Strategies for Optimizing Hospital Bed Management : Modeling and Scenario Analysis Using Real Surgical Hospital Data

Bed Management (BM) is essential for hospital efficiency, balancing the need to reduce patient waiting times caused by bed shortages with maintaining a capacity for unexpected demand increases. The complexity of BM is heightened by the variability in patient arrivals (elective vs. emergency), Length of Stay (LOS), and bed occupancy.

This study aims to: (1) examine the evolution of operations management research in the field of BM to identify research gaps, and (2) propose improvement strategies for BM to enhance operational Key Performance Indicators (KPIs) in hospitals. To achieve these goals, the first phase conducted a systematic literature review to analyze papers from three main research themes: planning bed numbers and allocation, optimizing patient flow, and considering both aspects. The second phase used a simulation-based optimization approach to analyze various BM strategies, using real data from a large surgical hospital. The modeled strategies included specialty-based bed allocation, shared bed pools, admission type-based allocation, and a threshold policy. Furthermore, the impact of converting regular admission (i.e., one day before the surgery) to day of surgery admission for elective surgeries, as well as various demand profiles, was analyzed.

The findings of the first phase identified seven research gaps, targeting mainly LOS and patient arrival patterns. In the second phase, thirty scenarios across five BM models have been examined. The analysis revealed that the simple merging strategy (shared beds pool between specialties) achieved the lowest number of beds and highest bed utilization. The allocation of beds based on admission type resulted in the lowest waiting times, whereas the threshold policy (shared beds pool with a limit on elective admissions) demonstrated superior overall performance.

In conclusion, researchers can use the identified gaps to advance bed management field, while care managers can apply the recommended strategies to improve hospital operations.