145:"Bed hiding", as it is sometimes called, is the practice of delaying admissions due to a falsely claimed lack of beds in the appropriate department. Bed hiding has several causes, including scheduling so many elective procedures that there are inadequate beds left for emergency admissions; frequent changes from ward to ward; inadequate communication, so that cleaning staff don't know when a bed has become available and needs cleaning; misalignment of tasks, so that skilled nurses are expected to take time away from direct patient care to clean beds; too few nurses scheduled for a shift; and overworked staff, who may be inclined to mis-report a bed as full, especially at the end of a shift, in an effort to shift the workload to another person. Bed hiding can be significantly reduced by careful tracking of bed status, making cleaning after discharge the top priority for cleaning staff, and even by physically moving patients to the ward as soon as they are ready for admission rather than boarding them in the emergency department. Reducing bed hiding in regular wards can reduce wait times in the emergency department.
30:
68:, there is naturally pressure to ensure high occupancy rates and therefore a minimal buffer of empty beds. However, because the volume of emergency admissions is unpredictable, hospitals with average occupancy levels above 85 per cent "can expect to have regular bed shortages and periodic bed crises." In the first quarter of 2017 average overnight occupancy in English hospitals was 91.4%.
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package in their own home. 6,354 delayed days were patients awaiting the completion of a social care assessment and 9,251 days related to patients awaiting spaces in residential homes. Other delays may be attributable to issues within the hospital, such as delays in arranging medication or completing tests.
52:
are a scarce resource. The "bed" in this context represents not simply a place for the patient to sleep, but the services that go with being cared for by the medical facility: admission processing, physician time, nursing care, necessary diagnostic work, appropriate treatment, food, cleaning and so
157:
In the month of April 2019 there were 130,800 total delayed days in
English NHS hospitals, a reduction from 145,300 delayed days in April 2018. The proportion attributed to social care decreased to 27.4%, compared to 30.7% in March 2018. 31.7% of the social care delays were patients awaiting a care
126:
Hospitals in developed countries cannot force a patient to leave if the patient's home is reasonably believed to be unsafe. For example, if a frail, elderly patient has recovered from an acute illness, but is unable to dress himself and prepare simple meals on his own, then the hospital must ensure
105:
started a new initiative to reduce the number of what it now called "stranded" or "super stranded" patients, super stranded being people in hospital for more 20 days. About 18,000 of the 101,259 acute and general beds in
English NHS hospitals were occupied by "super stranded" patients in May 2018.
113:
calculated that 1,419 people had their discharge from hospital delayed in that month, most commonly for health and social care reasons. 1,122 were delayed more than three days. Between them they had spent 40,813 days in hospital.
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workers, and related support organizations, beds may be unavailable for new, acutely sick patients because of the continued presence of the previous patients. This is sometimes known as a "bed blocking".
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Patients who are medically fit to leave may be delayed by many factors. Delays due to the lack of social care provision, care homes and residential care have received considerable publicity.
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In the UK, acute hospital bed management is usually performed by a dedicated team and may form part of a larger process of patient flow management; a bed manager may be part of such a team.
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Shortage of beds can result in cancellations of admissions for planned (elective) surgery, admission to inappropriate wards (medical vs. surgical, male vs. female etc.), delay admitting
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By August 2018 2,338 of these beds had been freed. Some of the delays were related to social care, but more related to the management of inpatient stays.
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there has been concern over inaccurate and sometimes fraudulently manipulated waiting list statistics, and claims that "the current
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patients, and transfers of existing inpatients between wards, which "will add a day to a patient's length of stay".
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for falsifying A&E discharge times between 2000 and 2010 to avoid breaches of four-hour waiting targets.
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target is simply not achievable without the employment of dubious management tactics." In 2013 two
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Boaden, Ruth; Nathan
Proudlove; Melanie Wilson (1999). "An exploratory study of bed management".
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271:"Can good bed management solve the overcrowding in accident and emergency departments?"
