A critical examination of “No Bed Syndrome”

My name is Dr. George Oduro. I am an emergency physician. Though I am now retired from active clinical service, I have spent many years at the front line of acute care. I have stood at the bedside when families are told there is no bed. I have worked alongside nurses, specialists, managers, and trainees who struggle daily to move patients safely through crowded corridors.

I write not as a commentator from a distance, but as someone who has lived this reality. Retirement has given me perceptive distance. It has not taken away my experience. I can still share insights shaped by years within local and international systems.

Emergency care spans a wide area of health planning. It touches ambulance services, primary care, specialist wards, laboratories, imaging units, finance systems, and hospital management. It is a living network, not a room with furniture. It is a chain, not a single link. When one part of a chain weakens, the strain is felt everywhere.

The current public discussion has focused on one phrase. “No Bed Syndrome.” It is a phrase that carries frustration and anxiety. It suggests scarcity. But it can also mislead. The problem is larger than the availability of beds. It is about flow. It is about patient flow. It is about coordination. It is about how emergency departments connect to the rest of the hospital and to the broader emergency care ecosystem.

My own specialism is emergency medicine. For that reason, this series will focus mainly on emergency departments and their linkages to the rest of the hospital system. We will examine what happens from the moment a patient walks into the emergency unit to the point of admission, discharge, or transfer. We will explore where the system holds, and where it falters. We will look closely at where delays occur and why.

This series will move in stages. We will begin by defining what “No Bed Syndrome” in an emergency department really means. We will examine some of the root causes of congestion in the emergency department. We will examine why patients get stuck. We will look at discharge delays, specialist engagement, allied and support services, financial barriers, and governance gaps. We will explore what can be fixed now, the so-called low hanging fruits. We will consider urban response, regional coordination and long term planning. We will ask what measurable progress would look like within a year or two.

Since Accra is a unique and rapidly expanding metropolis, we will also ask what kind of stronger, more resilient emergency care system can be built to meet the demands of the future. Lessons learnt from progress in Accra will be useful for other regions in the future. Every region faces its own pressures. Urban centres are expanding. Road traffic is increasing. Chronic diseases are rising. Trauma remains an increasing burden. If we can understand what works in Accra, we create a template others can adapt. Reform in one region can become learning for a nation.

This is not a series written to attack or criticize individuals. Systems are complex and fail for many reasons. They evolve over time. Blame rarely strengthens systems. Honest analysis can. Accountability matters. But accountability must be fair and constructive.

Most importantly, this is meant to be an interactive series. Little will be gained if it remains a one way conversation. Emergency care belongs to the public. It belongs to patients and families. It belongs to nurses, doctors, porters, administrators, policymakers, and ambulance crews. It belongs to all of us.

Therefore readers are invited to engage. Share your experiences. Offer suggestions. Challenge assumptions, including this author’s. No contribution is too small to consider. Often, the person closest to the problem sees what others overlook. Sometimes the quietest observation reveals the deepest truth.

Outrage may draw attention. But thoughtful dialogue builds reform. Over the coming weeks, let us move beyond the phrase “no beds” and look carefully at the system beneath it. Only by understanding the whole can we strengthen the parts.

 

Dr. George Oduro, FRCS, FRCEM (UK)

FGCSACESO Principal Investigator Consultant in Emergency Medicine

Email: [email protected]

 

 

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