Capacity Audit Tool: identifying inpatient delays to maximise service improvement
Kathryn M. Zeitz A B and Katie Tucker AA Royal Adelaide Hospital, North Terrace, Adelaide, SA 5045, Australia. Email: katie.tucker@health.sa.gov.au
B Corresponding author. Email: kathryn.zeitz@health.sa.gov.au
Australian Health Review 34(4) 395-399 https://doi.org/10.1071/AH08671
Submitted: 29 July 2008 Accepted: 8 June 2010 Published: 25 November 2010
Abstract
Objective. This case study describes the development of a process and tool, the ‘Capacity Audit’, to quantify key inpatient delays in an acute care tertiary hospital setting.
Method. The Capacity Audit Tool is an adaption of an existing Wasted Capacity Audit Tool supported by a systematic process to assess and quantify the status of patients in a cohort of inpatient beds. This paper reports on the application of the tool for all inpatient beds in an acute tertiary hospital assessed twice a day for a 15-day period.
Results. In total, 820 surveys were completed. This represents 9126 beds assessed in the morning shift and 9261 in the afternoon shift over the 15-day period. The simplicity of the Capacity Audit Tool and the process to collect data resulted in a 95% compliance rate. The audit revealed that 76% of beds audited were being used appropriately for acute care. The top three delays were patients awaiting a post-acute care, the bed being empty and awaiting a patient to be allocated, and patients awaiting discharge transport.
Conclusions. The Capacity Audit Tool facilitates a high level of compliance, providing a comprehensive understanding of the use of hospital bed stock and bed capacity. In addition, the process reveals key inpatient delays to target critical improvement strategies.
What is known about the topic? There is only one known tool available to assess acute care hospital bed capacity. The Institute of Health Care Improvement describes a wasted capacity audit tool but there are minimal supporting materials to facilitate application of this tool more broadly.
What does this paper add? This paper describes the application of an audit process, ‘Capacity Audit’, that can assist hospitals to measure bed capacity and reveal the key inpatient delays to bed turnover.
What are the implications for practitioners? The application of the Capacity Audit process enables practitioners to systematically assess key inpatient delays, reveal wasted capacity in bed usage and target improvement strategies in an evidenced versus anecdotal way.
References
[1] Haraden C. Wasted capacity audit tool. Institute for Healthcare Improvement (IHI), USA; 2006. Available at http://www.ihi.org/ihi [verified 15 November 2006].[2] Thacker D, Zeitz K, Beal C, Harlin K, Najar K. CNAHS Patient Journey Redesign ‘Capacity Audit Toolkit’ Central Northern Adelaide Health Service, SA Health; 2008.
