Is measuring bed utilization the wrong measure?

After all these years I still encounter hospitals for which bed utilization is one of the key measures to review the performances of their wards. But what do you think about this measurement unit ? Does it provide the correct information, or are we using the wrong measure ?


Let’s investigate it with an example.

(The example is based on real data from a Dutch regional hospital)


Susan B. and Fred H. are both ward managers at a small regional hospital. Susan is responsible for the Internal Medicine ward, and Fred is responsible for the General Surgery ward.

Both have the same boss, general manager Lisa G.

Lisa is fairly new to the hospital sector, but is eager to show her management experience. She considers the monthly performance meetings with her ward managers as an essential part to drive improvements. When she started a few months ago she didn’t want to change too much at once. So she still uses the management report of her predecessor. Bed utilization is one of the key measurements in this report.

Preparing for the next monthly performance meeting with Susan and Fred she notices that Fred again is scoring much lower than Susan on bed utilization. This worries her. Last meeting she already had a good discussion with him and expressed her expectation that he would achieve the overall objective for bed utilization.

The overall hospital objective is a bed utilization of at least 90%. Fred achieved 83% bed utilization last month, this is already better than last month, but is still far away from the objective of achieving  at least a 90% bed utilization. She expected that he would have achieved a much better result. She is disappointed in Fred and next time she won’t be so soft with him anymore. She will tell him clearly that he needs to improve, if not…


Fred is also preparing for the performance meeting, and he is a little bit afraid for the meeting. Last time Lisa was very clear in her expectations on his bed utilization, and once again his results are not good enough. He did improve a little but, so that’s positive, but he honestly does not know why he improved, or what he should do to obtain the objective. He is also afraid to admit that he does not know it. Apparently Susan is a much better manager than he is, because she always scores better on bed utilization. Maybe becoming a ward manager was not such a good idea ?


Lisa is confident about next performance meeting. She achieved the objective of 90% bed utilization. The highest score of the past 3 months. She has some pity for Fred, but can’t help him, because she does not know how to help him. She doesn’t even know why she achieved 93%. Hopefully Lisa only looks at the achieved result and doesn’t ask too much questions.

To think about…

In this series we don’t just provide answers. We try to trigger your thinking by posing questions that you have to answer…

So, let’s start…

  • Is Fred a bad manager and Susan a good one ?
  • What would happen if Susan and Fred would switch from department ? Would Susan then increase the ward’s performances, and Fred decrease the performances of Susan’s former ward ?
  • Does the fact that Susan’s ward is an Internal medicine ward, and Fred’s ward a General Surgery ward play a roll in the achieved performances ? If so, why ?
  • Are they both capable to affect bed utilization ? If not, who is ?
  • What triggers the utilization of beds at the Internal Medicine ward ? And at the General Surgery ward ?
  • Is bed utilization a good measure to assess the performances delivered by Susan and Fred ?
  • What key measures are best if you want to affect bed utilization ?
  • Why are so many hospitals still using bed utilization as a key metric ?


Written by Gwen Roosemont ; 4 July 2021

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