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588:"Performance Watch: Exclusive figures lay bare hospitals' capacity challenge"
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Latest research statistically proves A&E waiting times are not being met
131:, or the patient must remain in the hospital. In places with a shortage of
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that the patient will have sufficient assistance with these necessary
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NHS reforms by the coalition government and bed management technology
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Patients Wait for Hours in
Hallways; Strain Felt Throughout State
362:"Inpatient Admissions and Bed management in NHS acute hospitals"
195:"Faster access: Bed management demand and discharge predictors"
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403:"Bed occupancy rate hits record high in first quarter of 2017"
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Inpatient admissions and bed management in NHS acute hospitals
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729:"Bed blocking cases drop by 10% in England, NHS data reveals"
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False appearance or unnecessary creation of a bed shortage.
610:"Social care hold-ups blamed for 9% rise in bed-blocking"
405:. Health Care Leader. 26 May 2017. Archived from
718:at U.S. Department of Health and Human Services
558:"Stafford nurses struck off over waiting times"
269:Proudlove NC, Gordon K, Boaden R (March 2003).
264:
262:
124:Shortage of beds due to lack of other options.
459:"The NHS: Has the Additional Funding Worked?"
368:. 21 February 2000. p. 7. Archived from
169:"Bed management: Review of national findings"
78:These can be politically sensitive issues in
8:
488:Mayhew, Les; Smith, David (December 2006).
433:Bed management: Review of National Findings
465:. April 2005. pp. 2–3. Archived from
590:. Health Service Journal. 25 October 2018
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687:How hospitals are killing E.R. patients
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64:Because hospital beds are economically
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249:; pp. 43–50 & 123-130 &c
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677:New Haven Register, April 16, 2006.
635:Bed blocking threat to A&E unit
612:. Home Care Insight. 3 April 2019.
568:from the original on 30 August 2017
40:is the allocation and provision of
731:. Homecare Insight. 12 July 2019.
25:
735:from the original on 26 July 2024
320:Journal of Management in Medicine
616:from the original on 13 May 2019
33:Outline of bed management cycle
1:
94:nurses were struck off the
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241:. London: the King's Fund
133:skilled nursing facilities
129:activities of daily living
80:publicly funded healthcare
332:10.1108/02689239910292945
48:where beds in specialist
692:26 February 2010 at the
237:Day, Christopher (1985)
760:Health care management
714:14 August 2009 at the
178:. 2003. Archived from
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366:National Audit Office
239:From Figures to Facts
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770:Hospitals in England
709:Psychiatric boarding
673:3 March 2016 at the
640:26 July 2024 at the
499:Cass Business School
429:"Patient Experience"
287:10.1136/emj.20.2.149
211:. 24 February 2000.
191:Department of Health
185:on 25 February 2014.
765:Health care quality
651:5 May 2020 at the
201:on 6 January 2012.
109:In February 2019,
44:, especially in a
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518:on 3 January 2011
508:978-1-905752-06-5
469:on 28 August 2008
118:Specific problems
92:Stafford Hospital
16:(Redirected from
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197:. Archived from
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176:Audit Commission
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82:systems. In the
66:scarce resources
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646:Bed blocking
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18:Bed blocking
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540:|work=
275:Emerg Med J
229:19 February
103:NHS England
754:Categories
594:1 December
254:References
218:0105566748
60:Importance
739:25 August
698:Slate.com
542:ignored (
532:cite book
340:0268-9235
73:emergency
733:Archived
712:Archived
690:Archived
671:Archived
649:Archived
638:Archived
614:Archived
566:Archived
348:10787495
305:12642528
193:(2004).
101:In 2018
46:hospital
572:20 June
463:Civitas
413:10 July
296:1726041
88:A&E
53:forth.
620:13 May
522:20 May
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473:20 May
443:20 May
376:20 May
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516:(PDF)
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50:wards
741:2019
644:and
622:2019
596:2018
574:2018
544:help
524:2008
503:ISBN
475:2008
445:2008
415:2017
378:2008
344:PMID
336:ISSN
301:PMID
243:ISBN
231:2014
213:ISBN
42:beds
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657:BBC
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