Case Study: Implementing Technology to Prevent Hospital Overcrowding and Hallway Medicine

MCAP has helped to improve patient flow by providing objective clinical decision support data.



The MCAP tool, Making Care Appropriate for Patients, exists to help our clients remain at the forefront of efficient and effective patient care. MCAP is a patient flow tool that identifies patients that are clinically suitable for non-admission or discharge, delivering significant efficiencies in patient flow and care. MCAP does not challenge clinicians’ care decisions; it is a decision support tool based on an objective analysis of the individual patient care service requirements, using evidence based clinical criteria.

The goal of the MCAP Criteria is not to deny care, but to put people at the right level of care given their individual care needs.

MCAP Patient Appropriateness Review (PAR) Fact Sheet

The Review enables providers with the information to optimize patient flow and operational efficiency ensuring that the right care is provided at the right time.




After more than 15 years of development and refinement by our experts, MCAP is the most accurate and up-to-date CUR tool on the market today. MCAP brings to light the reasons for patient blockages and delays in real-time, giving providers the tools to:

  • Reduce length of stay
  • Improve care coordination
  • Reduce avoidable admissions
  • Reduce A&E wait times
  • Improve quality of care
  • Increase bed turnover
  • Achieve timely discharge
  • Improve patient satisfaction

Reducing Inappropriate Admissions

MCAP provides assessments for patients of all ages using 55 medical/surgical and 48 behavioral health and substance use criteria sets and recognizes more than 30 different levels of care. It helps clinicians identify patients who are clinically suitable for non-admission or could be provided care at alternative level of care, reducing inappropriate admissions.

MCAP has been applied in over 125 UK hospitals, where it has shown that a quarter of acute admissions could be avoided by providing care in an alternate, non-acute setting, including 5% of acute A&E patients that could go home with primary care follow-up or an outpatient appointment.


Reducing Length of Stay

MCAP’s specific, evidence-based clinical criteria identify the underlying root causes of patient flow blockages, these can be used to understand exactly what systemic issues the hospital is facing. MCAP findings provide data not otherwise readily available, revealing opportunities for systemic improvement.

In over 125 UK hospitals, MCAP has shown that half of continuing care days could be avoided or provided in an alternative setting, including 10% of acute and intermediate patients that could go home with primary care follow-up. Enhancing your system with MCAP typically enables appropriate patient discharge 2-3 days earlier on average than the current acute care system and 7-10 days earlier than community/intermediate care systems.



The structure and format of the criteria are designed with a single purpose: to obtain consistent and reliable information about the process of care delivery. MCAP does not challenge clinicians’ care decisions; it functions as an aid to advise on where care can best be delivered.

The evidence-based clinical criteria have been refined and updated by an international panel of experts during the last years; updated annually by the expert panel whilst reviewing the most up to date literature.

Critically, MCAP takes account of co-morbid and co-occurring conditions, providing assessments for patients of all ages using 55 medical and surgical and 48 mental health and substance abuse criteria sets in more than 30 different levels of care across medical, surgical, rehabilitation, neonatal, mental health and substance misuse services.

MCAP clinical utilization criteria are service-driven, the most effective, accurate, and least problematic method of determining the appropriate service level for patient care. The literature gives little direct guidance to healthcare providers on the appropriate setting in which to provide care, despite increasing recognition of complexity of admissions with co-occurring conditions. There is, however, significant literature providing evidence to support service-level decisions based on what care the patient requires. We have used that literature to create a service-driven tool, enabling our clients to quickly and accurately determine the most appropriate service level for the patient’s care.


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