Abstract
In October 2005 Hakujyuji Hospital, a mixed-case type hospital (299 beds for acute-stage patients; 167 beds for recovering patients, ) introduced ward rounds for bed management to achieve “effective utilization of hospital beds”, Rounds were established at each of the hospital's 8 wards on a once in 4-week rotation base. A total of 9 individuals conducted rounds, including 5 members of the community medical section, 3 members of the hospital bed management committee, and a nursing manager from the ward. Surveyed patients included acute-stage patients, who had been hospitalized for more than 30 days, and patients already in recovery, who had been hospitalized for more than 3 months. A form indicating the reasons for the patient's long-term hospitalization by the physician in charge was obtained the day before the rounds. During the rounds, future medical proposals were suggested, and the progress status was verified again 1 week later.
The actual conditions of long-term inpatients were recognized by implementing the rounds. In addition, it was possible to facilitate awareness of the effective utilization of hospital beds among the hospital staff. In many cases the need of further implementation of medical care for patients were identified during the rounds and the process of transferring the patient within the hospital or to another facility, or discharging him/her from the hospital was initiated. During this project the number of cases in which physicians in charge voluntarily transferred patients within the hospital or to other hospitals increased significantly. Furthermore, the number of hospital discharge cases, which were postponed due to social adjustment problems, also decreased. It is important to ensure well-organized medical collaboration, and utilize hospital beds effectively in order to perform medical care activities that meet the needs of the community.
