Opportunities and Barriers in the Planning of Hospital Bed Capacity in a Tertiary Care Hospital in Makkah, Saudi Arabia

Abstract

Introduction: In alignment with Saudi Arabia’s 2030 Vision to improve healthcare services, Saudi hospital policymakers must have a clear understanding of the needs of their hospitals to make strategic decisions regarding hospital bed capacity planning. King Abdullah Medical City (KAMC) is a tertiary and quaternary healthcare facility that has four state-of-the-art excellence centers, of which the Cardiac and Oncology Centers are among the largest and the most advanced in the west of Saudi Arabia. Methods: This study used a mixed-methods approach. The study’s quantitative component included a revision of retrospective data of KAMC’s operational parameters, such as bed capacity, bed occupancy rate (BOR), and length of stay (LOS). For the study’s qualitative component, researchers used semi-structured interviews. Personnel at different management levels were interviewed to explore factors that might influence an increase in the BOR and patients’ LOS. Results: KAMC’s key performance indicators showed an overall LOS of 9.9 days and an overall BOR of 88%. Analysis broken down by the department shows the General and the Neuroscience Intensive Care Units and the Hematology/Oncology departments to have the highest BOR, ranging between 95% and 97%. Qualitative analysis of semi-structured interviews suggested that the delays in the provision of consultation services among the hospital’s inpatients were among the factors that have the biggest influence on bed occupancy; the presence of dedicated case managers in every department was among the top suggested solutions. Conclusion: A battery of interventions might help to reduce the LOS by supporting timely patient discharge. The presence of a dedicated case manager with a medical background in each department is one of the most practical interventions. Other vital opportunities include reinforcement of back-referral policies, revising policies, and having cluster-level referral policies and bed management strategies. Although such efforts are likely to have a positive effect, they are expected to only partially meet the existing gap, which probably requires increasing the number of available active beds.