This paper reviews current literature on the bed management role seeking to highlight developments most likely to increase efficiency. A reduction in the number of in-patient beds due in part to innovative surgical techniques is causing increased pressure on a very finite resource. This requires a greater emphasis on the bed management role and the wider hospital team. A number of studies are presented describing initiatives implemented to support bed management both operationally, procedurally and from a decision support approach. Finally, literature on people, process technology approaches in healthcare is presented, which could support a sustainable improvement in the role.