COVID-19 hospital insights survey

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is strictly prohibited
COVID-19 hospital
insights survey
July 2021
Document intended to provide insight rather than
specific client advice

McKinsey & Company 2
Overview of this document
Solving the humanitarian challenge is the top priority. Much remains to be done globally to prepare, respond, and
recover from protecting populations at risk and supporting affected patients, families, and communities. To address this
crisis, countries including the United States will need to respond in an evidence-informed manner, leveraging public
health infrastructure and proactive leadership.
This document is meant to help with a narrower goal: provide timely insights on hospital systems reported
volumes and plans to address potential capacity challenges in response to COVID-19. These insights draw upon
findings from McKinsey’s Hospital Insights Survey from July 16-24, 2021. Results represent leaders’ stated
perspectives and are not meant to indicate or predict actual future volumes.
In addition, we have developed a broader perspective on implications for businesses across sectors that can
be found here: https://www.mckinsey.com/business-functions/risk/our-insights/covid-19-implications-for-business. This
supplemental material discusses implications for the wider economy, businesses, and employment; and sets out some
of those challenges and how organizations can respond in order to protect their people and navigate through an
uncertain situation.
For all formal guidance, you can find up-to-date information at CDC’s COVID-19 website, with a section specific to
healthcare professionals: https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/index.html.
Current as of July 24, 2021

Survey methodology
In July 2021 (July 16-24), McKinsey surveyed strategic and operational leaders from 100 large
private sector hospitals in the country to see how COVID-19 had impacted hospital volumes, and to
understand what expectations and implications were for the upcoming year(s). A similar survey was
also conducted in May 2021, February 2021, and July 2020, with ~30 large health system
respondents.
All of the 100 respondents represented hospitals with >200 hospital beds. These 100 hospitals
represented hospitals from all regions of the United States (Northeast, Midwest, South, and West),
and collectively represent ~10% of all hospital beds in the United States.
All survey questions were based on the experiences of an individual facility, rather than the system
overall. Responses were aggregated and weighted equally for analyses.

Demographics of the 100 US hospitals surveyed
Midwest: 21 respondents
South: 30 respondents
West: 18
respondents
Northeast: 31
respondents
200-500
500-1,000
More than 1,000 24%
25%
51%
Number of hospital beds, % of respondents1 Region of hospital, # of respondents2
Source: McKinsey survey of 100 large US hospitals
1. Q2: Number of hospital beds across your hospital?
2. Q3: In which state is your hospital located?

Executive summary: Hospital insights survey
Patient volumes
Ÿ US hospitals report patient volumes returned to 2019 levels in June and July across sites of care (outpatient, procedural, inpatient,
emergency department), and respondents expect patient volumes to grow throughout 2H 2021, with volumes 5-8% higher than in
2019 by 2022
— Regional variation exists with reported volumes in the West below 2019 levels across inpatient, procedural, and emergency care
— The Midwest has seen the fastest recovery of volume compared to 2019 (volumes up 3-9% across sites of care in June and July)
Ÿ Outpatient volumes have seen the greatest increase, and respondents expect to be ~9% above 2019 by 2023
— Providers report psychiatry and orthopedic surgery are areas where patient demand is most likely to exceed provider capacity
in the next six months
— Plastic surgery and ophthalmology saw the greatest decreases in outpatient volume in June compared to 2019 (-4% to -7%)
Ÿ Virtual care: ~20% of outpatient visits were shifted to virtual care in 2020, but that declined to ~15% of care in Q2 2021, which is
the rate that surveyed providers expect to persist
Capacity for care and operational responses
Ÿ ~45% of respondents indicated access to specialty care is worse today than in 2019
— More than 50% of hospitals surveyed are expanding clinic hours in order to increase outpatient access, and ~30% report
increasing physician productivity expectations as a result of COVID-19
— Providers are planning to take many actions to increase surgical throughput (eg, optimizing OR scheduling, expanding hours)
Ÿ Providers anticipate shifting 10% of surgical volume to outpatient settings by 2023, such that ~57% of procedures would be outpatient

