A Discrete Event Simulation Model to Manage Bed Usage for Non-Elective Admissions in a Geriatric Medicine Speciality

Over the past decade, the non-elective admissions in
the UK have increased significantly. Taking into account limited
resources (i.e. beds), the related service managers are obliged to
manage their resources effectively due to the non-elective admissions
which are mostly admitted to inpatient specialities via A&E
departments. Geriatric medicine is one of specialities that have long
length of stay for the non-elective admissions. This study aims to
develop a discrete event simulation model to understand how
possible increases on non-elective demand over the next 12 months
affect the bed occupancy rate and to determine required number of
beds in a geriatric medicine speciality in a UK hospital. In our
validated simulation model, we take into account observed frequency
distributions which are derived from a big data covering the period
April, 2009 to January, 2013, for the non-elective admission and the
length of stay. An experimental analysis, which consists of 16
experiments, is carried out to better understand possible effects of
case studies and scenarios related to increase on demand and number
of bed. As a result, the speciality does not achieve the target level in
the base model although the bed occupancy rate decreases from
125.94% to 96.41% by increasing the number of beds by 30%. In
addition, the number of required beds is more than the number of
beds considered in the scenario analysis in order to meet the bed
requirement. This paper sheds light on bed management for service
managers in geriatric medicine specialities.