TY - JOUR T1 - Global hospital bed utilization crisis. A different approach JF - Saudi Medical Journal JO - Saudi Med J SP - 434 LP - 436 VL - 31 IS - 4 AU - Abdelkarim Waness AU - Jalal U. Akbar AU - Mubashar Kharal AU - Salih BinSalih AU - Mohammed Harakati Y1 - 2010/04/01 UR - http://smj.org.sa/content/31/4/434.abstract N2 - OBJECTIVE: To test the effect of improved physician availability on hospital bed utilization.METHODS: A prospective cohort study was conducted from 1st January 2009 to 31st March 2009 in the Division of Internal Medicine (DIM), King Abdul-Aziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. Two clinical teaching units (CTU) were compared head-to-head. Each CTU has 3 consultants. The CTU-control provides standard care, while the CTU-intervention was designed to provide better physician-consultant availability. Three outcomes were evaluated: patient outsourcing to another hospital, patient discharge during weekends, and overall admissions. Statistical analysis was carried out by electronic statistics calculator from the Center for Evidence-Based Medicine.RESULTS: Three hundred and thirty-four patients were evaluated for admission at the Emergency Room by both CTU's. One hundred and eighty-three patients were seen by the CTU-control, 6 patients were outsourced, and 177 were admitted. One hundred fifty-one patients were seen by the CTU-intervention: 39 of them were outsourced, and 112 were admitted. Forty-eight weekend patient discharges occurred during this period of time: 21 by CTU-control, and 27 by CTU-intervention. Analysis for odds ratio in both the rate of outsourcing, and weekend discharges, showed statistical significance in favor of the intervention group.CONCLUSION: The continuous availability of a physician-consultant for patient admission evaluation, outsourcing, or discharge during regular weekdays and weekends at DIM, KAMC proved to have a positive impact on bed utilization. ER -