Optimizing Hospital Bed Operations：A Space Syntax and Discrete Event Simulation Study

Abstract

The conflict between rigid spatial layouts of hospital inpatient units and dynamic healthcare demands causes structural inefficiencies in bed utilization. Existing research often treats space as homogeneous, neglecting its impact on scheduling decisions. To address this issue, this study proposes a framework integrating Space Syntax and discrete-event simulation. A Spatial Friendliness Index is constructed to quantify the flexible potential of ward units, incorporating spatial synergy, nursing coverage, and vertical accessibility. This index is embedded as a decision parameter into a dynamic bed-scheduling model. The efficacy of different scheduling strategies is evaluated through simulation experiments. Results show that the framework effectively identifies highly flexible spaces. The robust optimization strategy enhances operational efficiency and spatial care quality simultaneously. This finding provides a practical guideline: inter-departmental cooperation should be spatially informed rather than blind. By identifying highly flexible units, hospitals can enable effective cross-departmental bed sharing without expanding collaboration to all units, reducing coordination costs and avoiding inefficient transfers across spatially incompatible wards. This study confirms the effectiveness of translating spatial attributes into operational decision parameters for achieving spatial resilience in hospital design.