Hospital bed utilisation in the NHS and Kaiser Permanente: Bed management in the NHS can be improved easily

doi:10.1136/bmj.328.7439.582-c

BMJ 2004;328:582-583 (6 March), doi:10.1136/bmj.328.7439.582-c

Letter

Hospital bed utilisation in the NHS and Kaiser Permanente

Bed management in the NHS can be improved easily

The first 150 words of the full text of this article appear below.

EDITOR—The comparison by Ham et al of bed utilisationin the NHS and Kaiser Permanente indicates that the NHS couldimprove its management of beds drastically but leaves open thepossibility that it could be expensive in effort and money toreach the degree of efficiency at Kaiser.¹ However, a body ofdirect evidence from other statistics in the NHS already showsthat large improvements are possible and likely to be cheapto implement.

Length of stay varies greatly in different hospitals (and forreasons not readily explained by demographics or differencesin specialisations). In most hospitals the expected length ofstay varies by around one day, depending on which day you arrive(a pattern with no conceivable clinical justification).²

Our models build a picture of hourly bed utilisation given knownpatterns of emergency arrivals (which are random), electivearrivals (which are, at least in principle, subject to . . . [Full text of this article]

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Stephen Black, principal consultant

PA Consulting, London SW1W 9SR stephen.black@paconsulting.com

Nathan Proudlove, lecturer in operational research

Manchester School of Management, University of Manchester Institute of Science and Technology, Manchester M60 1QD

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