5 Ways to Avoid Hospital Bed Shortages
Hospital bed shortages are driving healthcare challenges across the United States. This means that nationwide, acute care facilities are increasingly unable to accommodate patient demand (whether due to limited space, inadequate staffing, or both). These constraints often lead to hospital overcrowding, treatment delays, and higher rates of patient morbidity.
Preventing the care disruptions caused by hospital shortages is essential to both patient and organizational wellbeing. This guide provides a comprehensive overview of this specific capacity problem alongside expert-backed tips for avoiding it at your facility. With these proactive strategies to improve hospital bed availability, you can mitigate systemic bottlenecks while better protecting your patients, staff, and the long-term health of your organization.
What Causes Hospital Bed Shortages?
Today’s hospital bed capacity trends indicate that standard occupancy will surpass 85% (the safety checkpoint that informs current operational standards) by 2032. Some of the reasons that healthcare providers are struggling to meet patient demand include the following:
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Insufficient Staffing Levels |
Nursing shortages across the U.S. are contributing to understaffing that can limit hospital bed capacity, simply because there aren’t enough professionals to keep all beds operational. |
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Increasing Patient Volumes |
Patient volumes are steadily growing across the U.S., with few states experiencing any stagnation or decrease in demand. This inflation isn’t matched by clinician or service availability expansion, putting increased pressure on the existing systems. |
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Inefficient Patient Flow |
Examples of disruptions to expected patient movement through a hospital include specialized bed unavailability or preventable discharge delays. These lead to systemic breakdowns like hospital bottlenecks and emergency department boarding (where an ED bed is tied up by patients waiting on inpatient placement). |
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Infrastructure Limitations |
Physical constraints (like insufficient rooms, space, or resources) can also contribute to shortages. In some areas, regulations that restrict facility expansions further exacerbate hospital bed capacity issues related to inadequate infrastructure. |
Hospital Occupancy Rate: Calculation and Considerations
The healthcare challenges driving hospital bed shortages have been exacerbated by a more than 10% spike in average hospital occupancy rates since the COVID-19 Pandemic. Calculating this inpatient utilization rate requires two data points:
- The sum of inpatient daily censuses within a year.
- The organization’s bed days available, or the cumulative measure of operational inpatient beds, multiplied by the number of days they were available over the course of the year.
The hospital occupancy rate formula works by dividing the first data point by the second. Keeping the average inpatient utilization rate below 85% is important to patient safety and maintaining the ability to accommodate surges in patient volume. These surges can be predictable, occurring routinely (like with cold and flu seasons), or due to a catastrophic event (such as a natural disaster).
How Do Climbing Hospital Occupancy Rates Jeopardize Operations?
Hospital occupancy types that are most vulnerable to bed shortages often belong to units with variable lengths of stay (like the ED) and those that serve higher acuity patients (like the ICU). These departments may experience capacity issues first (or most acutely), but high occupancy rates and insufficient hospital bed availability have far-reaching effects that ultimately impact the entire organization.
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Hospital Bottlenecks |
Patient progression delays are costly because they restrict patient volume and impact care quality. This frequently presents as emergency department bottlenecks, meaning that patients are stuck in the ED in a boarding (rather than therapeutic) capacity while wait room times lengthen, delaying potentially critical treatments. |
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Unsustainable Workloads and Burnout |
As more patients present to hospitals, staff are tasked to keep more beds operational, often without additional support or resources. This is leading to record cases of burnout and increased nursing turnover. |
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Worsened Patient Outcomes |
Studies show that crowding and bed shortages negatively affect key performance indicators. For example, extended wait times delay care and have been linked to patients leaving the hospital without being seen, creating care trends that lead to significant patient safety and outcome concerns. |
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Systemic Financial Strain |
Longer length of stays (LOSs) for patients are associated with higher care costs, while turning away patients (or diverting them) decreases the capacity to generate more revenue. These breakdowns in patient flow eventually impact a facility’s bottom line. |
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Emergency Unpreparedness |
Hospital surge capacity depends on maintaining the ability to absorb swells in patient volume. When shortages affect that capability, it means that hospitals are unable to respond to sudden catastrophic demands. This poses safety concerns for the community and hospital staff. |
Avoiding Hospital Bed Shortages: 5 Facility Best Practices
Now that you know what contributes to bed shortages in hospitals — and how they impact patient and organizational outcomes — it’s time to talk about avoidance strategies. Here you’ll find practical methods for mitigating the demands that contribute to hospital bed insufficiency with tips for increasing baseline bed capacity.