On average, US hospitals surveyed report inpatient admissions have
returned to 2019 levels, and anticipate 2022 will be 6% higher
Inpatient admissions for 2021 relative to 2019 baseline, % change from 20191
Baseline (2019)
1. Q8: When comparing 2019 to 2021, what percentage change in inpatient admissions did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q9: When comparing 2019 to 2021 and beyond, what percentage change in inpatient admissions do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
3. Q29: When comparing 2019 to 2021, do you believe your hospital has the ability to increase surgical market share in the upcoming year due to changes in the healthcare landscape?
Projected inpatient admissions for 2022+,
% change from 20192
A previous survey of the largest health systems in May
2021 showed similar findings, with systems anticipating
to be ~4% higher than baseline in 2022
87% of hospitals surveyed report they believe they can
increase market share in the upcoming year3
-5
-10
10
0
5
Feb Aug
Mar
Jan Apr May Jun Jul Sep Oct Nov Dec
5%
-7%
-8%
-4%
-2%
-1%
2% 2%
5%
3%
4% 4%
6% 6%
2022 2023
Projections
Reported actuals

Hospitals in the Midwest report inpatient admissions are the highest above
2019 baseline, with the West still below 2019
Northeast—Inpatient admissions for 2021+ relative to 2019
baseline, % change from 20191
Baseline (2019)
1. Q8: When comparing 2019 to 2021, what percentage change in inpatient admissions did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q9: When comparing 2019 to 2021 and beyond, what percentage change in inpatient admissions do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
0
-20
-15
-10
-5
10
5
-7%
-9%
-5%
3%
-3% -3%
2% 2% 2% 2% 3% 3%
7% 6%
Midwest—Inpatient admissions for 2021+ relative to 2019
5
-5
-15
0
10
-20
-10
7%
2022
Jun
4%
-5%
Jan
9%
Feb Mar Apr May Aug
Jul Sep Oct Nov Dec
8%
2023
-4%
5%
3%
8%
6% 6% 7% 7% 6%
Baseline (2019)
South—Inpatient admissions for 2021+ relative to 2019
Baseline (2019)
-20
-15
5
0
-10
-5
10
4%
5%
-1%
3%
0%
-5% -4%
-2% -3%
1%
4% 5% 6% 6%
West—Inpatient admissions for 2021+ relative to 2019
-10
-15
-20
5
0
-5
10
-17%
Mar
Jan 2023
-3%
Feb Apr May Jun Jul Nov
Sep Oct
7%
Dec 2022
-12%
-7%
-5% -6%
2%
4% 5% 5% 6% 7%
-18%
Aug
Baseline (2019)
Projections
Reported actuals

On average, US hospitals surveyed report operating room procedure
volumes have returned to 2019 levels, and anticipate 2022 will be 6% higher
Operating room procedures for 2021 relative to 2019 baseline, % change from 20191
Baseline (2019)
1. Q14: When comparing 2019 to 2021, what percentage change in operating room surgeries did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q15: When comparing 2019 to 2021 and beyond, what percentage change in operating room surgeries do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
Projected operating room procedures for
2022+, % change from 20192
Reported operating room procedure volume
was 2-3% higher than 2019 baseline in
June and July, signaling a faster return to
baseline than previous survey estimates
4
-6
-14
-12
8
-10
-4
6
-8
-2
0
10
2 1%
Jan
5%
2%
Dec
Feb Apr May Jun Jul Aug Sep Oct Nov
3%
-13%
-12%
-6%
-2%
3% 3% 3%
4%
Mar
6% 6%
2022 2023
Projections
Reported actuals

Reported procedural volume is now above 2019 levels for all regions with
the exception of the West
Northeast—Operating room procedures for 2021+ relative to
2019 baseline, % change from 20191
Baseline (2019)
0
-10
-20
-15
-5
10
5
-13%
-1%
1%
-11%
-5%
3% 3%
1% 2% 2% 3% 4%
6% 5%
Midwest—Operating room procedures for 2021+ relative to
5
-20
-15
0
-10
10
-5
5%
Jan Aug
Feb Mar Apr May Jun Jul Sep Oct Nov Dec
7%
4%
2022
-2%
2023
5%
-11%-10%
-3%
2% 3%
5% 6% 7% 6%
Baseline (2019)
South—Operating room procedures for 2021+ relative to
Baseline (2019)
-10
10
-20
0
-5
-15
5 4%
-9% -9%
-3%
0%
2%
7%
4% 5% 5% 5% 6% 7%
9%
West—Operating room procedures for 2021+ relative to
0
-25
-5
-20
-15
-10
5
10
-23%
Jan Feb Mar Apr May Jun Aug
-4%
Sep Oct Nov
4%
Dec 2022 2023
-15%
-9%
-4%
-2% -1% -1% -1%
1% 0%
3%
Jul
-25%
Baseline (2019)
1. Q14: When comparing 2019 to 2021, what percentage change in operating room surgeries did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q15: When comparing 2019 to 2021 and beyond, what percentage change in operating room surgeries do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
Projections
Reported actuals

