Evaluation of ICU Bed Allocation Policy Implementation in Reducing Surgery Cancellation and Inpatient Care Indicators: A Qualitative Study
DOI:
https://doi.org/10.35870/emt.v10i1.5378Keywords:
ICU Beds Allocation, Surgical-Medical ICU, Inpatient Indicators, Surgery Cancellation Rate (SCR), Hospital Financial Loss RisksAbstract
Harapan Kita Women and Children Hospital Jakarta (RSABHK) receives referrals from patients in various regions every day. RSABHK performs at least 50 surgeries and procedures that require anesthesia daily. Approximately 10% of these procedures require ICU beds for post-operative management. RSABHK ICU categorizes patient beds into two categories: surgical and medical. This study aims to evaluate bed distribution policies based on surgical and medical conditions regarding the number of surgical cancellations and hospital indicators in the ICU. The research method is a qualitative observational retrospective study of indicators for BOR, LOS, TOI, BTO, surgical cancellation rates (SCR) and hospital financial risks 20 months preceding the policy implementation compared to 20 months following the policy implementation. The results showed that after the policy was implemented, there was a 54.45% reduction in the number of SCR, a 9.7% increase in BOR, 10.97% decrease in LOS, 56.16% decrease in TOI, and 24.54% increase in BTO. More than 30 million rupiahs reduced hospital risk of financial loss. The conclusion is that the policy is effective in reducing the rate of stagnation, the rate of surgery cancellations, and the risk of monetary loss for the hospital.
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Amurwani, F. S., & Rofi’i, M. (2018). Faktor Penyebab Penundaan Operasi Elektif di Rumah Sakit Pemerintah di Semarang. Jurnal Ilmu Keperawatan Medikal Bedah, 1(1), 17-25.
Bosque-Mercader, L., & Siciliani, L. (2023). The association between bed occupancy rates and hospital quality in the English National Health Service. The European Journal of Health Economics, 24(2), 209-236. https://doi.org/10.1007/s10198-022-01464-8.
Cunningham, J. B., Kernohan, G., & Rush, T. (2006). Bed occupancy, turnover intervals and MRSA rates in English hospitals. British Journal of Nursing, 15(12), 656–660. https://doi.org/10.12968/bjon.2006.15.12.21398.
de Oliveira, O. H., Pinto, R., DasGupta, T., Sirtartchouck, L., Rashleigh, L., Cross, N., Srikandarajah, A., Sukumaran, J., Wunsch, H., & Cuthbertson, B. H. (2019). Assessment of need for lower-level acuity critical care services at a tertiary acute care hospital in Canada: A prospective cohort study. Journal of Critical Care, 53, 91–97. https://doi.org/10.1016/j.jcrc.2019.06.004.
Fowler, A. L., Cullivan, O., Sibarte, S., O’Shea, A., Waldron, R., Khan, I., Khan, W., & Barry, K. M. (2019). Utilisation of critical care services for surgical patients in a model three hospital. Irish Journal of Medical Science, 188, 1137–1142. https://doi.org/10.1007/s11845-019-01981-1.
Isnaini, N., Fitriani, A. D., Nuraini, N., Sudiro, S., & Anggraini, I. (2024). Assessment of turnover interval (TOI) of inpatient services in hospitals. Jurnal Promotif Preventif, 7(3), 494–503.
Kaier, K., Mutters, N. T., & Frank, U. (2012). Bed occupancy rates and hospital-acquired infections—Should beds be kept empty? Clinical Microbiology and Infection, 1–5. https://doi.org/10.1111/j.1469-0691.2012.03956.x.
Koushan, M. (2022). Improving surgical service delivery: Managing surgery cancellations with comprehensive scheduling and simulation of operating room capacity management policies (Doctoral dissertation, University of Otago).
Park, K. U., Eichenhorn, M., DiGiovine, B., Ritz, J., Jordan, J., & Rubenfeld, I. (2018). Different harm and mortality in critically ill medical vs. surgical patients: Retrospective analysis of variation in adverse events in different intensive care units. The Permanente Journal, 16(189). https://doi.org/10.7812/TPP/16-189.
Pinheiro, S. L., Vasconcelos, R. O., Oliveira, J. L. C. D., Matos, F. G. O. A., Tonini, N. S., & Alves, D. C. I. (2017). Surgical cancellation rate: quality indicator at a public university hospital. Revista Mineira de Enfermagem, 21.
Rohrig, S. A. H., Lance, M. D., & Malmstrom, M. F. (2019). Surgical intensive care—Current and future challenges? Qatar Medical Journal, 2019, 1–4. https://doi.org/10.5339/qmj.2019.qccc.3.
Sudra, R. I. (2010). Statistik rumah sakit (1st ed.). Graha Ilmu.
Tipton, K., Lathren, B. F., & McDonald, N. K. (2021). Interventions to decrease hospital length of stay (Vol. 40). Rockville, MD: Agency for Healthcare Research and Quality.
Toptas, M., Samanci, N. S., Akkoc, E., Yucetas, E., Cebeci, E., Sen, O., Can, M. M., & Ozturk, S. (2018, March 20). Factors affecting the length of stay in the intensive care unit: Our clinical experience. Hindawi BioMed Research International, 1–4.
Volpe, F. M., de Miranda Magalhães, A. C., & Rocha, A. R. (2013). High bed occupancy rates: Are they a risk for patients and staff?. JBI Evidence Implementation, 11(4), 312-316.
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