Patient Bed Management in Hospital

Bed Management in Hospital

Effective bed management is Important  for handling both elective and emergency admissions efficiently, especially when there is pressure on the availability of beds. It ensures that patients are accommodated properly, regardless of the level of urgency, while maintaining smooth hospital operations and patient continuity of care.

Purpose:

The purpose of this process is to ensure that a systematic, planned, and agreed approach is followed for the review and allocation of hospital bed capacity, General ward, ICU. It also seeks to provide an overarching management strategy that ensures appropriate and consistent inpatient access, especially during times of high patient volume.

Beds are distributed in accordance with certain rules. When beds become available in the hospital, they are usually distributed according to a first-come, first-served policy, taking into account the patient's request and health status, and the Patient's critical situation.  In order to ensure prompt and sufficient treatment for surgical patients undergoing procedures, the standby beds are kept available.

Priority for Bed Allocation:

The priority for bed allocation is determined based on medical needs and urgency. Patients who are already admitted in Hospital are given first priority for bed assignment, keeping in view their medical condition and requests. Patients from outside the hospital are placed in a queue, where the severity of their condition guides the order of allocation.

Emergency and critically ill patients are always given top priority. Routine admissions are scheduled for a fresh date, and rescheduled patients are given preference over new admission requests. In the case of transfers from another hospital, the external facility may be asked to hold the transfer until a suitable bed or room becomes available.

Emergency Department:

In non-disaster situations, the most stable patients are either transferred to the ward or ICU, or discharged, depending on their condition. The decision regarding a patient’s stability and transfer is made by the Emergency In-Charge during routine hours and by the doctor on duty in consultation with the Emergency In-Charge during off-hours.

If none of the patients are stable and the inflow of patients continues, arrangements are made to shift or refer patients to other hospitals. In situations where the hospital’s emergency department is full, it becomes the responsibility of the doctor on duty to arrange emergency beds in other hospitals.

If no beds are available within Hospital, patients are referred to nearby hospitals within a 30 km radius after confirming bed availability. A comprehensive list of all nearby hospitals is maintained with the front office and emergency department for this purpose.

Critical Care Units (ICU, SICU):

When there is a demand for ICU beds, the stability of patients already admitted in the ICU is assessed solely by the ICU In-Charge. Only when the ICU In-Charge is confident about a patient’s stability, the patient may be shifted to the ward. Step-down to the ward is considered only for stable patients. In situations of extreme demand, a ward may be staffed and upgraded to provide care for critical patients, ensuring continuity of treatment and patient safety.