In the Philadelphia region, the demand for inpatient hospital care is growing faster than the supply of staffed inpatient beds. ER visits are steadily increasing; hospitals are closing their OB and behavioral health beds, and the remaining hospitals are left with the challenge of how to provide high-quality healthcare services to sicker patients using current resources. 

The Hospital of the University of Pennsylvania (HUP), a 695-bed quaternary academic medical center with a Level 1 trauma program, has occupancy routinely over 100% and CMIs among the highest in the nation. Between October 2005 and July 2006, HUP embarked on a Patient Flow project recognizing that effective patient flow is essential to effective case management.