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U.S. Department of Health and Human Services

Immediate Bed Availability

What is Immediate Bed Availability?

Immediate Bed Availability (IBA) is a means to provide appropriate levels of care to all patients during a disaster.  Healthcare Coalitions (HCCs) provide the foundation and partnerships required to execute IBA.  IBA makes 20% of staffed hospital beds in an HCC available to higher acuity patients within four (4) hours of a disaster. Through IBA, HCCs identify lower acuity patients and provide them with appropriate levels of care.  IBA increases an HCC’s ability to create medical surge capacity for both “no notice” and slower evolving disasters. 

What are the 4 pillars of IBA?

  1. Monitor patient acuity and staffed bed availability in real-time 
  2. Off-load patients by executing rapid bed turnover, discharging/transferring lower acuity patients, and deferring elective admissions and/or procedures
  3. On-load patients by redeploying existing resources to allow for higher-acuity admissions
  4. Track and document patient movement to ensure continuity of medical care rendered and ensure family members know the location of their loved ones at all times 

What is the goal of IBA?

  • The goal of IBA is to quickly provide higher-level care to more serious patients during a disaster with no new space, personnel, or equipment.

What does IBA look like in practice?

  • Coalition partners must continuously monitor acuity of patients and maintain full ability for patient movement.
  • Once a disaster happens, acute care facilities will need to prepare for an influx of new disaster patients.
  • Through agreements with coalition partners, lower acuity patients can move between appropriate facilities and care sites, which would make room for higher acuity patients. These same agreements ensure receiving facilities (such as long term care facilities or nursing homes) can provide the appropriate level of care.

Where does IBA fit into the Program Measures?

  • Medical Surge Indicator 4: The HCC has tested its coordinated mechanism to both deliver appropriate levels of care to all patients, as well as to provide no less than 20% immediate availability of staffed members' beds, within 4 hours of a disaster.
  • Medical Surge Indicator 5: The HCC has demonstrated the ability to do the following during an incident, exercise or event:  1) Monitor patient acuity and staffed bed availability in real-time, 2) Off-Load Patients, 3) On-Load Patients, 4) Track and document patient movement
  • Continuity of Healthcare Operations Indicator 3: The HCC has a process to enhance its member’s situational awareness to support activation of immediate bed availability through continuous monitoring.
For more information on this and other HPP Program Evaluation topics, please refer to the HPP Measure Manual: Implementation Guidance for the HPP Program Measures.  SHARPER welcomes your feedback. Please submit your questions and comments via e-mail at

SHARPER: Science, Healthcare, Preparedness, Evaluation and Research

  • This page last reviewed: July 16, 2014