On average, US hospitals surveyed report emergency department visits
have returned to 2019 levels, and anticipate 2022 will be ~5% higher
Emergency department visits for 2021 relative to 2019 baseline, % change from 20191
Baseline (2019)
1. Q12: When comparing 2019 to 2021, what percentage change in emergency department visits did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q13: When comparing 2019 to 2021 and beyond, what percentage change in emergency department visits do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
Projected emergency department visits
for 2022+, % change from 20192
Reported emergency department visit
volume returned to 2019 baseline levels in
June-July 2021, whereas previous survey
estimates did not anticipate returning to 2019
volumes until the end of 2021
5
-10
-5
0
10
Mar
4%
Feb
Jan
-9%
Jul
Apr May Jun Dec
Aug Sep Oct Nov
-9%
-6%
-4%
-2%
0%
1%
3% 3%
4%
5%
5%
6%
2022 2023
Projections
Reported actuals

On average, hospitals in all regions report that emergency department
volumes are expected to be above 2019 levels for the second half of 2021
Northeast—Emergency department visits for 2021+ relative
to 2019 baseline, % change from 20191
Baseline (2019)
-5
5
-20
0
-15
-10
10
15
0%
2%
-9%
-6%
-7%
-5%
-2%
0%
1%
3%
2% 3% 4% 5%
Midwest—Emergency department visits for 2021+ relative to
10
-5
-20
0
-15
-10
5
15
5%
4%
Jan
3%
Feb Apr May
6%
Jun Jul Sep
Aug Oct Nov 2022
Dec 2023
-2%
Mar
-2% -1%
2% 2%
6%
2%
5% 5% 4%
Baseline (2019)
South—Emergency department visits for 2021+ relative to
Baseline (2019)
0
-10
-20
10
-15
-5
5
15
-10% -10%
-6% -5%
-2%
0% 0%
2% 3% 4% 4% 3%
5% 6%
West—Emergency Department visits for 2021+ relative to
-5
-10
-15
-20
0
5
10
15
11%
7%
-3%
Feb Mar Apr May Jun Jul
5%
-8%
Sep
Jan Oct Nov Dec 2022 2023
5%
-12%
-1%
-7%
6%
9% 8%
-18%-18%
Aug
Baseline (2019)
1. Q12: When comparing 2019 to 2021, what percentage change in emergency department visits did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q13: When comparing 2019 to 2021 and beyond, what percentage change in emergency department visits do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
Projections
Reported actuals

On average, US hospitals surveyed report outpatient visits have surpassed
2019 levels, and anticipate 2022 will be ~8% higher
Outpatient visits for 2021 relative to 2019 baseline, % change from 20191
Baseline (2019)
1. Q10: When comparing 2019 to 2021, what percentage change in outpatient visits did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q11: When comparing 2019 to 2021 and beyond, what percentage change in outpatient visits do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
Projected outpatient visits for 2022+, %
change from 20192
Reported outpatient visit volume continues to be
above 2019 baseline, with survey estimates
similar to May 2021 results (~9% above 2019
by 2023)
0
-10
8
10
-2
-6
-12
2
6
-8
-4
4
Mar
Jan
-12%
Feb Apr May Jun Jul Dec
Aug Sep
3%
4% 4%
5% 5%
6%
Nov
6%
-11%
-6%
-2%
1%
Oct
8%
9%
2022 2023
Projections
Reported actuals

Outpatient visits have surpassed 2019 levels in all four regions, with the
Midwest at ~7% above 2019
Northeast—Outpatient visits for 2021+ relative to 2019
Baseline (2019)
10
-20
-10
-5
-15
5
0
15
-25
3%
2%
-1%
-7%
-13% -13%
-3%
2%
4% 4% 4% 3%
7% 7%
Midwest—Outpatient visits for 2021+ relative to 2019
-20
-15
0
-10
5
15
-5
10
-25
Apr
Jan Feb Mar May Jun Jul
5%
Aug
12%
Nov Dec
9%
2023
2022
-3% -4%
3%
6% 7% 7%
4%
7%
5%
7%
9%
Sep Oct
Baseline (2019)
South—Outpatient visits for 2021+ relative to 2019 baseline,
% change from 20191
Baseline (2019)
0
-20
-15
5
-10
-5
10
15
-25
1%
6%
-12%
-11%
-6%
2%
-3%
3% 4% 5%
7%
7% 8% 7%
West—Outpatient visits for 2021+ relative to 2019 baseline,
% change from 20191
-20
-10
-15
15
10
0
-5
5
-25
5%
Oct
Jan 2023
Feb Mar Apr May
11%
2%
5%
-4%
Jul Aug Sep Nov Dec 2022
-11%
0%
4%
8%
-20%
7% 8%
10%
-21%
Jun
Baseline (2019)
1. Q10: When comparing 2019 to 2021, what percentage change in outpatient visits did your hospital have in 2021 compared to the same month in 2019? (Eg, 10% decrease in admissions in April 2021 compared to April 2019.)
2. Q11: When comparing 2019 to 2021 and beyond, what percentage change in outpatient visits do you expect for each time period compared to 2019? (Eg, 10% increase in admissions in September 2021 compared to September 2019.)
Projections
Reported actuals

