LEVERAGING TECHNOLOGY TO TRANSFORM HEALTHCARE AND ENHANCE SURGICAL WARD EFFICIENCY IN A LEADING AFRICAN TEACHING HOSPITAL

Abstract

Context of the study: Surgical wards were critical to hospital operations, often serving as the backbone of inpatient care. However, inefficiencies in resource utilization, prolonged patient stays, and high bed occupancy rates significantly strained healthcare systems, particularly in resource-limited settings like Ghana. Despite their importance, comprehensive evaluations of ward performance that integrated both quantitative metrics and qualitative insights remained limited. Leveraging ten years of data (over 290,000 records) from Korle-Bu Teaching Hospital (KBTH), this study addressed a pressing need to evaluate and enhance surgical ward efficiency. By adopting the WHO’s People-Centered Approach to Health Systems (PATH) Framework, it sought to bridge the gap between data-driven findings and patient-centered care, providing actionable strategies to optimize resource allocation and improve outcomes.

Research Objectives: This study aimed to evaluate the operational efficiency of surgical wards at KBTH, Ghana. Using the WHO’s PATH Framework, the study sought to analyze key performance indicators such as Bed Occupancy Rate (BOR), Average Length of Stay (ALOS), Bed Turnover Rate (BTR), Turnover Interval (TOI), and Mortality Rate (MR) while integrating staff and patient perspectives to optimize resource allocation and improve patient-centered care.

Research Methodology Adopted: A 10-year retrospective, observational study spanning 2014–2023 with supplementary qualitative insights drawn from operational and clinical reports to contextualize the findings. Quantitative data from ward service activity records across eight surgical wards were analyzed retrospectively to identify trends and performance gaps using metrics such as admissions, discharges, deaths, etc. Using IBM SPSS Statistics 29.0, the study employed Pearson correlation, trend analysis, and Kruskal Wallis tests to identify significant differences. The analysis focused on five general surgical subspecialty disciplines within eight wards.

Key Findings and Practical Implications: Statistical analysis demonstrated significant differences between wards (p < 0.001) in bed availability, BTR, MR, BOR, TOI, TOR, and admission/discharge rates, with strong positive correlations between BTR and admission rates (r = 0.749 to 0.948) and discharge rates (r = 0.904 to 0.969). ALOS negatively correlated with admission rates (r = -0.260 to -0.575) and BTR (r = -0.523 to -0.698), while BOR showed strong positive correlations with admission rates (r = 0.638 to 0.890) and BTR (r = 0.680 to 0.901). Over the decade, ALOS decreased from 8.49 ± 1.23 days to 6.27 ± 1.1 days, while BTR increased from 1.9 ± 0.53 to 3.32 ± 1.09. TOI decreased from 9.02 ± 5.29 days to 3.83 ± 2.55 days. Mortality rates peaked in 2021 (7.59 ± 6.73%) before stabilizing at 4.91 ± 2.47% in 2023. Qualitative analysis revealed that national cancer awareness campaigns and improved bed bureau coordination significantly influenced patient flow, while enhanced medical officer availability and better post-surgical monitoring contributed to mortality rate management. The general performance showed improved operational efficiency from 2014 to 2023, with shortened ALOS, improved BTR, and reduced TOI, though BOR remained below WHO-recommended levels (75-85%). Ward efficiency practically can be achieved by implementing targeted bed management protocols including real-time tracking to achieve the WHO-recommended BOR of 75-85%. Standardize successful practices from SW2 and SW3 across all wards while monitoring quality metrics and optimizing transfer rates. Ensuring a reduced malfunction of beds and lastly investigating high mortality rates while reducing TOI to meet the “1-3” day standard.

Conclusion: This study established the essential role of adopting advanced software tools in managing and analysing extensive hospital service data to provide actionable and practical interventions to optimize surgical ward operations. While bed turnover and occupancy rates have improved, challenges such as resource constraints, malfunctional beds, and external factors persist. Reducing turnover intervals, strengthening discharge protocols, and enhancing early intervention strategies can further improve outcomes.