"Working Against Gravity": The Uphill Task of Overcapacity Management.

Area of Science:

• Health Services Research
• Hospital Management
• Patient Flow Optimization

Background:

• Many health systems implement interventions to manage patient demand exceeding capacity.
• Limited understanding exists regarding the long-term sustainability and effectiveness of these overcapacity management strategies.

Purpose of the Study:

• To explore experiences with overcapacity management strategies across diverse health regions.
• To identify mechanisms that support successful interventions and understand their long-term viability.

Main Methods:

• A large, multi-jurisdictional study involving 10 diverse health regions in Western Canada.
• Exploration of patient flow and overcapacity management strategies through participant experiences.

Main Results:

• Common interventions included overcapacity protocols, alternative patient locations, discharge-ready inpatient locations, and redistribution meetings.
• Successful interventions utilized capacity buffers and promoted inpatient unit action through accountability and solidarity.
• Interventions were resource-intensive, requiring significant management involvement, and effectiveness was generally temporary, highlighting chronic overcapacity issues.

Conclusions:

• Current overcapacity management processes are insufficient for long-term mismatches between demand and capacity.
• System redesign solutions are necessary to address persistent, chronic overcapacity in health systems.