For June 2021, providers surveyed saw the greatest decreases in
plastic surgery and ophthalmology volume compared to 2019
Neuro-
surgery
2%
Ophthal-
mology
Orthopedic
surgery
Gastro-
enterology
ENT2 Pediatrics Cardiology
Cardio-
vascular
surgery
-3%
Derma-
tology
General
surgery
Urology
0%
OB-GYN2
0%
General
internal
medicine
Plastic
surgery
Oncology Family
medicine
-4%
Psychiatry
-7%
-3% -3%
-2% -2%
0%
-1% -1% -1%
0%
2% 2%
6%
Neurology
1. Q16: For June 2021, what was the percentage change in outpatient volume for each of the following specialties compared to 2019? (Eg, 10% decrease in orthopedic surgery volume in June 2021 vs June 2019.)
2. ENT, ears, nose and throat; OB-GYN, obstetrics and gynecology.
Percentage change in outpatient volume in June 2021 vs 2019 by specialty,
% change in outpatient visits for June 2021 vs 20191

~60% of hospitals surveyed report new patient specialist
appointments can be scheduled in <14 days on average
15-21 days
Less than 7 days
4%
7-14 days 22-28 days
42%
18%
29-45 days More than 45 days
9%
14% 13%
Average number of days for a new patient to schedule a specialist appointment with employed
physicians, % of respondents1
1. Q23: For specialty care, how many days on average does it take for a new patient to schedule an appointment with your employed physicians (eg, days from appointment)?
2. Q24: Are your current patient access metrics (eg, days to 3rd available appointment) better or worse than in 2019?
~45% of respondents
indicated access to
specialty care is worse
today than in 2019,
while ~35% said it
improved and ~25%
said it is unchanged

~35% of providers expect patient demand to exceed provider
capacity in psychiatry and orthopedic surgery in the next 6 months
ENT2
Neurosurgery
21%
Psychiatry
General surgery
General internal medicine
Cardiovascular surgery
Orthopedic surgery
Cardiology
Oncology
17%
Gastroenterology
12%
15%
Urology
Neurology
26%
Dermatology
Plastic surgery
OB-GYN2
Ophthalmology
Family medicine
Pediatrics
37%
33%
24%
20%
20%
18%
20%
15%
15%
14%
9%
13%
12%
1. Q18: In which of the following specialties do you anticipate patient demand will exceed provider capacity within your hospital at some point in the next 6 months due to pent up demand (eg, increasing patient demand leading to longer wait times for care)?
2. ENT, ears, nose and throat; OB-GYN, obstetrics and gynecology.
Respondents who anticipate patient demand will exceed provider capacity in the next 6 months due to pent
up demand, % respondents1

Providers most often report availability of clinic support staff as the
barrier to increasing outpatient clinic volume, and they are hiring
more support staff in response
64%
Cancellations
Physical space
Availability of clinical support staff
Other
Physician capacity
30%
Patient-driven deferred care
COVID protocols
49%
45%
39%
20%
4%
Increasing marketing to patients
Hiring additional physicians
Hiring additional clinical support staff
(eg, techs, nurses)
Offering more virtual health appointments
Revising physician schedule templates
65%
Hiring additional advanced practice
providers
Proactively calling patients who have
delayed care
Expanding clinic hours
Increasing physician productivity
expectations to expand capacity
Expanding affiliations with non-employed
physicians
Other
46%
61%
57%
56%
53%
47%
43%
41%
23%
4%
Barriers to increase outpatient clinic volume in
upcoming months, % of respondents1
Actions respondents are pursuing to increase outpatient
clinic volume, % of respondents2
1. Q19: What challenges do you expect your hospital to face in trying to increase outpatient clinic volume in the upcoming months?
2. Q20: What actions are you pursuing to increase outpatient volumes?

