San Diego-based Scripps Health dusted off an initiative it used during COVID to help manage increased patient loads during flu season — internal patient transfers.
When patient levels returned to normal post-COVID, the system discontinued internal transfers. But in recent months, with the increased flu patients, the system's Chula Vista hospital reached a breaking point. The 25-bed ED had about 40 patients waiting for admission.
"Within a few hours, we mobilized the team and transferred seven patients out that afternoon," Ghazala Sharieff, MD, chief medical and operations officer and corporate executive vice president at the system, told Becker's. "We set up a mini command center through our centralized transfer service, monitoring data and census levels systemwide. Each site reported, multiple times per day, how many patients they could accept."
The system had this protocol hardwired during COVID, so starting it up again was easy, she said. Now, the system transfers about 85 patients per week across its five hospitals.
The protocol keeps patients out of hallway beds and makeshift spaces, and it improves morale among staff members.
"When a hospital is drowning in patients, knowing that sister hospitals are willing to help changes everything. It creates a sense of relief and solidarity — they're not alone," she said.
Scripps is also reconfiguring hospital spaces to improve patient flow. It converted their obstetrics unit into a medical-surgical extension unit with 16 beds.
"Renovating this space will cost $13 million, but we have to prioritize patient flow," she said. "If hospitalized patients are stuck in the ED, we can't see new patients, we can't offload ambulances, and everything backs up."
It also leased beds at skilled nursing facilities to improve discharge. That program has saved 14,731 bed days since January 2023. In 2023, the system leased about 24 beds at four facilities. As of January 2025, it had seven beds at one facility.
"We found that the cost was justified, given how expensive hospital stays are," she said. "Most of our patients fall under diagnostic-related groups, meaning we're reimbursed at a fixed rate. Whether a patient stays five days or 15 days, we're paid the same amount. Keeping patients in the hospital longer becomes costly, so leasing beds is a cost-effective solution for patient flow."