Rightsizing at Wilford Hall Medical Center: A Study to Determine the Appropriate Number and Mix of Inpatient Beds.
Final rept. Jul 95-May 96,
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATI ON
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Wilford Hall Medical Center WHMC has an inpatient operational capacity of 528 beds and an average daily census of 286 1 April 1995 - 28 January 1996. Since 1989 the average occupancy rate has dropped from 59 percent to 49 percent 42 percent in December 1995. These trends are similar to those found in civilian settings. In addition, facility budgets have been reduced for anticipated utilization management savings. Managed care initiatives are in place, the TRICARE contract began 1 November 1995 and active duty and adult health maintenance organizations have been established. Pressures are present to reduce the size of the military medical service. In an effort to get out ahead of the pack, the Commander of WHMC appointed three right sizing teams medicalsurgical, maternalchild and mental health to 1 develop a medical center with an inpatient capacity of 350 beds or less and 2 reallocate the resources to the outpatient setting. Between 5 April and 18 April 1996, each team presented a concept briefing to the Commander. They outlined a 326 bed inpatient facility with a heavy focus on reducing unnecessary admissions through outpatient and outreach services. A three phase implementation process would achieve this sizing. First is the cutting of the fat, which includes reducing medicalsurgical beds from 374 to 240 and mental health beds from 63 to 40. The second phase involves education and training to focus practice patterns on eliminating unnecessary admissions and prolonged lengths of stay. The elimination of unnecessary admissions and reduced lengths of stay allow for the further reduction in inpatient capacity to 167 medicalsurgical beds for an overall total of 326 beds. This paper traces the MedicalSurgical Rightsizing Teams effort to create a 326 bed medical center.
- Medicine and Medical Research
- Logistics, Military Facilities and Supplies