There is wide variation in the patterns of use of intensive care unit beds across hospitals in the United States. There is also variation between the United States and the United Kingdom.

An array of interrelated factors influence patient triage decisions, including physician behavior, hospital policies and real-time conditions such as intensive care unit capacity. Patients evaluated for admission to the intensive care unit during times of high intensive care unit capacity may have adverse outcomes related to delays in care.

While standardization can be a strategy for improving outcomes in the critical care setting, we do not recommend standardizing patient triage policy across hospitals given the different resources at different hospitals. Hospitals should develop local guidelines for patient triage taking into account their unique set of resources.

In order to optimize patient triage to the intensive care unit within hospitals, there should be a better matching of bed supply and demand. There may be opportunities for innovation, including the flexible use of inpatient beds, telemedicine-capable beds and mobile critical care teams.