The digital transformation applied to bed management in hospitals

Freitas, Rute; Araújo, Claudia

doi:10.1590/1678-6971/eRAMR240099

Rute Freitas Correspondence concerning this article should be addressed to Rute Freitas, Rua Joaquim Floriano, 533, Itaim Bibi, São Paulo, São Paulo, Brazil, ZIP code 04534-011. Email: ru_freitas@yahoo.com.br

Rute Freitas is now the Director of Operations of Sírio-Libanês Hospital; Claudia Araújo is now an associate professor at the Center for Health Services Management Studies of Institute of Graduate Studies and Research in Administration (Coppead) of Federal University of Rio de Janeiro (UFRJ).

Getulio Vargas Foundation, São Paulo, SP, Brazil

https://orcid.org/0009-0000-8415-9163

Claudia Araújo

Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

https://orcid.org/0000-0003-0290-4807

Correspondence concerning this article should be addressed to Rute Freitas, Rua Joaquim Floriano, 533, Itaim Bibi, São Paulo, São Paulo, Brazil, ZIP code 04534-011. Email: ru_freitas@yahoo.com.br

RAM does not have information about the existence of open data regarding this manuscript.

Figures (4)
Tables (2)

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Figure 1
Key benefits expected by respondents based on the frequency of citations during the interviews

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Figure 2
Frequency of answers related to benefits, grouped by DT elements

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Figure 3
Main difficulties expected by respondents based on the frequency of citations during the interviews

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Figure 4
Frequency of answers related to the difficulties grouped by DT elements

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Table 1
Profile of interviewees

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Specific objectives established Questions asked in the field work (interview script) Understand how bed management is performed in the hospital. 1.1 How is the process of managing beds done in the hospital?1.2 Is there a responsible area? (Kerpedzhiev et al., 2019; Baru et al., 2015). 1.3 How is the interface done of the Housekeeping (Cleaning) and Maintenance area with the bed management area for a bed to become open for use? (Raffa et al., 2017; Cameron et al., 2015).1.4 How is the process of requesting beds done by the Emergency Care Center, Surgical Center (elective and emergency surgeries), Clinical Hospitalization, and Internal Transfers? (Barado et al., 2012; Cameron et al., 2015; Raffa et al., 2017).1.5 What indicators do you monitor regarding the bed management process? (average length of stay, occupancy rate, replacement interval, bed rotation, mean time of bed availability after medical discharge?) (Raffa et al., 2017; Rocha et al., 2018). Understand if DT has been applied to assist in the bed management flow. 2.1 What management tools do you use for bed management? (Barado et al., 2012; Landa et al., 2018; Dai & Shi, 2019).2.2 Do you use real-time data? (Barado et al., 2012; Landa et al., 2018; Rocha et al., 2018; Abedian et al., 2018; Dai & Shi, 2019).2.3 Do you consider the tools to be appropriate? Why? (Do they meet the needs of requests for a bed from Emergency Care, Surgical Center, elective hospitalization, internal transfers?) Identify the perceived DT benefits in the control of the resources (structure) of hospital beds. What are the perceived DT benefits in the control of the resources (structure) of hospital beds? (Reis et al., 2018) Identify the perceived difficulties of implementing DT for controlling hospital beds. What are the difficulties perceived when implementing DT for controlling hospital beds? (Reis et al., 2018)

Nature	Sector	Interviewee	Education	Position
Presidency	Presidency	E19	Doctor	Assessor to the President
Bed control	Critical Cardiology Units	E11	Biomedicine	Administrative Manager
	Critical Cardiology Units	E12	Nurse	Care Manager
	General Critical Units	E9	Doctor	Medical Manager
	General Critical Units	E10	Nurse	Care Manager
	Bed Control	E13	Nurse	Coordinator
Bed requesters	Patients Admitted	E1	Doctor	Medical Superintendent
	Patients Admitted	E2	Administrator	Administrative Manager
	Emergency Care	E5	Nurse	Care Manager
	Surgical Unit	E8	Nurse	Care Manager
	Emergency Care	E4	Doctor	Medical Manager
	Patients Admitted	E3	Nurse	Care Manager
	Surgical Center and Emergency Care	E6	Administrator	Administrative Manager
	Surgical Unit	E7	Doctor	Medical Manager
Bed turnover support	Maintenance	E17	Engineer	Administrative Manager
	Housekeeping	E16	Administrator	Care Manager
	Facilities Director	E15	Nurse	Superintendent
	Medical Practices	E14	Doctor	Medical Manager
	Patients Admitted	E18	Administrator	Administrative Coordinator

