Emergency Room Transformed: From Overcrowded to Open Spaces with Long-Stay Beds

Emergency Room Overload? How 'Long-Stay' Hospital Beds Can Ease the Pressure

Lena Voss in Health & Wellness December 2025 • 4 min read.

"A new study explores how setting up long-stay beds in smaller hospitals can significantly improve the efficiency of tertiary emergency care, reducing overcrowding and improving patient outcomes."

Emergency rooms are the front lines of healthcare, but what happens when they become overwhelmed? Overcrowding in emergency departments isn't just an inconvenience; it impacts patient care, stresses medical staff, and drives up costs. A recent study published in the journal Revista de Saúde Pública investigates a practical solution: the implementation of 'long-stay' beds in smaller, regional hospitals.

The core idea is elegantly simple: transfer patients who no longer require the advanced resources of a tertiary (specialized) hospital to smaller facilities equipped for longer-term care. This frees up crucial beds in the emergency department for those with acute, critical needs. But does it actually work? This study dives deep into the real-world impact of such a program in a region of Brazil.

Let's explore how this approach can revolutionize emergency healthcare.

The Long-Stay Bed Solution: A Step-by-Step Breakdown

Emergency Room Transformed: From Overcrowded to Open Spaces with Long-Stay Beds

The study focused on a specific region in Brazil, where a major tertiary hospital collaborated with smaller hospitals in surrounding municipalities. These smaller hospitals each established ten 'long-stay' beds, specifically designed for patients with chronic conditions who needed ongoing care but not the intensive resources of the main emergency hospital.

Here’s the process in detail:

Identifying the Right Patients: The emergency department staff carefully assessed patients to determine who were stable enough to be transferred to a long-stay bed. These were typically individuals with conditions like cardiovascular problems, neurological disorders, or those recovering from surgery.
Partner Hospital Selection: Smaller hospitals were chosen based on their willingness to participate and their ability to meet specific care standards. The hospitals also had to be in a strategic location for easy patient transfer and family access.
The Transfer Protocol: A detailed protocol was established, outlining the responsibilities of each institution. Before transfer, patients and their families had to agree, and a family member was offered a chance to visit the partner hospital.
Comprehensive Patient Information: When a patient was transferred, the receiving hospital received detailed medical, nursing, and social work reports to ensure continuity of care.
Financial Incentives: Participating hospitals received a daily financial incentive for each long-stay bed occupied, helping to offset the costs of providing extended care.

The success of this program hinged on collaboration, clear communication, and a commitment to providing quality care in all settings.

The Future of Emergency Care: Thinking Outside the (Hospital) Bed

The study offers a compelling case for the potential of long-stay beds to alleviate pressure on tertiary emergency departments. By strategically transferring stable patients to smaller, well-equipped facilities, hospitals can free up resources for those in critical need, potentially saving lives and improving the overall quality of care. As healthcare systems face increasing demands, innovative solutions like this will be crucial for creating a more efficient and patient-centered future.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1590/s0034-8910.2015049006078, Alternate LINK

Title: Impact Of Long-Stay Beds On The Performance Of A Tertiary Hospital In Emergencies

Subject: Public Health, Environmental and Occupational Health

Journal: Revista de Saúde Pública

Publisher: FapUNIFESP (SciELO)

Authors: Antonio Pazin-Filho, Edna De Almeida, Leni Peres Cirilo, Frederica Montanari Lourençato, Lisandra Maria Baptista, José Paulo Pintyá, Ronaldo Dias Capeli, Sonia Maria Pirani Felix Da Silva, Claudia Maria Wolf, Marcelo Marcos Dinardi, Sandro Scarpelini, Maria Cecília Damasceno

Published: 2015-01-01

Everything You Need To Know

What is the primary goal of implementing 'long-stay' beds in smaller hospitals?

The main objective is to improve the efficiency of tertiary emergency care by reducing overcrowding in emergency departments. This is achieved by transferring patients who no longer need the advanced resources of a tertiary hospital to smaller facilities equipped for longer-term care. This strategic move frees up crucial beds in the emergency department for those with acute, critical needs, ultimately aiming to improve patient outcomes and alleviate the strain on the healthcare system.

How does the transfer process work when using 'long-stay' beds, and what measures are taken to ensure quality patient care?

The transfer process involves several key steps. First, the emergency department staff identifies stable patients suitable for transfer, often those with chronic conditions or recovering from surgery. Once identified, a detailed protocol is followed, which includes patient and family consent, and offering family members a chance to visit the partner hospital. The receiving hospital is provided with comprehensive medical, nursing, and social work reports to ensure continuity of care. This structured approach emphasizes collaboration and clear communication to maintain quality care across different healthcare settings.

What types of conditions are suitable for patients in 'long-stay' beds?

Patients with chronic conditions that require ongoing care, but do not necessarily need the intensive resources of a tertiary hospital, are suitable for 'long-stay' beds. These include conditions like cardiovascular problems, neurological disorders, or individuals recovering from surgery. The key is that these patients need continued care but are stable enough to be transferred to a smaller facility, freeing up beds in the tertiary emergency department for those with acute, critical needs.

What are the benefits of transferring patients to 'long-stay' beds for both the patients and the healthcare system?

For patients, the transfer can lead to a more appropriate setting for their care, potentially with a more personalized approach, depending on the capabilities of the partner hospital. The healthcare system benefits from reduced overcrowding in the emergency department, allowing for better allocation of resources and improved care for those with acute needs. This can lead to better patient outcomes, reduced stress on medical staff, and potentially lower costs associated with prolonged stays in tertiary hospitals.

How were the partner hospitals selected, and what role did financial incentives play in the success of the 'long-stay' bed program?

Smaller hospitals were chosen based on their willingness to participate and their capacity to meet specific care standards. Strategic location, allowing for easy patient transfer and family access, was also a key factor. Financial incentives were provided to participating hospitals, offering a daily payment for each occupied 'long-stay' bed. This helped offset the costs of providing extended care, encouraging participation and ensuring the program's sustainability. This financial support was crucial in fostering collaboration and ensuring the successful implementation of the program.