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queuing theoryJoe Segen2017-03-16T10:04:16+00:00
A theory by Danish mathematician AK Erlang (1878-1929), which he developed to determine the capacity of telephone networks.
Queuing theory becomes immediately applicable to UK medical practice by substituting hospital beds–arguably the NHS’ most precious commodity–for Erlang’s telephone lines; call arrival rate becomes admission rate into beds; and average call duration becomes average length of stay.
Queuing theory explains why average bed occupancy depends on the size and functional requirements of each specialty bed pool.
Whereas large hospitals in the USA and Europe have a 77-78% national average bed occupancy rate, the UK average is 87%, a rate which results in patient turnaway (queues for a bed, cancelled operations, medical patients in surgical beds), missed waiting time targets, and the sceptre of organisational chaos manifested by increased use of antidepressants by burnt-out staff, increased hospital errors, cross-infection and patient deaths.
R Jones, author of a paper linking the theory to the UK’s chronic bed shortage, compellingly argued that the Stafford Hospital scandal and its 400 (at least) excess deaths were linked to the unrecognised role of excessive whole hospital occupancy. If someone told the NHS chiefs, who advocate reducing the bed stock in hospitals as a way of saving money, about the dangers of such a move, would they listen?
References Jones R (2011) Hospital bed occupancy demystified. Brit J Healthcare Man 17(6): 242-248