1. Bed Management Meeting More Than Just Measurement : Outcomes
Patient Flow Collaborative
Learning Session 3
Trevor Rixon
Access Manager
8 February 2005

2. Bed Management Meeting - What do we want to achieve?
Improved RCH patient experience
- ensure timely access to hospital for our patients & families
Collect accurate & timely information
- for both day-to-day & longer term decisions about managing
patient flow & capacity
Identify & remove barriers to good bed management practice
A flexible system, capable of effectively managing fluctuations in activity whilst maintaining efficiency
Active involvement of the RCH community in bed management

3. Length of Stay (Total)
80% of patients (excluding sameday) at this hospital had a length of stay between 1 and 6 days with the maximum length of stay currently at 360 days.
Ave LOS:

4. Average Admissions & Discharges by DOW
For the period Jul03-Mar04 the highest number of average admissions for multiday patients was on a Monday (67), and the highest number of average discharges was on a Friday (70).
The lowest number of average admissions (excluding weekends) was on a Friday (1), and the lowest number of average discharges was on a Monday (40).

6. Understanding Patient Flow
Minimal influence over emergency arrivals
Emphasis on managing discharges & elective admissions
- all other outcomes then follow
Requires sufficient data & information to properly understand how things are currently operating
Inpatient Flow: align elective & emergency flows to better manage demand & capacity
Patient Discharge: create capacity in the system by increasing the efficiency of patient discharge processes

7. Data and Information Effective Bed Management requires:
regular monitoring of current situation through timely analysis of accurate data set
supported by the smooth flow of information throughout the whole organisation
Core set of operational data is collected & monitored by the Access Management Team on a daily basis

8. Story so far…… Access Manager appointed
Met with stakeholders
Reviewed bed management process & practices
Identified service gaps
Discussion paper distributed
Developed & implemented IT-based Bed Management Tool
illustrates the variation of bed management activity on a periodic basis

9. Story so far…… Bed management meetings commenced: August 2004
Access Management Team (Access Manager, Bed Allocations Officer) co-ordinates meeting
All ward/unit nursing staff attend daily
Completed bed management template sent to staff daily
data assists in planning & managing elective & emergency demand
Enhanced communication & liaison between RCH & Royal Bank (casual staffing provider)

10. Bed Management Tool
Through valid data collection, increase awareness of all staff of the need for good bed management practice to underpin achievement of key access targets
To inform good and effective bed management
To provide an easy to use format & access to information that improves bed management processes

13. Lessons Learnt
Systems & tools enable better understanding of resource requirements by all participants
Information presented in a structured format ensures an agreed understanding & minimises disputation of data
Dealing with bed management issues in group forum allows time to identify & resolve issues
‘meeting after the meeting’
Enhances staff development - access to mentors & champions
Important to acknowledge and celebrate progress

17. Improvement Plan Staff Survey undertaken
Organisational review of bed management policy & practices
Inform Admissions & Discharge process changes
Develop an ‘on-line’ bed management system
Dedicated venue
Further integrate process into culture & context by seeking involvement of key medical & allied health staff
Assist nursing management to manage staffing issues that impact on bed availability:
casual staffing requirements; sick leave patterns; rostering practices

18. Bed Management Meeting More Than Just Measurement : Outcomes?