Hallway Medicine: A convergent mixed methods study on perspectives from the frontlines of care

Introduction: Hospitals are increasingly using hallway beds to address capacity challenges. Limited research exists about patients and health care providers’ (HCPs) perception of care in these settings. This study assessed a hallway bed initiative on general internal medicine (GIM) wards and gathered feedback from HCPs and patients. Methods: Convergent mixed methods study conducted on six GIM wards in Alberta, Canada. Data included hallway bed utilization, patient complaints, and patient safety (PS) reports. Surveys were distributed to patients and HCPs. Data were analyzed descriptively, underwent thematic analysis, and compared. Results: A total of 913 hallway bed stays, involving 824 patients, were analyzed. Most beds (98%) were used mid-stay or near discharge, with median durations of 18.5–21.7 hours. Patients were predominantly male (57%) and aged ≥ 65 (42%). Patient complaints (n = 9) and survey responses (n = 55) revealed a lack of empathy, privacy, space, confidentiality, access to basic needs, dissatisfaction with bed location and expressions of gratitude for care. Twelve PS reports identified safety concern categories: falls, care transitions, and environmental risks. HCP survey responses (n = 140) aligned with patient feedback and additionally identified care delivery challenges, unclear criteria, poor staff morale, and advocacy to discontinue use. Discussion: Hallway bed usage is a short-term remedy to overcrowding. Findings emphasize the importance of making immediate improvements including stricter patient selection criteria and optimized staffing while also developing long-term, system-level strategies and infrastructural investments to reduce reliance on hallway beds, upholding patient dignity and provider well-being. These findings may inform interdisciplinary policy development and targeted initiatives in capacity management.