Once a discharge schedule is in place, internal transfers of patients — for example, from an ICU to a patient care unit — can be synchronized to that schedule. Individual units can begin scheduling and orchestrating the movement of their patients at the local level. This synchronization allows local, unit-level control and system-wide optimization to occur simultaneously.

Communication and planning across units is important to create a process for placing admissions and transfers into beds made available by patients discharged out of the hospital. Many hospitals use bed huddles to coordinate this planning. Bed boards placed in a central location (or made available electronically) are a communication tool that helps to link admissions and transfers to anticipated discharges.