Elkhuizen Sylvia G, Bor Gert, Smeenk Marjolein, Klazinga Niek S, Bakker Piet J M
Department of Innovation and Process Management, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
BMC Health Serv Res. 2007 Nov 30;7:196. doi: 10.1186/1472-6963-7-196.
Capacity management systems create insight into required resources like staff and equipment. For inpatient hospital care, capacity management requires information on beds and nursing staff capacity, on a daily as well as annual basis. This paper presents a comprehensive capacity model that gives insight into required nursing staff capacity and opportunities to improve capacity utilization on a ward level.
A capacity model was developed to calculate required nursing staff capacity. The model used historical bed utilization, nurse-patient ratios, and parameters concerning contract hours to calculate beds and nursing staff needed per shift and the number of nurses needed on an annual basis in a ward. The model was applied to three different capacity management problems on three separate groups of hospital wards. The problems entailed operational, tactical, and strategic management issues: optimizing working processes on pediatric wards, predicting the consequences of reducing length of stay on nursing staff required on a cardiology ward, and calculating the nursing staff consequences of merging two internal medicine wards.
It was possible to build a model based on easily available data that calculate the nursing staff capacity needed daily and annually and that accommodate organizational improvements. Organizational improvement processes were initiated in three different groups of wards. For two pediatric wards, the most important improvements were found to be improving working processes so that the agreed nurse-patient ratios could be attained. In the second case, for a cardiology ward, what-if analyses with the model showed that workload could be substantially lowered by reducing length of stay. The third case demonstrated the possible savings in capacity that could be achieved by merging two small internal medicine wards.
A comprehensive capacity model was developed and successfully applied to support capacity decisions on operational, tactical, and strategic levels. It appeared to be a useful tool for supporting discussions between wards and hospital management by giving objective and quantitative insight into staff and bed requirements. Moreover, the model was applied to initiate organizational improvements, which resulted in more efficient capacity utilization.
容量管理系统能够洞察所需资源，如人员和设备。对于住院医院护理而言，容量管理需要每日及每年关于床位和护理人员能力的信息。本文提出了一个全面的容量模型，该模型能洞察所需护理人员能力以及在病房层面提高容量利用率的机会。
开发了一个容量模型来计算所需护理人员能力。该模型利用历史床位利用率、护士与患者的比例以及与合同工时相关的参数，计算出每个班次所需的床位和护理人员数量以及病房每年所需的护士数量。该模型应用于三组不同医院病房的三个不同容量管理问题。这些问题涉及运营、战术和战略管理问题：优化儿科病房的工作流程、预测心脏病房缩短住院时间对所需护理人员的影响，以及计算合并两个内科病房对护理人员的影响。
基于易于获取的数据构建一个模型是可行的，该模型可以计算每日和每年所需的护理人员能力，并适应组织改进。在三组不同的病房中启动了组织改进流程。对于两个儿科病房，发现最重要的改进是优化工作流程，以便达到商定的护士与患者比例。在第二个案例中，对于一个心脏病房，使用该模型进行的假设分析表明，通过缩短住院时间可以大幅降低工作量。第三个案例表明，合并两个小型内科病房可以实现容量节约。
开发了一个全面的容量模型，并成功应用于支持运营、战术和战略层面的容量决策。通过对人员和床位需求提供客观和定量的洞察，它似乎是支持病房与医院管理层之间讨论的有用工具。此外，该模型被用于启动组织改进，从而提高了容量利用率。
