BOOKS OF RtfiDIfGS - PAHO/WHO

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AECOCL. Table 2. Eflect of Changc in Schedulcd
Caincellation (SC) and Emergency Turnaway (ET)
Rates on Maximum Average Occupancy
Maximum average Average no.
No. of o/<
bds
beds EMG
%
sched.uled
occupancy SC + ET for
1-3% con
SC and SC and
ET: 1-3% ET: 2/mo tra
320 30 30 99.3 98.7 8.3
320 30 90 94.6 90.6 25.6
320 90 90 96.1 90. 21.9
80 30 30 97.6 96.5 3.2
80 30 90 90.7 87.3 5.4
80 90 30 90.8 85.0 4.7
*Fewer than two per month but as close to tw as posible.
In general, if percent scheduled is below a certain level (approximately
80-90 percent) or if patients are scheduled seven days a week,
maximum average occupancy will increase as percent EMG dqcreases.
It is advantageous (from a maximum average occupancy standpoint)
to schedule seven days a week because no weekend drop-off
then occurs. Figure 5a shows that when percent scheduled is high, the
use of seven-day scheduling allows a higher maximum average occupancy
than does the use of five-day scheduling. This is to be expected
since the'weekend drop.off for five-day scheduling has a greater effect
when percent scheduled is high. Thus, when sizing a facility it is necessary
to be aware of how patients are to be scheduled.
The results of varying mean LOS are shown in Fig. 5b, where it
can be seen that mean LOS has a much smaller effect on maximum
average occupancy than the other parameters do. In sizing larger
facilities, the mean LOS will have little effect on the results, but the
same cannot be said for small facilities (fewer than 40 beds).
As mentioned previously, the maximum average occupancy is affected
by percent cancellations and turnaways. In Table 2 the maximum
average occupancy with the 1-3 percent constraint on cancellations
and turnaways is compared with the maximum average occupancy
with the sum of the cancellations and turnaways being less than
but as close as possible to 2 per month. For 320 and 80 beds, the constraint
change results in a decrease in the cancellations and turnaways
and the maximum average occupancy also decreases. For comparison,
the sum of cancellations and turnaways for the 1-3 percent constraint
is also given in average occurrences per month. For purposes of
planning or determining the number of beds needed, the scheduledcancellation
and emergency.-turnaway rates should be viewed as a
HEALTH matter of policy. Once agreement is reached on their acceptable level,
LSEAR' CH lthen maximum average occupancies can be computed using the simulator.
It should be noted here that the occupancy data for 320 beds
are not strictly part of this research and are furnished only for their