{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:07:24Z","timestamp":1792109244916,"version":"4.4.0"},"reference-count":10,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Qual"],"accepted":{"date-parts":[[2023,6,11]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Overstay of inpatients is a big challenge to healthcare systems which interferes with the proper utilisation of the available resources and efficient delivery of care. Unnecessary days in the hospital may lead to patient complications including healthcare-associated infections, falls and delirium, which can negatively impact both patient and staff experience. This project aimed to reduce the cost of bed days of inpatient overstay through facilitating the discharge process using a multidisciplinary intervention approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The root causes of inpatient overstay were defined via a multidisciplinary approach. This project applied the extension Deming Cycle method: Find-Organise-Clarify-Understand-Study-Plan-Do-Check-Act (PDCA). Solutions to the root causes which led to process variation were implemented through three PDCA cycles conducted between January 2019 and July 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was a significant reduction in the total number of overstay inpatients, the total number of overstay days, and the related bed costs in the first 3 quarters of 2019. A significant and sustained improvement in the emergency department average boarding time was attained in the first half of 2019 (reduced from 11.9 hours to 1.7 hours). A total estimated cost saving of SR30 000 000 (US$8 000 000) in terms of operational efficiency was achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early discharge planning and facilitating the patient discharge process significantly improves the average length of inpatient stay and patient outcomes and decreases hospital costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjoq-2022-002142","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T13:15:23Z","timestamp":1687266923000},"page":"e002142","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Reduction of hospital bed cost for inpatient overstay through optimisation of patient flow"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3746-6998","authenticated-orcid":false,"given":"Sultanah","family":"Alharbi","sequence":"first","affiliation":[{"name":"Case Management Department, Al Hada Armed Forces Hospital, Taif, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alasmari","sequence":"additional","affiliation":[{"name":"Medical Administration, Al Hada Armed Forces Hospital, Taif, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehab","family":"Hanafy","sequence":"additional","affiliation":[{"name":"CQI & PS, Al Hada Armed Forces Hospital, Taif, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9844-5360","authenticated-orcid":false,"given":"Alia","family":"Ellawindy","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Suez Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,20]]},"reference":[{"key":"2025083113264656000_12.2.e002142.1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-0929-6"},{"key":"2025083113264656000_12.2.e002142.2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01967579"},{"key":"2025083113264656000_12.2.e002142.3","unstructured":"Association AH . Trendwatch Chartbook 2018: Trends Affecting Hospitals and Health Systems. Washington, DC: American Hospital Association, 2018. Available: https:\/\/www.aha.org\/system\/files\/2018-07\/2018-aha-chartbook.pdf"},{"key":"2025083113264656000_12.2.e002142.4","doi-asserted-by":"crossref","first-page":"98","DOI":"10.7861\/clinmedicine.12-1-98","article-title":"The cost of long hospital stays","volume":"12","author":"Jenkins","year":"2012","journal-title":"Clin Med (Lond)"},{"key":"2025083113264656000_12.2.e002142.5","doi-asserted-by":"publisher","DOI":"10.1093\/hsw\/2.1.163"},{"key":"2025083113264656000_12.2.e002142.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0224899","article-title":"Exploring the hospital patient journey: what does the patient experience?","volume":"14","author":"Gualandi","year":"2019","journal-title":"PLoS One"},{"key":"2025083113264656000_12.2.e002142.7","unstructured":"The Joint Commission . Optimizing patient flow: advanced strategies for managing variability to enhance access, quality and safety. 2018."},{"key":"2025083113264656000_12.2.e002142.8","first-page":"113","article-title":"Hospital bed utilization: perceptions of healthcare practitioners from Northern India","volume":"4","author":"Kanwar","year":"2015","journal-title":"Int J Hosp Res"},{"key":"2025083113264656000_12.2.e002142.9","unstructured":"OECD . Length of hospital stay (indicator); 2022. https:\/\/www.oecd-ilibrary.org\/social-issues-migration-health\/length-of-hospital-stay\/indicator\/english_8dda6b7a-en"},{"key":"2025083113264656000_12.2.e002142.10","unstructured":"Available: https:\/\/www.isixsigma.com\/dictionary\/deming-cycle-pdca\/"}],"container-title":["BMJ Open Quality"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjoq-2022-002142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T20:26:55Z","timestamp":1756672015000},"score":1,"resource":{"primary":{"URL":"https:\/\/qir.bmj.com\/lookup\/doi\/10.1136\/bmjoq-2022-002142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,6,20]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/bmjoq-2022-002142"],"URL":"https:\/\/doi.org\/10.1136\/bmjoq-2022-002142","relation":{},"ISSN":["2399-6641"],"issn-type":[{"value":"2399-6641","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}