Investigating Challenges of Bed Management in Referral Teaching Hospitals in Mashhad

Background: Access to services is one of the main intermediate outcomes of health system which directly affects people's health. Increasing demand for services, on the one hand, and insufficiency of existing beds according to the relevant standards in many hospitals in the country, on the other hand, necessitate the optimal use of existing beds. The present study aims to investigate the challenges of bed management in the referral educational hospitals of Mashhad. 
Methods: This was a qualitative study using content analysis method. The study population consisted of managers working in Imam Reza and Ghaem hospitals, as referral hospitals in Mashhad, and staff managers. Authors continued data collection until saturation was reached. Researchers used in-depth and semi-structured interviews to collect data. For data analysis, the authors transcribed and coded interviews, and at the same time, collected data using MaxQDA 11 software. 
Results: Data were continuously compared in terms of similarities and differences to similar codes. They can be integrated together, leading to the creation of 7 main concepts. They included challenges regarding admission, bed allocation, sustainability, discharge, process, structure, and human resources. 
Conclusion: Attention to the challenges of bed management in this study can greatly assist the correct emergency organization and patient flow in the hospital. Authorities need to recognize the problems arising from bed management and movie towards solving them. By doing so, the health system will enjoy higher productivity, and the patients ' access to health care will be enhanced without the need to increase the cost.