Topic 4: Bed planning

In a hospital, different decisions are made regarding bed planning. The total number of beds,
for example, is a strategic decision. It depends on multiple aspects such as the structure of
the hospital and the number of beds in each room. Also, the equipment each specialism
needs are necessary to take into account. Yearly, these beds are distributed among the
different specialisms, often this is done in clusters of specialisms. The historical data is used
to forecast the bed demand per specialism for the coming year. To avoid unbalance in bed
use, bed pooling or flexible beds can be used. However, both have negative effects on travel
times and nurse requirements.
Gabrielle van Nes (10) introduces five alternatives for the current bed allocation. Currently,
the hospital only has a fixed allocation of beds. These alternatives include an optimization of
this fixed allocation, introducing one large flex department to the current situation, adding
one flex department on each floor, adding small flex departments in between two adjacent
departments, and adding small flex departments in between two adjacent departments,
including different floors. During the class discussion, it became clear that the alternative
whereby there are … option 4 by the fixed allocation of beds for each specialism is
preferred based on multiple criteria. One of the main criteria is allocating patients to their
own department as this ensures better service and patients are surrounded by patients with
similar problems. This helps in the daily rhythm.

However, one should note that depending on the weight put on each criteria, the preferred
alternative could differ. For example when more importance is placed on .., one would
probably choose for another alternative namely … Furthermore, it is quite hard to determine
the relative weight for each criteria.
For example when more importance is placed on bed occupancy, one would probably
choose for alternative 2, because in one flex department the uncertainty of different
departments is cancelled out to some extend, whereby less beds are neccessart.