Optimizing patient care and hospital operations through interhospital admission transfers: The load balancing protocol.

Carmichael, Harris L; Balls, Adam; Bledsoe, Joseph; Pirozzi, Michael; Starr, Nathan · J Hosp Med · 2026

other · Level V

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Abstract

Overwhelming inpatient capacity at referral hospitals undermines both regional healthcare networks and patient outcomes. To address increasing capacity constraints, Intermountain Health implemented a Load Balancing Protocol to redirect stable, lower-acuity admissions from our overburdened quaternary hospital to three community hospitals. By aligning patient acuity with optimal care settings, our strategy preserves advanced care capacity and enhances safe, equitable, and efficient care. In 4 years, our protocol diverted 5112 bed-days from the quaternary hospital and has undergone several iterative improvements. In this article, we describe the barriers and keys to innovation that contribute to the success of this Load Balancing Protocol.

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