ABSTRACT
The management of inpatients bed allocation in public hospitals is increasingly becoming complex as a result of inadequate bed capacity, poor scheduling policies and financial constraints in hospitals.
This study utilized survey design with the aid of questionnaire to examine hospital bed space management information system in Barrau Dikko teaching hospital, Kaduna. The questionnaire was administered to 70 in-patients and staff of the hospital, with the data gathered analyzed using descriptive statistics and bar charts.
The results from the study shows that bed space allocation in the hospital is poor as patients spend hours waiting allocation. Many of the in-patient are not convenient with the bed space as they are either in bad condition or they are not well positioned for cross ventilation. The study also shows that the hospital management makes bed space available based on individual status and that some patients are admitted based on their critical condition and not only admitted when the number of available bedsexceeds some (prespecified) threshold.
The study concludes that good bed space management strategies will help in increasing progression of patients through the hospital system.
The study recommends an effective bed space management system that will help to free-up space for adequate use of patient and further avoid unnecessary delay for patients and their loved ones. It was also recommended that there should be constant checks on ward conditions by the hospital management to know the true state of bed space in each ward.
CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Hospital is an institution for the treatment, care, and cure of the sick and wounded, the study of disease, and the training of physicians, nurses, and allied health care personnel (Lippincott, and Wilkins, 2005). People that visit hospital for a particular treatment are called patients and the visit could be outpatient or in-patient. Out-patients are short visit to the hospital that last not more than a day, while in-patients are visit to the hospital that require at least one night stay in a ward (Henderson, 2013). Bed allocation is the management of all processes necessary to place a patient into an appropriate vacant bed in the hospital. There are many different types of hospital bed, reflecting differences in the kind of patient they are designed to accommodate. The processes taken into consideration include the admission of a patient, length of stay, type of specialist bed (if needed) and the pending discharge date (Nicholls and Young, 2007). Bed availability is significant as a bed can be viewed as “one of the most fundamental inputs in the provision of acute health care” (Nicholls and Young, 2007).
The management of available and appropriate beds and their occupancy levels in hospitals is an integral part of the economical and ethical management of health care (Nicholls and Young, 2007). One of the major problems within a hospital environment is dealing with the bottleneck of patient allocation and the availability of beds (Ward 2004). Most times, poor bed allocation management occur as a result of shortage of bed spaces which can lead to cancellations of admissions for planned surgery, admission to inappropriate wards, delay in admitting emergency patients, and transfers of existing inpatients between wards thereby delaying their discharge which can cause enormous frustration and distress (Proudlove, Gordon and Boaden, 2003).
Through increased public scrutiny there is also a greater degree of accountability required from health care professionals with regard to facilities management and information administration. Many hospitals in Nigeria and around the world are running at peak capacity which almost guarantees queuing in the emergency department for available beds and other critical inpatient services (Richardson 2003).
Hospital management and staff must find a balance between the demands for available beds and demands through the needs of continuous care of the patient and emergency. This necessitates the need for this topic which examines hospital bed space information management system using Barrau Dikko teaching hospital, Kaduna.
1.2 Statement of the Problems
The management of available and appropriate beds and their occupancy levels in hospitals is an integral part of the economical and ethical management of health care. Inefficiencies and continuing management difficulties within hospitals have not been overcome and continue to be a source of practical, financial and management frustration (Nicholl and Young, 2007).
Shaw (2012) observed that hospital is a place where the staff have more complaints than the patients”. Existing hospitals systems rely on a large number of diverse methods to gather and collate patient and patient related information. The dissemination of this information does not enable the best informed and accurate decisions for planning and managing bed allocation, and hence providing the best economical, timely and beneficial patient care.
Hospitals also have a problem with losing beds, which further complicates bed allocation processes. Some hospitals do experience a high rate of beds allocation, which usually result into elective surgery being cancelled for that week and an increased bottleneck in placing patients into beds.
1.3 Research Objectives
The aim of this study is to examine hospital bed space information management system using Barrau Dikko teaching hospital, Kaduna. This aim will be achieved with the following objectives;
1. To know the level of availability of bed space in the hospital
2. To examine the bed space allocation management in the hospitals## t G.D ()nt clinical units.
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3. To identify the difficulties in bed space allocation in the hospital
4. To proffer solutions to bed space allocation management issues the hospital might be experiencing
1.4 Significance of study
This study is of great significance to the hospital management and government in general. The study will be useful for the hospital management to achieve an improve quality care by using a properly developed hospital bed space allocation decision management system that will aid hospital staff and health decision makers, thus reducing costs and in-patient length of stay.
The government will benefit from this study as it will expose them to bed space issue being faced in public hospitals which necessitates the need to be provide facilities that can improve the health care system in the state and the country in general.
1.5 Research Questions
The following research questions will guide the study
1. What is the level of availability of bed space in Barrau Dikko teaching hospital, Kaduna?
2. How is bed space allocation management being carried out in the hospital?
3. What are the difficulties in bed space allocation in the hospital?
4. What are the possible solutions to bed space allocation management issues in Barrau Dikko teaching hospital, Kaduna?
1.6 Scope of the study
This study will only focus on Barrau Dikko teaching hospital, Kaduna. It will specifically focus on the hospital’s bed space information management system in the hospital.
1.7 Definition of terms
Bed: A piece of material usually made of furniture or iron, typically a framework with a mattress for sleep or rest.
Space: A continuous area or expanse which is free, available, or unoccupied.
Medical Records: It is the records that spell out the patient’s illness and treatment during a particular period for outpatients and inpatients.
Out Patients: Any person who goes to receive treatment in the Hospital but does not stay overnight.
Ward: A section in the hospital where inpatient stays and receives treatment on regular bases.
Inpatients: A patient staying and receiving treatment in the hospital.