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5 HOSPITAL BEDS
MANAGEMENT SYSTEM
In a modern hospital, the management of hospital
beds is an essential part of the in-patient workflow
system, as it indicates not only the flows of in-
coming patients into the wards, but also the
resources and manpower required to support these
patients using the beds. Therefore, the pattern of
hospital bed usage is often used as a proxy to
measure the number of patients treated in the
hospital.
Deliberation:
Problem identification:
There is no central control to overseeing the release
of beds for the admission of new patients.
Definition of problem:
Although a bed management system is installed at
Khoo Teck Puat Hospital (KTPH), it is only a
situation map to display the status of hospital beds
usage in terms of R (Ready to use), or P (Prepare for
discharge), but does not monitor the transition from
“P” to “R”. Hence, we define the goal as follows:
Goal: To monitor the realization and execution of
the operational plan to transform from “P” to
“R”.
Objectives: Discharge (A, F, T, L) Æ C.
The goal could be decomposed into a list of
objectives shown above. Patient discharges are often
decided upon during the physician visit to the ward
every morning. A list of activities followed
thereafter must be completed before patients leave
hospital; scheduling appointment (A), collecting
prescriptions (F), arranging family member to take
them home (T), collecting letter from the doctor who
decide to discharge them (L). These activities are not
sequential, and therefore could be executed in
parallel. Once the bed is freed, the bed should be
cleaned (C) before the status changes from “P” to
“R”. In theory, cleaning process could take place in
parallel with Discharge (A, F, T, L) provided the
discharged patient could be moved off the bed into a
discharge lounge, where patients could rest and wait
in the lounge for the completion of “A”, “F”, “T”
and “L”.
Planning:
Show in the situation map, the existing bed
management system indicates the number of “P” and
the number of “R” on the screen, to indicate the
status of patient admission into the wards. The
execution of the course of actions for Discharge (A,
F, T, L) are undertaken outside the system, only
when “P” is transformed into “R” status would the
status be displayed onto the system.
To speed up the transformation from “P” to “R”,
tactical planning for “A”, “F”, “T” and “L” will be
formulated as part of the co-cooperative plan.
Co-operative plan 1
Strategic Plan 1: Discharge (D Lounge) Æ C Æ R
Tactical Pan 1: If patient is well enough to be send
home, discharge to the Discharge
Lounge, would enable the bed to be
cleaned, and proceed to turning the
status of bed from “P” to “R”.
Co-operative plan 2
Strategic Plan 2: Discharge (A, F, T, L) Æ C Æ R
Tactical Plan 2: However, if the patient is not well
enough to be moved off the bed, the
completion of “A”, “F”, “T”, and
“L” will be the precondition to
proceed to cleaning the bed “C”.
This will become the task for DSS
operational manage to monitor and
execution during the plan
realization stage.
Co-operative plan 1 and Co-operation plan 2 are the
alternative realization for the same goal to transform
from “P” to “R”.
Plan Selection:
Different sets of Co-operative plan will be studied
and compared for the selection of the best plan as
the operational plans, leaving the rest of the plans as
stand-by plans.
Plan Realization:
One of the strength of Co-operative planning is in its
ability to repair or change plan during execution in
respond to changes in environment; either
strategically, or tactically. For instance, if status “F”
have not completed within a predetermined time,
alert will be sent to pharmacy to look into the matter.
Same is applicable to “L” status, if letter from doctor
is unable to be completed in time, then alternatively
solution such as sending it by email, or post, could
be activated. The role of DSS operational manager is
to study and monitor to ensure the operational plan
is successfully executed.
In summary, the operational procedure of the KTPH
bed management system consists of 4 stages:
1. Deliberation:
A Dashboard or Situation Map will
consolidate information about bed status to
be displayed onto the nurse station in the
wards, and the A&E department.
PROBLEM SOLVING FRAMEWORK WITHIN DECISION SUPPORT SYSTEMS
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