Creation and piloting of a new hospital capacity assessment tool in a major urban area

Document Type

Journal Article

Publication Date



Public Health


Volume 123, Issue 11

Inclusive Pages



Crowding; Emergency Service, Hospital--organization & administration; Hospital Bed Capacity--statistics & numerical data; Hospitals, Urban--statistics & numerical data; Need Assessment; Emergent Care; Safety Net; Hospitals; Quality improvement


Objectives: Crowded hospital emergency departments (EDs) can undermine the ability of a region’s safety net to provide safe, timely care. However, data to measure hospital capacity community-wide is generally unavailable. This study aimed to assess hospital crowding, capacity and patient flow in an urban community using the newly developed hospital capacity assessment tool (HCAT).

Study design: A survey of the eight acute care hospitals in the District of Columbia (DC) with active EDs.

Methods: Existing emergency care assessment tools were reviewed. Eighteen of the 57 questions on the HCAT were adapted from existing hospital surveys, while the remaining 39 questions were constructed de novo for use in this assessment. Hospitals were provided with paper and electronic versions of the HCAT.

Results: All eight DC hospitals completed the HCAT; however, three hospitals were unable to answer many of the questions due to a lack of regular data collection. The HCAT data shows throughput times in DC hospitals that are substantially longer than national averages.

Conclusions: The HCAT is a promising tool for evaluating community-wide emergency care. Findings from the HCAT allowed for the introduction of new ED performance data into the local decision-making process.