overflow - to exceed limits or capacity

over-complement / over-capacity / overflow beds

Hospital beds are a scarce resource and always in need. The beds are often organized by clinical specialties for better patient care.

When the Accident & Emergency Department (A&E) admits a patient, there may not be an available bed that matches the requested specialty.

The patient may be thus asked to wait at the A&E till a matching bed is available, or assigned a bed from a different specialty, which results in bed overflow.
While this allows the patient to have faster access to an inpatient bed and treatment, it creates other problems.
For instance, nursing care may be suboptimal and the doctors will need to spend more time to locate the overflow patients.
The decision to allocate an overflow bed, or to let the patient wait a bit longer, can be a complicated one.
While there can be a policy to guide the bed allocation decision, in reality it depends on clinical calls, current supply and waiting list, projected supply (i.e. planned discharges) and demand.
The extent of bed overflow can therefore vary greatly, both in time dimension and across specialties. In this study, we extracted hospital data and used statistical and data mining approaches to identify the patterns behind bed overflow.
With this insight, the hospital administration can be better equipped to devise strategies to reduce bed overflow and therefore improve patient care.
Computational results show the viability of these intelligent data analysis techniques for understanding and managing the bed overflow problem.

http://www.ncbi.nlm.nih.gov/pubmed/21222220

Exclusion Criteria for Denominator
• Closed beds (Permanent closures which would be physically ready to open if staffing and funding were available) are not included.
• Over Complement Beds used are not included in available acute care beds number. Over complement beds can include beds located in lounges, shower rooms, hallways or similar temporary spaces. It may also include physical beds which are non-funded or closed or blocked but in use to handle additional patient capacity with current staff. Terminology in use for this category of bed may differ by site and can include “overflow”, “over capacity” or “over complement” spaces. Patients in these spaces are considered over complement or overflow patients.
• Operating rooms

http://www.health.alberta.ca/documents/PMD-Hospital-Occupanc...

I feel like this article was written for me! I have worked in a large hospital in Edmonton for 14 years, and I see how nursing care has been declining. We have overcapacity beds, which are just stretchers that are shoved into the corner of the rooms to allow for more patients. We are not allowed to advocate for patients because it’s seen as insubordination. We are told by bed managers and coordinators to move dying patients to other units, so our beds can be filled by new patients from emergency. How, then, do we practise the art of nursing, or adhere to our standards of practice and code of ethics? Eighty per cent of our nursing staff are internationally educated, and they see leadership and advocacy in a different way; most of them do not like confrontation, so it’s up to others to try to fix the problems. And alas, we don’t always have time to talk to patients. Worse, most staff don’t know what to say anyway, and use “speak to the doctor” as their default response. I can say that I have not lost the drive to fulfil my professional obligations. But it can be a struggle.

https://www.canadian-nurse.com/en/articles/issues/2013/febru...

Current strategies to improve patient flow during peak pressure periods include:
• Fast track chair area is designed for patients with more minor injuries and illnesses in a separate area, thereby reserving ED stretchers for more serious and critically ill and injured patients.
• The Ambulatory Care Area is for patients who have been assessed by a physician and are waiting for test results or specialist assessment and are able to wait in a chair. Caring for patients in the Ambulatory Care area allows other patients to be seen in the available ED stretches.
• Overcapacity beds on inpatient floors are used when patients are waiting in ED for admission to an inpatient unit.

Strategies to reduce ED pressures aim to achieve the best outcomes for all patients, and system efficiencies, by matching the right program and provider, as early as possible.

The protocols guide response to overcapacity, while increasing access to healthcare services and maintaining patient safety and quality of care.

http://www.albertahealthservices.ca/rls/ne-rls-2010-12-17-ba...