One of the common issues that most of the popular hospitals face is that they frequently run out of their bed capacity and find it difficult to accommodate new patients seeking admission. This creates a problem for both, patients and the hospital, and if not handled properly can lead to patient’s dissatisfaction, inadequate care of patient or even losing the patient to other hospitals. It is prudent for hospitals to have the policy to address such situations so that negative impact of unavailability of beds can be prevented. This post describes a sample policy on how can hospitals manage such situations effectively.
POLICY: In case the bed is not available for admitting a new patient following policy shall be followed. Responsibility for implementing this shall be with the admissions staff under the supervision of manager patient care. Understanding of how hospital services are priced is important to address this issue.
1. If the bed in the category desired by patient is not available, the patient shall be informed about the same and shall be offered bed/room in another category which is closest to the desired category. Patient shall be clearly explained about facilities and the charges of the category and if that would cause any difference in the cost of medical care. Patient shall also be informed about the waiting time for bed becoming available in the category they desired and whether they can be shifted during their stay to their desired category. An alternative policy for this situation can be to admit the patient in the next higher category at the charge of the category that they desired for and as soon as the bed become available in the desired category, shift them back. This will help in increasing building customer satisfaction and loyalty towards the hospital. (Check - sample patient satisfaction feedback form)
2. If the bed in other categories are also not available or patient doesn’t want to be admitted in any other category the patient shall be informed about the waiting period for the bed to become available in the desired category. If there are more than one patient, they shall be kept on waiting list on they shall be updated about the status from time to time through phone or email.
3. If admission cannot be post-poned then the patient shall be admitted in a temporary holding area. Identified and designated temporary holding areas shall be used for admitting such patients. Such areas shall be equipped with basic resources required for patient care. Capacity of temporary holding areas and maximum duration for which a patient can be kept there shall be determined and it shall not be exceeded. Patient shall be shifted from temporary holding area as soon as the bed becomes available.
4. If temporary holding area is not available or full and patient cannot wait, then the patient shall be informed about alternate hospitals where he/she can get admission. To facilitate, the admission department must have contact numbers of those hospitals and they can get the information of bed availability for the patient.
5. If patient is in critical condition and bed is not available in ICU then the clinical condition of patient shall be assessed by the intensivist to determine the priority of ICU admission. If the condition is of high priority, effort shall be made to see if any stable patient in ICU can be discharged or shifted to HDU for making bed available for the new patient. Hospital must also keep one critical care bed vacant all time to ensure that such patients can be temporarily provided critical care
6. Behaviour towards patient: At all time the behaviour of admission staff towards patient shall be courteous and helpful. As much help and information shall be provided to the patient, as possible, during such situations
7. Decision: Patient has the right to make the final decision of admission and choice of the category of bed. The admission staff shall help them in making decision but shall not influence for any specific decision
8. Uniformity: The policy shall be uniformly applied for all such patients and no bias or discrepancy shall be done with any patient in case of making bed available.
