occupancy rates (BOR). This research was conducted at Caruban Hospital with a sample of 214 people drawn randomly from 480 populations, data were collected by questionnaire and analyzed by descriptive and ordinal regression. The results of the data analysis show that service presiders, doctor services, nurse services, facilities and infrastructure, and bed occupancy behavior (BOR) are in the &ldquo;good&rdquo; category and there is an influence of service procedure, doctor services, nurse services, and facilities and infrastructure on behavior bed occupancy (BOR).


Health Policy ◽  
2019 ◽  
Vol 123 (8) ◽  
pp. 765-772 ◽  
Author(s):  
Rocco Friebel ◽  
Rebecca Fisher ◽  
Sarah R. Deeny ◽  
Tim Gardner ◽  
Aoife Molloy ◽  
...  

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