Specific objectives established	Questions asked in the field work (interview script)
Understand how bed management is performed in the hospital.	1.1 How is the process of managing beds done in the hospital? 1.2 Is there a responsible area? (Kerpedzhiev et al., 2019Kerpedzhiev, G., Manner-Romberg, T., Meindl, O., & Regal, C. (2019). Towards a maturity model: Bed management capabilities in hospitals. Proceedings of the European Conference on Information Systems (ECIS2019), Stockholm-Uppsala, Sweden, 27.; Baru et al., 2015Baru, R. A., Cudney, E. A., Guardiola, I. G., Warner, D. L., & Phillips, R. E. (2015, January). Systematic review of operations research and simulation methods for bed management. Proceedings of the IIE Annual Conference and Expo 2015, Nashville, USA.). 1.3 How is the interface done of the Housekeeping (Cleaning) and Maintenance area with the bed management area for a bed to become open for use? (Raffa et al., 2017Raffa, C., Malik, A. M., & Pinochet, L. H. C. (2017). A tecnologia da informação no apoio à gestão de leitos: Um estudo multicaso em hospitais privados. Revista Administração em Diálogo, 19(3), 1-23. https://doi.org/10.23925/2178-0080.2017v19i3.31356 https://doi.org/10.23925/2178-0080.2017v... ; Cameron et al., 2015Cameron, A., Rodgers, K., Ireland, A., Jamdar, R., & McKay, G. A. (2015). A simple tool to predict admission at the time of triage. Emergency Medicine Journal, 32(3), 174-179. https://doi.org/10.1136/emermed-2013-203200 https://doi.org/10.1136/emermed-2013-203... ). 1.4 How is the process of requesting beds done by the Emergency Care Center, Surgical Center (elective and emergency surgeries), Clinical Hospitalization, and Internal Transfers? (Barado et al., 2012Barado, J., Esparza, L., & Ochoa, S. (2012). A mathematical model for simulating daily bed occupancy in an intensive care unit. Critical Care Medicine, 40(4), 1098-1104. https://doi.org/10.1097/CCM.0b013e3182374828 https://doi.org/10.1097/CCM.0b013e318237... ; Cameron et al., 2015Cameron, A., Rodgers, K., Ireland, A., Jamdar, R., & McKay, G. A. (2015). A simple tool to predict admission at the time of triage. Emergency Medicine Journal, 32(3), 174-179. https://doi.org/10.1136/emermed-2013-203200 https://doi.org/10.1136/emermed-2013-203... ; Raffa et al., 2017). 1.5 What indicators do you monitor regarding the bed management process? (average length of stay, occupancy rate, replacement interval, bed rotation, mean time of bed availability after medical discharge?) (Raffa et al., 2017Raffa, C., Malik, A. M., & Pinochet, L. H. C. (2017). A tecnologia da informação no apoio à gestão de leitos: Um estudo multicaso em hospitais privados. Revista Administração em Diálogo, 19(3), 1-23. https://doi.org/10.23925/2178-0080.2017v19i3.31356 https://doi.org/10.23925/2178-0080.2017v... ; Rocha et al., 2018Rocha, H. A. L., Santos, A. K. L. C., Alcântara, A. C. C., Lima, C. S. S. C., Rocha, S. G. O., Cardoso, R. M., & Cremonin, J. R. (2018). Bed management team with Kanban web-based application. International Journal for Quality in Health Care, 30(9), 708-714. https://doi.org/10.1093/intqhc/mzy108 https://doi.org/10.1093/intqhc/mzy108... ).
