To the Editor: Many of the arguments put forward by Bain and colleagues about modelling hospital occupancy1 are true in an academic sense. We agree that many acute care models use simplified inputs and outputs, without accounting for rapid daily fluctuations in occupancy. Occupancy definitions are often misleading and subject to gaming. We agree with the work by Bain, Taylor and others that highlights as a problem “the inability to move patients from the [emergency department] to a ward” and that hospitals should “engage procedures to free inpatient beds well in advance” of access block occurring.2 The capacity of a hospital must have flexibility to deal with demand fluctuations.1
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- David Mountain1,2
- Daniel Fatovich3,2
- Sally McCarthy2,4
- 1 Department of Emergency Medicine, Sir Charles Gairdner Hospital, Perth, WA.
- 2 Australasian College for Emergency Medicine, Melbourne, VIC.
- 3 Centre for Clinical Research in Emergency Medicine, University of Western Australia, and Emergency Department, Royal Perth Hospital, Perth, WA.
- 4 Emergency Medicine, Prince of Wales Hospital, Sydney, NSW.