Safer Scoring

Understanding WArd Strain - Effects on Patients and Staff (WASPS)

Hospital capacity strain arises when demand for care exceeds available resources such as staff, beds, or equipment. Although this imbalance was magnified during the COVID-19 pandemic, it has long existed as a structural feature of many health systems. Persistent strain affects the system's ability to provide timely, safe care, causing delays, longer waits, higher deterioration risks, and reduced monitoring capacity. Most literature on capacity strain has been examined in Emergency Departments and Intensive Care Units, while general wards—where the majority of hospital care occurs—have received significantly less attention.

This research project will apply mixed methods evaluation to understand ward strain. The qualitative study aims to improve our understanding of the causes and effects of hospital capacity strain on patient care within ward settings. Patients and carers will be interviewed and observed to investigate the effects of ward strain from their perspectives and their experience of their care when the ward is strained. Staff will be interviewed and observed to understand the causes of ward strain in different settings, how different staff groups experience it, and investigate the effects of it on patient care and their well-being when the ward is strained. The qualitative data generated from this study will be combined with the quantitative data (e.g., electronic health record and staff roster dataset) to develop a measurement of 'strain' capable of identifying areas of need where patients and staff may be adversely affected if mitigating actions are not implemented.

Lead Investigators

Katharina kohler

Research Team

Georgia Bercades