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Bed management is the allocation and provision of beds, especially in a hospital where beds in specialist wards are a scarce resource. The "bed" in this context represents not simply a place for the patient to sleep, but the services that go with being cared for by the medical facility: admission processing, physician time, nursing care, necessary diagnostic work, appropriate treatment, and so forth.
In the UK, acute hospital bed management is usually performed by a dedicated team and may form part of a larger process of patient flow management.
Because hospital beds are economically scarce resources, there is naturally pressure to ensure high occupancy rates and therefore a minimal buffer of empty beds. However, because the volume of emergency admissions is unpredictable, hospitals with average occupancy levels above 85 per cent "can expect to have regular bed shortages and periodic bed crises." In the first quarter of 2017 average overnight occupancy in English hospitals was 91.4%.
Shortage of beds can result in cancellations of admissions for planned (elective) surgery, admission to inappropriate wards (medical vs. surgical, male vs. female etc.), delay admitting emergency patients, and transfers of existing inpatients between wards, which "will add a day to a patient’s length of stay".
These can be politically sensitive issues in publicly funded healthcare systems. In the UK there has been concern over inaccurate and sometimes fraudulently manipulated waiting list statistics, and claims that "the current A&E target is simply not achievable without the employment of dubious management tactics." In 2013 two Stafford Hospital nurses were struck off the nursing register for falsifying A&E discharge times between 2000 and 2010 to avoid breaches of four-hour waiting targets.
In 2018 NHS England started a new initiative to reduce the number of what it now called "stranded" or "super stranded" patients, super stranded being people in hospital for more 20 days. About 18,000 of the 101,259 acute and general beds in English NHS hospitals were occupied by “super stranded” patients in May 2018. By August 2018 2,338 of these beds had been freed. Some of the delays were related to social care, but more related to the management of inpatient stays.