Understanding the links between delayed discharges and hospital congestion

In January 2022 NHS figures showed that more than 12,000 patients occupying hospital beds in England no longer met the ‘criteria to reside’.  

Eric Wolstenholme suggests that the potential savings to health from reducing delays to discharge are being significantly underestimated in current solutions but that realising these savings is very challenging …

“The case for Health subsidies to Social Care is strong in terms of saving beds but is overwhelming in terms of reducing hospital congestion.”

Delayed discharge is a persistent problem in hospitals and there is growing momentum to address it. However, solutions are still elusive and decisions need to be made on the role of ICSs and government to help fund discharge.

In this data-led session Professor Wolstenholme will examine the impact of delayed discharge on hospital congestion, and the unintended consequences of reactive strategies to counter congestion for patients, staff and performance.

This presentation suggests that the potential savings to health from reducing delays to discharge are being significantly underestimated in current solutions. Solving delayed discharge does directly save bed costs, but can also significantly reduce congestion, the use of reactive strategies to counter congestion and the unintended consequences of these for patients, staff and performance.

The talk used system maps and archetypes to trace out feedback connections within hospital patient flows which give rise to congestion. It will be pertinent to those interested in the way hospitals function and/or the use of practical systems methods, but minimum analytical knowledge is necessary.

Eric Wolstenholme is a Professor of Management Science and Business Learning and has consulted and published widely in systems thinking and system dynamics.

Associate readings are:

Wolstenholme, E.F. Using Cascaded and Interlocking Generic System Archetypes to Communicate Policy Insights—The Case for Justifying Integrated Health Care Systems in Terms of Reducing Hospital Congestion. Systems 2022, 10,135. https://doi.org/10.3390/ systems10050135 https://www.mdpi.com/2079-8954/10/5/135/pdf

Wolstenholme, E., McKelvie, D. (2019). Towards a Dynamic Theory of How Hospitals Cope in Times of High Demand. In: The Dynamics of Care. Springer, Cham. https://doi.org/10.1007/978-3-030-21878-2_10