Evidence map›Paper›PMID 35987642›Full record

ArticleBMC health services research2022

Optimising acute stroke pathways through flexible use of bed capacity: a computer modelling study.

Richard M Wood, Simon J Moss, Ben J Murch, Christos Vasilakis, Philip L Clatworthy

Abstract read
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Richard M WoodBristol, North Somerset and South Gloucestershire ICB, National Health Service, South Plaza, Marlborough St, BS1 3NX, Bristol, United Kingdom. richard.wood16@nhs.net.
Simon J MossBristol, North Somerset and South Gloucestershire ICB, National Health Service, South Plaza, Marlborough St, BS1 3NX, Bristol, United Kingdom.
Ben J MurchBristol, North Somerset and South Gloucestershire ICB, National Health Service, South Plaza, Marlborough St, BS1 3NX, Bristol, United Kingdom.
Christos VasilakisSchool of Management, University of Bath, Claverton Down, BA2 7AY, Bath, United Kingdom.
Philip L ClatworthyNorth Bristol Trust, National Health Service, Southmead Road, BS10 5NB, Bristol, United Kingdom.

Funding

The Health Foundation Evidence into Practice
6 · The paper itself

Abstract

backgroundOptimising capacity along clinical pathways is essential to avoid severe hospital pressure and help ensure best patient outcomes and financial sustainability. Yet, typical approaches, using only average arrival rate and average lengths of stay, are known to underestimate the number of beds required. This study investigates the extent to which averages-based estimates can be complemented by a robust assessment of additional 'flex capacity' requirements, to be used at times of peak demand.

methodsThe setting was a major one million resident healthcare system in England, moving towards a centralised stroke pathway. A computer simulation was developed for modelling patient flow along the proposed stroke pathway, accounting for variability in patient arrivals, lengths of stay, and the time taken for transfer processes. The primary outcome measure was flex capacity utilisation over the simulation period.

resultsFor the hyper-acute, acute, and rehabilitation units respectively, flex capacities of 45%, 45%, and 36% above the averages-based calculation would be required to ensure that only 1% of stroke presentations find the hyper-acute unit full and have to wait. For each unit some amount of flex capacity would be required approximately 30%, 20%, and 18% of the time respectively.

conclusionsThis study demonstrates the importance of appropriately capturing variability within capacity plans, and provides a practical and economical approach which can complement commonly-used averages-based methods. Results of this study have directly informed the healthcare system's new configuration of stroke services.

Indexed as

Intensive Care UnitsStrokeComputersComputer SimulationCritical PathwaysHospital Bed CapacityHumansDemand and CapacitySimulationStroke CareStroke Centralisation

Identifiers

PMID35987642
PMCPMC9392305

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.