Daily capacity management for hospitals: a Brazilian case study

What is it about?

In the short term, the main challenge for hospitals is to employ their facility capacities efficiently, but relatively little attention has been paid to monitoring of daily operations. We propose a dashboard that is designed to measure the hospital performance on a daily basis, based on the Input-Throughput-Output conceptual model, related to admissions, capacity, and discharges. Empirical data from a Brazilian university hospital is utilized to demonstrate how to deploy the performance indicators, revealing improvements in admission and capacity management. The dashboard supports decisions such as the number of patients to be admitted, the expected number of discharges, provides a more acute measure of bed occupancy, a trend indicator of length of stay, and it allows to tune the daily arrival rate and throughput. We advocate that there is room for improvement by implementing a set of daily operational performance indicators.

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Why is it important?

The importance of daily operational control has received some attention in the literature. In particular, the importance of controlling the patient discharge rate has been pointed out because variation and delays in this process creates bottlenecks that ultimately delay most care pathways, especially new admissions. In this paper, we propose further operational control mechanisms designed to measure different aspects of daily bed capacity. We propose a set of operational performance indicators (PIs) to support decision-making processes related to admissions and daily capacity planning.

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