Assessing immediate bed availability and barriers to discharge in a US children's hospital

ObjectiveTo quantify immediate bed availability in a US children's hospital and treatment needs of hospitalized patients whose needs could be met outside a traditional hospital setting.MethodsUsing a novel tool to capture census, scheduled discharges, and resource needs for hospitalized patients, we surveyed our hospital's five non-neonatal inpatient pediatric units on four days over one year.ResultsMedian ward occupancy was 81% (range 58-79), median ICU occupancy was 80% (range 7-19), and median IBA was 42% (range 34-59). A median of 14 patients per day (13% of total capacity) had treatment needs that could be met by providing limited support in a non-traditional setting; the most common reason for requiring ongoing hospitalization in this group of patients was a safe discharge plan.ConclusionsOur median IBA of 42% exceeds federal recommendations, but varies widely between days surveyed. Even on days when IBA percentage is high, our total number of available beds is unlikely to meet pediatric population needs in a large-scale public health emergency.