1. Improve Patient Journey Transitions and Flow
Ensuring each patient’s hospital care journey progresses without unnecessary impediment is crucial to operational flow. Transfers from the ED to other care areas are commonly referenced healthcare bottlenecks, but movement from the patient room to diagnostic imaging can also create delays that increase LOS. Any slight delay has the capacity to exacerbate bed shortages in hospitals.
Takeaways:
- Reducing LOS (through improved workflows or the use of discharge lounges, even) is key to providing better patient flow and making space for more critical patients.
- Proper discharge (or patient transfer) planning and implementation helps facilities optimize hospital bed usage to avoid hospital boarding scenarios.
2. Expand Alternate Care Access Points
Creating additional access points for care is another key method for avoiding hospital bed shortages. Certain systems have had success reducing the community demand for inpatient care by increasing the availability of primary care services and preventative measures. By offering alternatives that reduce facility foot traffic (such as remote services), this can also help keep hospital beds free for those that truly need them.
Takeaways:
- Leverage technology through remote monitoring and appointment services to help stem hospital overcrowding.
- Additional access points can be added to offset departmental strain, such as the use of observational units to mitigate the risk for ED bottlenecking.
3. Provide Value-Based Patient Care
By utilizing a healthcare delivery model that focuses on patient outcomes, hospitals can help reduce the risk of readmissions and better target treatments to reduce LOS. Although this may require additional investment in staffing, it can help ensure that patients are receiving the comprehensive nursing coverage needed to ensure a smoother care journey.
Takeaways:
- A value-based care approach can mitigate the risk of missed therapeutic needs that could necessitate hospital readmission later on.
- By providing more comprehensive, person-centered care, treatment can be better tailored to the specific needs of the patient, streamlining goals and care delivery to decrease LOS.
4. Optimize Staffing Models and Protocols
Selecting a staffing model that meets the specific needs of your organization and patient population can help optimize staff availability to meet patient demand. Nursing professionals are necessary for keeping beds operational, so taking care of staff and ensuring their wellbeing is essential to any bed shortage mitigation plan.
Takeaways:
- Invest in nursing retention efforts to ensure you can maintain the robust staffing necessary to meet increasing patient volumes.
- Consider training staff across multiple care delivery models so they’re capable of transitioning to more economical systems (like the functional nursing framework) when census exceeds standard capacity.
5. Monitor Predictive Patient Demands
Healthcare creates 30% of the world’s digital data volume and uses trend analysis to drive many quality improvement initiatives. That meaningful information use can be harnessed to predict future hospital bed requirements and patient surges. This can better position facilities for meeting future challenges and growing without the risk of hospital bed underutilization.
Takeaways:
- Partner with neighboring providers to track intersystem patterns and inform the success of your efforts to expand and encourage alternate care access points. This can direct better investment in follow-up marketing strategies and outreach programs.
- Stay up to date on regulatory changes and compliance requirements that may dictate bed utilization, facility growth, and future surge responses.
Need Help Tackling Today’s Biggest Healthcare Challenges?
Hospital bed shortages aren’t the only current systemic issue straining healthcare facilities. For taking on those other challenges, our facility guides and expert-backed tips can help you safely navigate disruptive change while continuing to provide the highest quality patient care.