Evaluating Software-Based Methods for Replacing Manual Collection of Midnight Totals: A Study from Sri Lanka

The manual collection of midnight totals in hospitals has long been used to calculate key performance indicators such as bed occupancy rates. Despite technological advancements, many hospitals still rely on labour-intensive manual methods prone to inaccuracies at multiple stages. This study introduces and evaluates the Smart Hospital Metrics Calculator, a tool developed to automate the calculation of midnight totals and same-day discharges using patient admission and discharge dates from the electronic Indoor Morbidity and Mortality Return (eIMMR). Both manual and software-based methods exhibited inaccuracies, but errors in software-based calculations were primarily due to issues with entering dates, which can be mitigated by improving workflows and refining the eIMMR system. In contrast, improving manual methods requires addressing challenges across multiple levels. Data from three hospitals were analysed, and while the results do not yet demonstrate these outcomes, it is postulated that with enhanced date entry processes, software-based methods, such as the Smart Hospital Metrics Calculator, could achieve near-zero inaccuracies. These findings suggest that transitioning to this automated approach has the potential to streamline data collection, enable real-time monitoring, and improve hospital data management—without requiring additional workload or significant investment. If successfully implemented, this change could represent a seamless transformation, realizing benefits without disrupting current operations.