bed management

P_RN, ADN, RN · Sep 2, 2001

Hello DLOCKA and welcome to the forum. I know very little about the protocol in the UK.

In my facility (USA) we had a Bed Control office. All admissions were arranged through them. A Registered Nurse worked with the office directing patients to the most appropriate unit. OUr rooms were mostly private with possibly 2-3 semiprivate (2bed) rooms on each floor. There was a separate Children's Hospital that occupied one floor.

Control tried to keep the patients appropriate, but that didn't always work. On orthopaedics I have taken care of gestational diabetics, post CVA, 5 year old children with appendectomies etc.

Emergency (A&E) patients were seen by the supervisor who then contacted bed control with placement overriding any "scheduled" admissions. I'm not certain that was always best, because it led to postoperative patients remaining in the recovery/post anaesthesia unit sometimes as long as 48 hours due to no bed availability.

YOu may also want to post this question on the management forum here.

Mijourney · Sep 3, 2001

Hi DLOCKA. I'm curious. Does your bed management department work out of the emergency room department? Will it be staffed by nurses or other staff or a combination of both?

I don't know about the UK, but I believe the EMTALA law in the states that requires for all emergency admissions to be screened by a physician has made bed management a core function within the hospital. On the back end, more and more hospitals in the states are employing hospitalists which are doctors who work in a unit or a cluster of units and see patients for private physicians who may be overwhelmed with office duties due to managed care. Hospitals are also starting to employ case managers in the emergency rooms. Both of these strategies are supposedly used for bed control. Some hospitals also employ triage nurses in a call center for bed control. Call center nurses are available 24/7 and they use approved, standardized medical protocol to advise people who call in with health and medical concerns. Now that I think about that, in addition to going to the management forum for advice, if there's a triage nurse forum, you may consider that also. Best wishes.

P_RN, ADN, RN · Sep 4, 2001

Mijourney, maybe I misspoke? I didn't mean to say that the ER patients were ADMITTED by someone other than the doctor. They were all admitted by a physician either through ER or from the doctors' offices. I meant only that our admissions office was called Bed Control.

That unfortunately took all "control" out of the hands of the nrusing units. First we would get inappropriate patients, then "our type patients" would end up being put on inappropriate units so we played shift-the-patient almost every day. Something ELSE for the nurses to do in our spare time.