America’s Hospital Bed Shortage Might Have a Practical Fix Through Smart Command Centers
America’s hospitals are running out of beds, and the situation is becoming more visible to patients every day. Across the country, people sit for hours or even days in emergency departments waiting for inpatient beds to open up. Smaller hospitals struggle to transfer patients who need advanced care, while patients who are medically ready to leave often remain stuck in their rooms due to slow discharge processes. All of this adds pressure to a system already strained by an aging population, policy shifts, insurance-related financial challenges, and ongoing shortages of clinical staff.
A recent study from the University of Michigan Health suggests that there may be a powerful way to ease this problem without building new hospitals or adding hundreds of physical beds. Instead, the answer lies in using data, technology, and operational redesign to manage hospital capacity more intelligently.
The study focuses on the Michigan Medicine Command Center, commonly known as M2C2, a centralized hub designed to coordinate inpatient bed use across University of Michigan Health’s three Ann Arbor hospitals. The results show that improving how hospitals use their existing beds can dramatically increase capacity, reduce wait times, and even deliver strong financial returns.
Understanding What the Michigan Medicine Command Center Does
M2C2 stands for Michigan Medicine Capacity Operations and Real-time Engagement Center, also referred to as the C.O.R.E. Center. It officially opened three years ago and brings together multiple teams that previously handled bed coordination, patient transfers, and capacity management separately.
Instead of working in silos, these teams now operate together from a dedicated space on the medical campus. The command center features three rooms lined with 32 large digital screens, displaying real-time data about bed availability, patient flow, discharge status, and incoming transfer requests. This information is also accessible through the hospital’s intranet, allowing staff across the system to stay informed.
At the heart of M2C2 are two major technological components. The first is a set of data dashboards built on the Epic electronic health record system, which is widely used by hospitals nationwide. The second is an artificial intelligence–based patient placement tool, developed in-house by University of Michigan Health’s own capacity management team. Together, these tools help staff make faster and more accurate decisions about where patients should go and when beds can be freed up.
Measurable Improvements in Bed Efficiency and Patient Flow
The study evaluated hospital performance before the command center opened and then again after two full years of operation. The findings reveal significant improvements across nearly every aspect of patient flow.
For adult patients at University Hospital and the Frankel Cardiovascular Center, the total time spent waiting for an inpatient bed dropped by 33%. This included a 37% reduction in the time it took to assign beds to adults arriving through the emergency department who were approved for hospital admission.
Pediatric patients also saw benefits. At C.S. Mott Children’s Hospital, the time required to assign beds decreased by 13%, helping reduce delays for children needing inpatient care.
Patient transfers showed meaningful gains as well. Before M2C2, University of Michigan Health accepted about 70% of incoming transfer requests from other hospitals. After implementing data-driven prioritization processes, that number rose to 80%, allowing more patients to access high-level quaternary care services that are not available at smaller facilities.
Discharge efficiency improved as well. Adult patients experienced a 12% reduction in the time between a discharge order and actually leaving the hospital, while pediatric patients saw a 9% decrease. These changes helped free up beds more quickly without compromising patient safety.
Perhaps most notably, the average length of stay for adult patients dropped by 8%, even after adjusting for patient complexity. This indicates that the improvements were not simply due to treating less complicated cases, but rather to more efficient care delivery and coordination.
Equivalent to Adding Dozens of New Hospital Beds
When all of these improvements were combined, the impact was substantial. The researchers estimated that the increased efficiency achieved through M2C2 was equivalent to adding 63 adult inpatient beds across the system. Importantly, this gain came without constructing new buildings or expanding physical infrastructure.
From a financial perspective, the results were equally striking. The command center cost $2.1 million to build using converted space on campus, and it requires about $1.5 million per year to staff and operate. Even with these expenses, the initiative produced an estimated $19.5 million net positive impact on the health system’s finances. Some of the initial funding for M2C2 came from philanthropic donors.
Why Technology Alone Is Not Enough
One of the key messages from the study is that technology, while essential, is only part of the solution. The success of M2C2 depended just as much on governance, standardized procedures, clear goals, and cross-department collaboration.
By building its own data infrastructure instead of purchasing a third-party command center solution, University of Michigan Health was able to fully customize its tools and share detailed findings publicly through the research paper. This transparency is intended to help other hospitals learn from the model and adapt it to their own environments.
Leadership support also played a crucial role. Aligning information technology, nurse staffing, clinical operations, and hospital administration around a shared command center structure ensured that decisions could be made quickly and consistently.
How the Command Center Performs During Major Transitions
Beyond everyday operations, M2C2 has proven valuable during major system changes. Recently, the command center helped coordinate the movement of 186 adult inpatients into newly opened beds at the D. Dan and Betty Kahn Health Care Pavilion, which will ultimately house 264 private inpatient rooms.
The command center also supported the launch of multiple observation units, including one opened in April for patients requiring very short hospital stays, often following emergency department visits. Additionally, two levels of University Hospital South, a building that once housed the children’s hospital, were converted to meet rising demand for observation care.
Looking ahead, M2C2 will be instrumental in an upcoming renovation of University Hospital, which was built 40 years ago when shared rooms were standard. The command center will help manage changing bed configurations during and after the renovation process.
Expanding the Model Beyond Ann Arbor
University of Michigan Health is now extending aspects of the command center model to its regional network. Hospitals such as UM Health-Sparrow in Lansing and UM Health-West in the Grand Rapids area are beginning to implement similar processes, adapting the system to local needs while following the same core principles.
The space has also attracted attention from other health systems, students, and researchers. Visitors from across the country have come to study how M2C2 operates, and the center has become a learning environment for students from medicine, engineering, information science, and public health.
What This Means for Hospitals Nationwide
The challenges facing U.S. hospitals are unlikely to ease anytime soon. With demand for care rising and staffing shortages persisting, simply adding more beds is often unrealistic. The M2C2 experience suggests that hospitals may be able to unlock hidden capacity by eliminating avoidable delays, improving discharge coordination, and making smarter use of real-time data.
Efficient bed management also supports better clinical outcomes. When care milestones are met on time—such as early patient mobilization or timely removal of medical devices—patients recover faster, lengths of stay shrink, and readmission rates can decline.
The key takeaway is clear: hospitals cannot simply layer a command center onto an inefficient system. Operational optimization must come first, supported by strong leadership commitment and integrated technology.
Research Reference
Jennifer L. Pardo et al., Designing a Hospital Command Center with Proven ROI: The University of Michigan M2C2 Model, NEJM Catalyst (2025).
https://doi.org/10.1056/cat.25.0080
