How to Increase Hospital Bed Capacity by 20-30 Percent

The United States has 941,520 licensed hospital beds. Just under 65,000 of them are intensive care beds.1

That’s not enough.

As the COVID-19 crisis spreads throughout the United States, hospital capacity will be tested and strained. After years of “just in time” staffing and inventory, most hospitals run at nearly full capacity on a regular basis.2-3 According to an article in the New England Journal of Medicine, of more than 400 existing intensive care unit (ICU) beds, there were only 21 available in a typical U.S. metropolitan area during the second week of March this year.4

It's time to dramatically boost bed capacity. Here’s how:

Manage patient flow to free up bed capacity

You need to take steps now to ensure that your hospital beds are available only to patients who absolutely need them. You may be able to decrease emergency room visits and hospital admissions by increasing or expanding medical clinic hours, so patients with chronic or acute medical conditions can receive care before their condition escalates.

Streamlining and expediting discharge of hospitalized patients can also free up precious bed space. Under normal conditions, hospitals typically discharge far fewer patients on weekends. During a pandemic, any patient who can be safely handled at home or in a less-acute setting should be considered for discharge. A 2009 study found that three hospitals were able to achieve a net surge capacity of 66-81 percent over 19 weeks by utilizing “reverse triage,” or the process of assessing currently hospitalized patients to determine which ones may be eligible for discharge.5

Virtually all hospitals have already cancelled elective surgeries to free up up post-anesthesia care unit (PACU) staff and space. Most have also converted operating rooms into intensive care units. Many others have worked with local post-acute care facilities to accelerate discharge of lower acuty patients to preserve inpatient capacity. Moreover, many hospitals are converting rehab, psych and other specialty beds into acute patient rooms and some acute patient rooms in negative pressure rooms. These conversion are happening at pace all over the world .6

Utilize all available space to increase bed capacity

According to the 2013 Hospital Preparedness Program (HPP) Healthcare Preparedness Capability Review National Call, utilizing the “flat spaces” (lobbies, waiting rooms, and hallways) can increase operating bed capacity by 10 percent.7 Simply moving patients who are awaiting discharge to a designated discharge holding area can free up crucial bed space.

Add an extra bed to all private rooms that are licensed as semi-private rooms.

Psychiatric beds may be available for use if you can safely care for psychiatric patients elsewhere. Work closely with community mental health providers when considering the discharge of psychiatric patients.

Add capacity to your current resources

In hard-hit parts of the country, hospital systems have already taken drastic steps to increase capacity. In Seattle’s King County, two hospital tents have been erected on a youth soccer field. Officials have also purchased a motel that may be used to isolate COVID-19 patients.8-9 New York state is also setting up field hospitals, including one at the Jacob Javits Convention Center, and there are plans to dock the USNS Comfort, a 1,000-bed Navy hospital ship, in New York City’s harbor.10

Look for potential useful spaces within your community, including vacant buildings, hotels, college dormitories, and convention centers. In many cases, such spaces will be most useful as isolation centers for people who test positive for the new coronavirus, but do not require hospitalization; such facilities can prevent the spread of infection in the community and ultimately drive down demand for hospital beds. Alternative care settings may also be used to provide continued care to patients who require continuous monitoring but no longer need specialized equipment or services.


  1. Definitive Healthcare: US Hospital Beds Dashboard. ArcGIS. Accessed March 25, 2020.
  2. How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)? Annals of Internal Medicine. Accessed March 25, 2020.
  3. Hospital Preparedness Program (HPP) Healthcare Preparedness Capability Review National Call Capability 10: Medical Surge and Immediate Bed Availability (IBA) Meeting Summary. Public Health Emergency. Accessed March 25, 2020
  4. Novel Coronavirus and Old Lessons — Preparing the Health System for the Pandemic. New England Journal of Medicine. Accessed March 25, 2020.
  5. Considerations for the Use of Temporary Surge Sites for Managing Seasonal Patient Surge. HHS ASPR, the Technical Resources, Assistance Center, and Information Exchange (TRACIE). Accessed March 25, 2020
  6. Beaumont nears capacity: 635 hospitalized for COVID-19 with limited ventilators. The Detroit News. Accessed March 25, 2020
  7. Hospital Preparedness Program (HPP) Healthcare Preparedness Capability Review National Call Capability 10: Medical Surge and Immediate Bed Availability (IBA) Meeting Summary. Public Health Emergency. Accessed March 25, 2020
  8. A Seattle Suburb Is Turning Its Soccer Field into a Makeshift Hospital. New York Magazine. Accessed March 25, 2020
  9. Flood of COVID-19 Patients Could Swamp Hospitals. Medscape. Accessed March 25, 2020
  10. New York Is Still Scrambling to Find Enough Hospital Beds for Its Coronavirus Patients. Vice. Accessed March 25, 2020