Many patient flow bottlenecks result from the rigid deployment of medical devices, especially patient monitors. Its been reported in the literature that as much as 17% of ICU patients are there for monitoring, do not require the 1:1 or 1:2 nurse to patient ratio, and could be safely cared for in a lower acuity unit -- if monitoring were available. A key concept is the ability to place patients in the lowest cost care setting with the most appropriate level of care. This frees up more specialized beds like the ICU for patients requiring the high level of care provided there.
One take on flexible monitoring is available here, presented by Jim Welch, CTO of Welch Allyn at the Fall 2004 Oregon HIMSS chapter meeting. (Be patient, its a pretty big file, and their server is slooow.)
Most hospitals are organized with fixed units with predefined capabilities. Along with rigid staffing levels and a specific suite of equipment, many times bolted to the wall, these units have very specific meds protocols, policies and procedures.