Hospitals surveyed have wide-ranging expectations for
physician productivity, with ~30% reporting higher
expectations as a result of COVID-19
No standard
productivity
expectations
exist
60th percentile 75th percentile
50th percentile 80th percentile 90th percentile Other
70th percentile
12%
21%
1%
9%
17%
16%
19%
5%
Physician productivity expectations compared to wRVU1 benchmark, % of respondents2
1. wRVU, work relative value units.
2. Q21: Does your organization have physician productivity expectations, and if so, what percentile is expected?
3. Q22: Have the physician productivity expectations at your organization changed as a result of COVID-19?
~30% of hospitals
surveyed report
productivity
expectations have
increased as a result of
COVID-19, while ~45%
say they have not
changed and ~15% say
they have decreased3

~30% of respondents indicated new expansion plans to grow their
number of employed physicians as a result of COVID-19
Expansion plans exist, but existed prior to 2020
New plans to grow the ambulatory footprint and
the number of employed providers exist
(plans developed in 2020 or 2021)
No expansion plans exist
New plans to grow the ambulatory footprint exist
(plans developed in 2020 or 2021)
18%
Expansion plans existed prior to 2020, but have
been put on hold
4%
New plans to grow the number of employed
providers exist (plans developed in 2020 or 2021)
9%
42%
14%
13%
Plans to increase ambulatory footprint or increase number of employed physicians in the
next year as result of COVID-19, % of respondents1
1. Q25: Is your organization planning to increase your ambulatory footprint (eg, new facilities) or increase the number of employed physicians in the next year as a result of COVID-19?

On average, US providers surveyed shifted ~20% of outpatient visits to
virtual care in 2020, but that declined to ~13% in July 2021
Percent of outpatient visits occurring via virtual care in 2021 YTD, % of total outpatient
visits1
1. Q31: What percent of outpatient visits occurred, or are expected to occur, via virtual care in each time period? (eg, 10% of all outpatient visits were conducted via virtual care in Q1 2020.)
5
20 17 15 13
95
80 83 85 87
2019 Q1 2021
20 Q2 2021 July 2021
100%
Percent of outpatient visits occurring via
virtual care in 2021+, % of total outpatient visits1
In-person care
Virtual care
14 13 14 15
86 87 86 85
22 2023
Q3
2021
Q4
2021

Providers report family medicine and psychiatry are the specialties
where virtual care is used most frequently
64%
Family medicine
Orthopedic surgery
Dermatology
Gastroenterology
Psychiatry
Neurology
General internal medicine
Pediatrics
Cardiology
General surgery
Ears, nose, and throat (ENT)
Obstetrics and gynecology
Neurosurgery
Oncology
10%
Plastic surgery
13%
Urology
Ophthalmology
28%
67%
62%
43%
33%
28%
24%
12%
23%
21%
18%
17%
16%
15%
13%
Specialties that routinely leverage virtual care for outpatient visits, % of respondents1
1. Q32: In which of the following specialties do you routinely leverage virtual care for outpatient visits?

Providers report workforce shortages and OR room capacity as the
biggest challenges to increasing elective volume, and systems are
taking a variety of actions to mitigate
Sub-optimal allocation
of OR block time
OR room capacity
79%
Workforce shortages
Inpatient bed availability
Access for outpatient visits
15%
Limited patient demand
COVID protocols (eg, testing)
Last-minute cancellations
of procedures
29%
PPE1 shortages
Other
45%
40%
39%
27%
18%
5%
3%
59%
1%
Reevaluate OR block allocation
Hire additional staff
Proactively contact patients a day in advance
Optimize room turnover times
Extend typical hours of operation each day
Increase inpatient bed capacity
Improve analytic capabilities in perioperative services
Schedule elective procedures on weekends
Optimize length of stay
Stock up on PPE and testing supplies
Increase affiliations with independent surgeons
5%
Build additional ORs
Increase use of virtual care
3%
Re-evaluate productivity of employed physicians
Establish hospital command center
6%
Reimagine OR experience
Reimagine the continuum of care
Other
48%
35%
34%
4%
24%
17%
9%
16%
15%
8%
7%
7%
2%
Barriers to increase elective surgery volume in
upcoming months, % of respondents indicating the
issue is one of their top 3 challenges2
Actions respondents are pursuing to increase OR1
utilization, % of respondents answering in top 3 actions3
1. OR, operating room; PPE, personal protective equipment.
2. Q27: What are the top 3 challenges your hospital may face in trying to increase elective surgery volume in the upcoming months?
3. Q28: What actions is your hospital planning to take in the medium-term (ie, next 12 months) to increase operating room utilization? Rank all that apply in order of importance.
0%
Change since
May survey
-5%
-5%
-35%
-3%
+6%
+6%
+23%
+2%
+12%
Change since
May survey
-4%
+5%
-12%
+1%
-23%
-13%
+9%
-32%
-14%
-2%
-23%
-6%
-14%
-5%
-9%
-14%
-25%
+1%