Understand if DT has been applied to assist in the bed management flow.	2.1 What management tools do you use for bed management? (Barado et al., 2012Barado, J., Esparza, L., & Ochoa, S. (2012). A mathematical model for simulating daily bed occupancy in an intensive care unit. Critical Care Medicine, 40(4), 1098-1104. https://doi.org/10.1097/CCM.0b013e3182374828 https://doi.org/10.1097/CCM.0b013e318237... ; Landa et al., 2018Landa, P., Sonnessa, M., Tànfani, E., & Testi, A. (2018). Multiobjective bed management considering emergency and elective patient flows. International Transactions in Operational Research, 25(1), 91-110. https://doi.org/10.1111/itor.12360 https://doi.org/10.1111/itor.12360... ; Dai & Shi, 2019). 2.2 Do you use real-time data? (Barado et al., 2012Barado, J., Esparza, L., & Ochoa, S. (2012). A mathematical model for simulating daily bed occupancy in an intensive care unit. Critical Care Medicine, 40(4), 1098-1104. https://doi.org/10.1097/CCM.0b013e3182374828 https://doi.org/10.1097/CCM.0b013e318237... ; Landa et al., 2018; Rocha et al., 2018Rocha, H. A. L., Santos, A. K. L. C., Alcântara, A. C. C., Lima, C. S. S. C., Rocha, S. G. O., Cardoso, R. M., & Cremonin, J. R. (2018). Bed management team with Kanban web-based application. International Journal for Quality in Health Care, 30(9), 708-714. https://doi.org/10.1093/intqhc/mzy108 https://doi.org/10.1093/intqhc/mzy108... ; Abedian et al., 2018Abedian, S., Bitaraf, E., & Askari, M. (2018). Advantages of a web-based real-time bed-management system for hospital admission monitoring in Iran. In A. Ugon, D. Karlsson, G. O. Klein, & A. Moen (Eds.), Studies in Health Technology and Informatics (pp. 536-540). IOS Press. https://doi.org/10.3233/978-1-61499-852-5-536 https://doi.org/10.3233/978-1-61499-852-... ; Dai & Shi, 2019). 2.3 Do you consider the tools to be appropriate? Why? (Do they meet the needs of requests for a bed from Emergency Care, Surgical Center, elective hospitalization, internal transfers?)
Identify the perceived DT benefits in the control of the resources (structure) of hospital beds.	What are the perceived DT benefits in the control of the resources (structure) of hospital beds? (Reis et al., 2018Reis, J., Amorim, M., & Mel, N. (2018). Digital transformation: A literature review and guidelines for future research. In A. Rocha, H. Adeli, L. P. Reis, & S. Costanzo (Eds.), Trends and advances in information systems and technologies (Vol. 745, pp. 411-421). Springer. https://doi.org/10.1007/978-3-319-77703-0_41 https://doi.org/10.1007/978-3-319-77703-... )
Identify the perceived difficulties of implementing DT for controlling hospital beds.	What are the difficulties perceived when implementing DT for controlling hospital beds? (Reis et al., 2018Reis, J., Amorim, M., & Mel, N. (2018). Digital transformation: A literature review and guidelines for future research. In A. Rocha, H. Adeli, L. P. Reis, & S. Costanzo (Eds.), Trends and advances in information systems and technologies (Vol. 745, pp. 411-421). Springer. https://doi.org/10.1007/978-3-319-77703-0_41 https://doi.org/10.1007/978-3-319-77703-... )

[1] Correspondence concerning this article should be addressed to Rute Freitas, Rua Joaquim Floriano, 533, Itaim Bibi, São Paulo, São Paulo, Brazil, ZIP code 04534-011. Email: ru_freitas@yahoo.com.br

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The digital transformation applied to bed management in hospitals

A transformação digital no gerenciamento do fluxo de leitos nos hospitais

Abstract