Assessing Immediate Bed Availability and Barriers to Discharge in a United States Children's Hospital

Objectives: The aim of this study was to quantify immediate bed availability (IBA) in a United States children's hospital and treatment needs of hospitalized patients whose needs could be met outside a traditional hospital setting. Methods: Using a novel tool to capture census, scheduled discharges, and resource needs for hospitalized patients, we surveyed our hospital's 5 non-neonatal inpatient pediatric units on 4 d over 1 y. Results: Median ward occupancy was 81% (range, 58-79), median intensive care unit 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 nontraditional setting; the most common reason for requiring ongoing hospitalization in this group of patients was a safe discharge plan. Conclusions: Our 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.