The bed board, sorted out before 7:30.

An integer program, not a model that guesses.

Every bed is a slot, every waiting admit is an item, and every rule the hospital already enforces (1:4 acute RN ratio, 5150 holds stay in acute, single-sex rooms, 14-day LOS cap, line-of- sight cameras for LPS) is a linear constraint. A cron job at 3 AM runs CBC on the census laptop. The solver picks the assignment that fills the most beds without breaking a rule. A typical solve takes 2.8 seconds; the charge nurse re-runs it on demand whenever a mid-shift change comes in.

Every override is logged with a reason. Those overrides are what we use to tune the objective weights each quarter. The current override rate is below eight percent and trending down.

Same building, same staff, seventeen more admits a month.

Monthly utilization moved from a 62% baseline to a six-month average of 91%. Morning ED holds dropped from three to four hours down to under one. The facility placed roughly seventeen more patients per month without opening a bed or hiring a nurse. The methodology paper was accepted at APA 2024.