Systems anticipate a ~10% shift in operating room surgeries
from inpatient to outpatient settings by 2023
1. Q30: Approximately what percent of your operating room surgeries were performed in an inpatient vs outpatient setting in the following years (eg, 60% inpatient, 40% outpatient)?
Estimated percentage of surgeries performed in outpatient vs inpatient setting from
2019 to 2023, % of respondents1
48
20
53 51
21
47
2019
52
49
45
Outpatient
55
22
43
57
2023
Inpatient
+10
percentage
points

The majority of respondents reported a shift in orthopedics care to
the outpatient setting, followed by general surgery and ENT
Obstetrics and gynecology
Plastic surgery
Gastroenterology
23%
Interventional cardiology
Orthopedic surgery
General surgery
8%
36%
Ears, nose, and throat (ENT)
Urology
79%
Neurosurgery
43%
42%
33%
20%
14%
13%
1. Q17: Which of the following specialties at your institution have seen a shift in the percentage of procedures performed in an inpatient vs outpatient setting (eg, 5% shift to outpatient setting)?
Percentage of respondents reporting a shift in the percentage of
procedures performed inpatient vs outpatient, % of respondents1
Average percent shift from inpatient
to outpatient among those indicating
a shift
18%
14%
20%
18%
21%
26%
20%
14%
12%
13%

~30% of providers report system capacity is most limited
in inpatient beds
Inpatient beds Outpatient
clinic
Emergency
department
No areas
at capacity
Operating
room
Endoscopy
suite
29%
Cath lab
18%
15%
14%
11%
7%
6%
Area where system capacity is currently most limited, % of respondents1
1. Q26: Where is hospital capacity currently most limited?
Change from May
2021 survey of 30
large health systems
+16% +8% -8% +1% -12% -6% +3%

Providers report several COVID-19 protocols are in place in
outpatient and inpatient settings
Masking requirements for patients
Vaccination requirements for patients
Restrictions on visitors with patient
Increased spacing between
chairs in waiting room
Expanded waiting room space
Temperature checks for patients
Waiting room closed,
having patients wait in car
Vaccination requirements for employees
96%
97%
78%
75%
49%
5%
22%
40%
10%
Other
COVID-19 protocols currently in place in outpatient clinics,
% of respondents1
1. Q4: What COVID protocols do you currently have in place in outpatient clinics?
2. Q5: What COVID protocols do you currently have in place for inpatients in your hospital?
Temperature checks for patients
Other
Vaccination requirements for employees
Vaccination requirements for patients
Masking requirements for patients
Restrictions on visitors with patient
42%
80%
79%
88%
12%
6%
COVID-19 protocols currently in place for inpatients, % of
respondents2

Providers continue to report workforce challenges, and ~60% say they
would reduce inpatient elective volume if COVID-19 surged this winter
8%
Supply of COVID-19 vaccinations
Supply chain logistics
and supply availability
Supply of COVID-19 testing 10%
Other
Clinical support staff coverage
Nursing workforce coverage
None
Patient-driven deferred care
84%
45%
60%
4%
50%
5%
COVID-19 challenges respondents still face, % of respondents1
1. Q6: What challenges related to COVID-19 does your hospital still face?
2. Q7: Which of the following actions would you take in response to a potential increase in the number of patients hospitalized with COVID-19 this winter (if patient volumes at your hospital mirrored last winter)?
Reduce the number of outpatient
elective procedures
Stand down all outpatient care
Stand down non-urgent outpatient care
Pause elective admissions
12%
Reduce the number of inpatient
elective procedures
None of the above unless mandated
47%
33%
49%
Other
59%
27%
5%
Actions respondents would you take in response to a
potential COVID-19 increase this winter, % of respondents2

COVID-19 hospital insights survey

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