Optimizing Capacity: Hospital Experts Share Six Keys to Success (New Report)

Recently our team surveyed industry experts from Dartmouth-Hitchcock, UPMC, and other leading organizations to identify successful strategies to increase capacity through patient flow initiatives. Every hospital is different. Your efforts will be unique to your needs. But if you want to help more patients, decrease staff burnout, and optimize resources, consider these six capacity optimization keys:

  1. Emphasize accurate patient placement
  2. Initiate daily multi disciplinary rounding and daily bed huddles
  3. Discharge patients as soon as possible
  4. Smooth your patient census
  5. Communicate with staff and patients
  6. Measure and distribute the correct metrics

You can download the entire report by clicking here.


To get a taste of some of the content, here are a few insights from the report contributors:

Discussing patient placement as a best practice, Deb Kaczynski, MS, Senior Administrative Director at University of Pittsburgh Medical Center (UPMC) and IHI Patient Flow Faculty, said: “Whether your hospital is at 75% capacity or 110% capacity, patients should always be at the right LEVEL of care.” Placing patients off-service increases LOS and heightens the likelihood of adverse patient outcomes.

Siloed processes are one of the fastest ways to blockade patient flow. “To facilitate cross-silo communication, our team utilizes multidisciplinary rounding,” says Kathy Pecenka-Johnson, BSN, MN, Access Center Director at Children’s Hospital of Los Angeles (CHLA). These efforts have streamlined coordination across services at CHLA, leading to shorter LOS.

Appropriate discharge timing is critical to reduce readmissions, increase patient safety, and streamline throughput. “If a patient doesn’t need to remain in the hospital, then he or she should be discharged, even if census is 70%,” said Laura Ostrowsky, RN, CCM, MUP, Director of Case Management at Memorial Sloan-Kettering Cancer Center (2012, CMSA Case Manager of the Year). “Hospitals are 24-7 operations,” said Ostrowsky. “Limiting yourself to morning discharge is not focusing on timely discharge, nor is it in the best interest of the hospital or the patient.”

Smoothing patient census can be a game-changer for capacity optimization efforts. “Virtually every hospital has fewer admissions on weekends,” say Ostrowsky. “A few years ago we started scheduling elective surgeries on weekends to help flatten out our census curve.” This shifted some of the weekday volume to the weekends and helped Memorial Sloan-Kettering reduce congestion, freeing up resources and thereby reducing LOS.