Scheduling and Bed Management | Moana Digital Health

Overview

Effective patient flow management is one of the highest-leverage operational problems in any health system. When appointment books are managed on paper, bed occupancy is tracked in a ward register, and referrals are communicated by phone, the consequences compound: patients wait unnecessarily, beds sit unallocated while wards overflow, clinicians operate without knowing what resources are available, and referrals are lost between facilities.

The Scheduling and Bed Management module replaces these disconnected processes with a single real-time operational layer. Appointment scheduling, emergency triage queuing, bed allocation and occupancy tracking, and inter-facility referral coordination are all managed in one system, with live updates delivered via WebSocket to every connected workstation. The same dashboard that shows a ward nurse which beds are occupied shows a hospital administrator the facility-wide occupancy rate and the expected discharge list for the afternoon.

The module is purpose-built for multi-department, multi-ward facilities while remaining accessible to smaller clinics managing a simpler appointment book. A rural health post uses the same platform as a district hospital, configured to match the operational complexity of each site. Configuration is hierarchical: system-level defaults apply across the network, facility-level settings override for a specific site, and department-level settings override for a specific department.

For health systems managing patient flow across multiple facilities, the referral management capability provides structured digital referrals that carry the patient's full clinical record, track acceptance and completion status, and eliminate the information loss that occurs when referrals are verbal or communicated on paper.

Core Capabilities

Appointment Scheduling and Provider Calendar Management

Clinicians and administrative staff book, reschedule, and cancel appointments with full provider calendar visibility and real-time conflict detection. Doctor availability is managed at the individual clinician level and at the department level, with scheduling rules configurable per facility including daily consultation limits, session times, and break intervals. When a slot is booked, the system checks availability in real time, preventing double-booking. Appointment types are configurable: standard consultations, specialist reviews, follow-up visits, procedure bookings, and preventive care appointments all have distinct types with appropriate time allocations. Appointment history is retained on the patient record.

Patient Reminder and Notification System

Automated patient reminders are sent via in-app notification, SMS via Twilio, and email via configurable SMTP. Reminder timing is configurable per appointment type, for example 48 hours and 2 hours before the appointment. For facilities in environments with low smartphone penetration, SMS remains the primary channel. Clinician notifications on appointment cancellation and reschedule are sent automatically, reducing the administrative overhead of managing appointment changes.

Emergency Triage Queue Management

Emergency presentations enter a structured five-level triage queue: Resuscitation, Emergent, Urgent, Semi-urgent, and Non-urgent. Each patient's queue position is determined by triage category, not arrival time, ensuring the most critically ill patients are seen first regardless of when they registered. The triage queue is visible in real time to all ED staff via a WebSocket-driven dashboard, showing each patient's category, wait time, and assigned clinician. Wait-time threshold alerts fire automatically when patients in higher-acuity categories exceed defined waiting periods, notifying supervisors before the delay becomes a safety risk. Triage assessments are timestamped and auditable.

Live Bed Occupancy and Allocation

A real-time bed status board shows occupancy across all wards and bed types simultaneously: general medical, surgical, ICU, HDU, isolation, maternity, NICU, and paediatric beds. Each bed is classified by type and location, and its status updates via WebSocket the moment an admission, discharge, or transfer is processed. The bed board is the single source of truth for bed availability at any point in time. Bed assignment is completed directly from the board at the point of admission, with the clinician selecting an available bed and the system recording the allocation with timestamp and assigning clinician.

Admission, Discharge, and Transfer Processing

Admissions, discharges, and transfers are processed as atomic events that update bed status, patient record status, and ward lists simultaneously. When a patient is admitted, the originating encounter closes, the admission opens, and the bed status changes from available to occupied in a single transaction. When a patient is discharged, the bed status returns to available, a discharge summary is generated, and the patient record is updated. Expected discharge dates are tracked at ward level to support forward planning of bed availability, allowing ward managers to anticipate free capacity rather than reacting to vacated beds.

Operating Theatre and Specialist Resource Booking

Operating theatre sessions are bookable as a distinct resource type with procedure-specific time allocations, equipment requirements, and team composition. Theatre booking conflicts are detected in real time. Specialist consultations and shared diagnostic resources are bookable across departments with the same conflict detection logic. Resource utilisation reports show booked versus available capacity by resource, department, and time period, supporting operational planning and scheduling efficiency analysis.

Inter-Facility Referral Management

Referrals between connected Moana facilities are created digitally, with the referring clinician selecting the receiving facility, the reason for referral, and the urgency level. The referral automatically attaches the relevant sections of the patient's clinical record: active diagnoses, current medications, recent investigations, and the referring clinician's notes. Referral status is tracked from initiation through acceptance or rejection to completion. The referring clinician is notified automatically when the referral is accepted and when the receiving episode is documented. For referrals to facilities outside the Moana network, a structured referral letter is generated from the patient record and can be printed or exported as a PDF.

Reporting and Operational Analytics

Scheduling and bed management data feeds the reporting layer with a standard set of operational KPIs: average length of stay by ward and diagnosis, bed turnover rate, bed occupancy rate by ward and facility, emergency wait times by triage category, appointment no-show rate by clinic and provider, and referral completion rates. These metrics are available in real-time dashboards for ward managers and administrators, and in scheduled summary reports for facility and network leadership.

Who Uses This Module

Reception and Administrative Staff

Book, reschedule, and manage appointments. Register arriving patients against booked appointments. Manage the walk-in queue for clinics without pre-booked appointments.

Triage Nurses and Emergency Staff

Assign and record triage categories for emergency presentations. Monitor the real-time ED queue. Respond to wait-time threshold alerts.

Ward Nurses and Charge Nurses

Manage bed occupancy across their ward. Process admissions and discharges. Record expected discharge dates. Complete shift handover using ward lists generated from live bed status.

Hospital Administrators and Operations Managers

Monitor facility-wide bed occupancy and patient flow. Access scheduling efficiency and referral completion analytics. Manage provider availability calendars and department-level scheduling rules.

How This Connects to the Rest of Moana

Scheduling and Bed Management is tightly integrated with Clinical Care Management: admissions and discharges are processed jointly, with clinical records and bed status updating simultaneously. Laboratory and Radiology investigation orders are linked to the scheduling record for the encounter that generated them. Billing entries are created from admission and discharge events. Referral records link to clinical episodes at both the referring and receiving facilities. The operational data generated here feeds the Reporting and Clinical Decision Support module for real-time and historical operational analytics.

Standards and Interoperability

Appointment and scheduling data is structured to FHIR R4 Appointment, Schedule, and Slot resources. Bed occupancy data is available via FHIR R4 Location resources. HL7 v2 ADT messaging supports admit, discharge, and transfer notifications to connected systems, enabling integration with legacy facility information systems in multi-vendor environments. Referral records are structured to FHIR R4 ServiceRequest and ReferralRequest resources.