A new survey of frontline nurses supporting triage and transfer services for health systems and medical practices nationwide highlights several operational factors that can influence health system readiness during periods of increased demand, including workforce capacity, patient flow, after-hours access and operational visibility.
Conducted by Conduit Health Partners, the survey of 54 nurses identified four operational areas that respondents believe warrant close attention as winter demand approaches:
- 51% of nurses in transfer center roles identified real-time visibility into bed availability and system capacity as critical to timely transfers.
- 57% said delays in access, placement or coordination often or very often put patients at risk of receiving care later than clinically appropriate.
- 77% of triage nurses said after-hours access limitations often or very often contribute to patients seeking higher-acuity care than may be clinically necessary.
- 67% said workforce capacity and resource availability often or very often make it harder to guide patients to the appropriate level of care.
The challenge of seasonal surges is not new to healthcare. A 2025 Health Affairs study found that over the last three years, boarding rates climbed from about 25% in non-peak months to roughly 35% in winter peak months, with nearly 5% of peak-month admissions waiting more than 24 hours for a bed in 2024. Becker's Hospital Review has likewise tracked emergency department boarding and capacity management as persistent operational challenges that can become more difficult during periods of elevated demand. Against that backdrop, nearly eight in 10 nurses surveyed said health systems face winter readiness challenges, underscoring the value of proactive planning before seasonal volumes increase.
"Winter readiness isn't something you can build in the weeks before volume spikes. It has to be an operating discipline health systems maintain year-round," said Cheryl Dalton-Norman, president and co-founder of Conduit Health Partners. "These findings suggest many organizations may face increased pressure on staffing, patient flow and after-hours access as winter demand rises. Part of the answer is strengthening capacity, but just as important is reducing the volume that shouldn't be hitting the ED in the first place, whether that is preventable visits, redundant testing or chronic conditions that aren't being managed before they become emergencies."
Conduit's own operational data reflects the impact of demand-reducing strategies such as the availability of nurse triage, which can help patients reach the most appropriate care setting while preserving capacity for higher-acuity needs. From October 2024 through January 2025, 74% of triage cases were resolved without an ED visit, with that rate peaking at 76% in winter and dipping to 71% in summer.
Conduit Health Partners has published a companion Winter Readiness Checklist covering 10 areas, including workforce flexibility, discharge and downstream capacity, operational visibility and sustained performance, to help health system leaders identify where additional planning or support may be needed before demand increases.
For more information, visit conduithp.com.
Conduit Health Partners is a nurse-led healthcare solutions company specializing in patient transfer coordination and URAC-accredited Health Call Center with nurse-first triage. With deep clinical and operational experience, Conduit partners with health systems to solve critical challenges such as provider burnout, administrative burden for clinical teams, and network leakage. Supported by more than 150 registered nurses, Conduit Health Partners has delivered scalable, cost-effective solutions since 2017, improving patient experience, care coordination, and operational efficiency across over 400 facilities in all 50 states. Learn more at www.conduithp.com.
