‘Hospital Week’: Case study of bed management in the context of healthcare staffing shortages

Abstract

A significant portion of the hospital workforce is composed of nursing staff, whose staffing parameters are well defined. Noncompliance with these standards compromises the quality and safety of care, leads to staff overload, and may result in service discontinuity, including bed closures. This study evaluated the ‘Hospital Week’ strategy implemented at the Hospital das Clínicas of the Ribeirão Preto Medical School, University of São Paulo, as an alternative to mitigate care disruption resulting from a 20% deficit in healthcare personnel accumulated between 2016-2019. This is a single case study employing an implementation analysis approach, integrating secondary data on beds and hospital admissions, document analysis and semi-structured interviews with hospital managers and key professionals. The strategy involved the dynamic management of hospital beds between weekdays and weekends, with the temporary closure of up to 23% of eligible beds during weekends. The results indicated that, despite the reduced staffing levels, the institution maintained the number of active beds, inpatient admissions, and surgical procedures, with no significant impact on care delivery profiles or average length of stay. This novel experience within the Brazilian Unified Health System demonstrated both feasibility and potential for replication, particularly in contexts characterized by human resource shortages in hospitals.