Innovative capacity building: University of Utah Health’s success with a collaborative capacity action plan

In response to mounting capacity constraints, rising emergency department (ED) boarding and left-without-being-seen (LWBS) rates and projections indicating the need to nearly double inpatient capacity within a decade, University of Utah Health launched a comprehensive, system-wide Capacity Action Plan in 2022. This case study outlines the strategic shift from a siloed, reactive approach to a coordinated, data-driven and collaboratively governed framework designed to drive short- and mid-term capacity gains while laying the groundwork for long-term, sustainable growth. In its first year, the Capacity Action Plan yielded over 6,800 additional bed days — equivalent to 18 staffed inpatient beds — alongside a 5 per cent decrease in inpatient occupancy, a 1 per cent drop in LWBS, a 2 per cent reduction in ED boarding and a combined US$19.1m in contribution margin and cost avoidance. Year 2 sustained and expanded these results, delivering over 5,200 additional bed days, US$8.3m in contribution margin and US$5.2m in operational savings, while also increasing online self-scheduling by 109 per cent, conducting 10 per cent of outpatient visits virtually and improving radiology and surgical throughput. Beyond outcomes, the initiative catalysed cultural change and operational alignment, with lessons learned around prioritisation, cross-functional execution and adaptability. University of Utah Health demonstrated that capacity expansion does not always require new buildings — it can be achieved through disciplined execution, shared ownership and continuous learning. This case study presents a replicable model for health systems aiming to enhance care access, efficiency and financial resilience in the face of increasingly complex demands. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/.