Using operational information and information systems to improve in-patient flow in hospitals.

PURPOSE: To consider how information and information systems can be used to support improving patient flow in acute hospitals (a key target for the National Health Service in England), and the potential role of the National Programme for Information Technology currently being developed. DESIGN/METHODOLOGY/APPROACH: The literature plus past and present research, teaching and consulting experience with all levels of the National Health Service is drawn on to consider information provision and requirements. FINDINGS: The National Programme for Information Technology specifies many features designed to support improving patient flows, though timescales for implementation are longer than those for the pledged flow improvements, and operational use of this type of information system has been problematic in the National Health Service. RESEARCH LIMITATIONS/IMPLICATIONS: The work is limited to the National Health Service and information systems in use and planned for it. The National Health Service access targets, flow improvement initiatives and the National Programme for Information Technology apply primarily to England. PRACTICAL IMPLICATIONS: Some bed/flow management information systems currently in use incorporate tools and capabilities in advance of what is outlined in the National Programme for Information Technology, and some rare cases of culture changes in information system use have been achieved. One should learn from these to inform development and implementation of National Programme systems. These existing information systems and approaches may also be useful to hospitals considering systems prior to implementation of the National Programme for Information Technology. ORIGINALITY/VALUE: There has been very little consideration of the use of operational information and information systems for bed/flow management in the literature. Development and implementation of National Programme for Information Technology systems should build from an understanding of the practice and context of bed/flow management.

An exploratory study of bed management.

This paper analyses the role of bed managers and the processes involved in admission, stay, transfer and discharge of patients in the hospital setting. The paper seeks to begin a discussion of the difficulties entailed in the allocation of beds within the context of confined resources. This is achieved by: a review of the somewhat sparse literature on bed management and associated issues; the development of frameworks of analysis with regard to what bed managers do and the information used to support the bed management function; and an explication of results from fieldwork. This is followed by a discussion of the scope of responsibility and career role of the bed manager as well as the potential and problems of bed data. Contacts with others investigating this field and other trusts indicate that the situation in Greater Manchester may be typical of most areas.