تحليل بهره‌وري تخت بيمارستاني با استفاده از يك شاخص نوآورانه

Analyzing Hospital Bed Productivity Using an Innovative Indicator

زﻣﯿﻨﻪ و ﻫﺪف: ﺑﻬﺮهوري ﺗﺨﺖ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ از ﻣﻮاردي اﺳﺖ ﮐﻪ ﺑﺮاي اﯾﺠﺎد ﻣﺪﯾﺮﯾﺖ ﮐﺎرآﻣﺪ ﺑﺴﯿﺎر ﺣﯿﺎﺗﯽ اﺳﺖ. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻇﺮﻓﯿﺖ ﺑﻬﺮهﻣﻨﺪي ﺗﺨﺖ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ در ﺑﯿﻤﺎرﺳﺘﺎن اﻟﻒ در اﺻﻔﻬﺎن ﺑﺎ اﺳﺘﻔﺎده از ﯾﮏ ﺷﺎﺧﺺ ﻧﻮآوراﻧﻪ ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. روشﻫﺎ: ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﻪ روش ﺗﻮﺻﯿﻔﯽ در ﺳﺎل 1397 اﻧﺠﺎم ﺷﺪ. ﺑﺎ اﺳﺘﻔﺎده از دادهﻫﺎي آﻣﺎري ﺑﯿﻤﺎرﺳﺘﺎن اﻟﻒ، ﺑﺮرﺳﯽ ﻣﯿﺪاﻧﯽ، ﺑﺮرﺳﯽ ﭘﺮواﻧﻪ رﺳﻤﯽ ﺑﯿﻤﺎرﺳﺘﺎن و ﺟﺎﯾﮕﺬاري آن در ﺷﺎﺧﺺ ﭘﯿﺸﻨﻬﺎدي اﯾﻦ ﻣﻄﺎﻟﻌﻪ، ﻇﺮﻓﯿﺖ ﺑﻬﺮهﻣﻨﺪي ﺗﺨﺖ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ ﺑﺮاي ﮐﻞ ﺑﯿﻤﺎرﺳﺘﺎن و ﺳﻪ ﺑﺨﺸﯽ ﮐﻪ ﺑﺼﻮرت ﺗﺼﺎدﻓﯽ اﻧﺘﺨﺎب ﺷﺪﻧﺪ )ﺑﺨﺶ ﮔﻮارش، ﺟﺮاﺣﯽ ﻧﻮزادان و ﺑﺨﺶ ﻗﻠﺐ-ﭘﻮﺳﺖ-ﻏﺪد-post CCU( ﻣﺤﺎﺳﺒﻪ و ﺗﺤﻠﯿﻞ ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻇﺮﻓﯿﺖ ﺑﻬﺮهﻣﻨﺪي ﺗﺨﺖ ﮐﻞ ﺑﯿﻤﺎرﺳﺘﺎن 50/7%، ﺑﺨﺶ ﮔﻮارش 68/9%، ﺑﺨﺶ ﺟﺮاﺣﯽ ﻧﻮزادان 24/9% و ﺑﺨﺶ ﻗﻠﺐ، ﭘﻮﺳﺖ، ﻏﺪد و post CCU 70/9 % ﺑﺪﺳﺖ آﻣﺪ. ﺗﺄﺛﯿﺮ ﺗﺨﺖ ﻓﻌﺎل ﺑﺮ ﻓﺮﻣﻮل ﺑﻪ دﻟﯿﻞ ﺗﻐﯿﯿﺮ ﮐﺎرﺑﺮي داﺋﻢ ﯾﺎ ﻣﻮﻗﺖ )ﺗﻌﻤﯿﺮات( ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ ﮐﻪ ﺳﺒﺐ ﻣﯽﺷﺪ ﺑﺮﺧﯽ ﺗﺨﺖﻫﺎ از ﭼﺮﺧﻪ ﻓﻌﺎﻟﯿﺖ ﺧﺎرج ﺷﻮﻧﺪ. ﻣﺸﮑﻞ درﺻﺪ اﺷﻐﺎل ﺗﺨﺖ ﻧﯿﺰ در ﻣﻮرد ورودي ﺑﯿﻤﺎران و ﺗﻮزﯾﻊ ﺑﯿﻤﺎران در ﺑﺨﺶﻫﺎ و ﺗﺄﺛﯿﺮ ﻣﻨﻔﯽ ﻣﺘﻮﺳﻂ ﻣﺪت اﻗﺎﻣﺖ ﺑﺮ ﻓﺮﻣﻮل ﻧﯿﺰ از ﻧﻈﺮ ﻋﻠﻞ ﺳﯿﺴﺘﻤﺎﺗﯿﮏ و ﻓﺮدي ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻓﺮﻣﻮل ﭘﯿﺸﻨﻬﺎدي اراﺋﻪ ﺷﺪه در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﺳﻨﺠﺶ ﻣﯿﺰان اﺳﺘﻔﺎده از ﻇﺮﻓﯿﺖ ﻣﻮﺟﻮد و ﺷﻨﺎﺳﺎﯾﯽ ﻋﻠﻞ ﻋﺪم اﺳﺘﻔﺎده از ﺣﺪاﮐﺜﺮ ﻇﺮﻓﯿﺖ ﺑﺮاي رﺳﯿﺪن ﺑﻪ ﻇﺮﻓﯿﺖ ﺑﻬﺮهﻣﻨﺪي ﻣﻄﻠﻮب ﺑﻪ ﻣﺪﯾﺮان در اﻓﺰاﯾﺶ ﺑﻬﺮهوري ﺑﯿﻤﺎرﺳﺘﺎن ﮐﻤﮏ ﺧﻮاﻫﺪ ﮐﺮد.

Background and Aim: Hospital bed productivity is crucial for efficient management. In this study, the capacity of hospital beds in Al-Zahra Hospital in Isfahan was evaluated using an innovative indicator. Methods: The present study was performed by a descriptive method in 2018. Using the statistical data of Al-Zahra Hospital, field survey, review of the official license of the hospital and putting in the proposed indicator of this study, hospital bed productivity for the whole hospital and three randomly selected wards (gastrointestinal ward, neonatal surgery ward and heart-dermatology-endocrine-post CCU ward) was calculated and analyzed. Results: The overall hospital bed productivity was 50.7%. The indicator was estimated for the gastrointestinal ward 68.9%, neonatal surgery ward 24.9%, and for the heart-dermatology-endocrine-post CCU ward 70.9%. The effect of the active bed on the formula was investigated which caused some beds to exit from the activity cycle. The problem of bed occupancy rate in terms of patient admission and patient distribution in wards and the negative effect of the average length of stay in the formula was also examined for systematic and individual causes. Conclusion: The proposed formula presented in this study will help managers to increase hospital productivity by measuring the extent of existing capacity utilization and identifying the reasons for not using the maximum capacity to achieve optimal utilization capacity.