The Mortality and Ethical Impacts of Hospital Strain: How Can Hospitals Prepare for Future Capacity Crises?

The COVID-19 pandemic created significant strain on adult hospitals. Pediatric hospitals are now experiencing similar strain in the setting of an early spike in RSV cases. Hospitals use ambulance diversion and inpatient transfer restrictions to reduce flow to the hospital. However, there are mortality and ethical concerns related to these methods. Other methods that are frequently explored are confined to individual health systems despite the capacity strain typically being widespread, impacting multiple hospitals across a region at one time. In the setting of seeing more frequent hospital strain in both adult and pediatric populations, it is important to examine the options available and to plan for similar events in the future with cooperation across multiple health systems in an effort to provide the best possible outcomes for patients in a region while minimizing moral distress among patients and providers.