Occupancy Smoothing May Reduce Hospital Crowding

Smoothing can be achieved by rescheduling an average of 2.6 percent of admissions

FRIDAY, June 3 (HealthDay News) -- Use of smoothing strategies may reduce midweek overcrowding in children's hospitals, according to a study published online May 24 in the Journal of Hospital Medicine.

Evan S. Fieldston, M.D., M.B.A., M.S.H.P., from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues assessed the difference in occupancy between weekdays and weekends at a children's hospital, and investigated the use of smoothing inpatient occupancy to reduce crowding. The occupancy rate in 39 tertiary-care children's hospitals was calculated based on inpatient census data. The impact of smoothing on variation in occupancy, change in the number of patients, patient-days, and high-occupancy was estimated.

The investigators found that the mean occupancy was 8.2 percent more on weekdays than on weekends, and that it varied from 70.9 to 108.1 percent on weekdays and 65.7 to 94.9 percent on weekends. After smoothing, there was a mean 6.6 percent reduction in the weekly maximum occupancy. To achieve occupancy of less than 95 percent, a total of 39,607 patients were removed through smoothing. Within-week smoothing was achieved by scheduling a median of 2.6 percent of admissions (median of 7.4 patients per week) to a different day of the week.

"Children's hospitals often face high midweek occupancy, but also have substantial unused weekend capacity. Hospitals facing challenges with high weekday occupancy could proactively use a smoothing approach to decrease the frequency and severity of high occupancy," the authors write.

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