Towards effective capacity planning in a perinatal network centre

Objective: To study the arrival pattern and length of stay in a neonatal intensive care/high dependency unit (NICU/HDU) and special care baby unit (SCBU) and the impact of capacity shortage in a perinatal network centre. To provide an analytical model for improving capacity planning.

Methods: The data used in this study have been collected through the South England Neonatal Database (SEND) and the North Central London Perinatal Network Transfer Audit between 1 January and 31 December 2006 for neonates admitted and refused from the neonatal unit at University College London Hospital (UCLH). Exploratory data analysis was performed. A queueing model is proposed for capacity planning of a perinatal network centre.

Outcome measures: Predicted number of cots required with existing arrival and discharge patterns; impact of reducing length of stay.

Results: In 2006, 1002 neonates were admitted to the neonatal unit at UCLH, 144 neonates were refused admission to the NICU and 35 to the SCBU. The model shows the NICU requires 7 more cots to accept 90% neonates at the NICU. The model also shows admission acceptance can be increased by 8% if length of stay can be reduced by 2 days.

Conclusion: The arrival, length of stay and discharge of neonates having gestational age < 27 weeks were the key determinants of capacity. The queuing model can be used to determine the cot capacity required for a given tolerance level of admission rejection.