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Tactical capacity planning is crucial when hospitals must cope with substantial changes in patient requirements, as recently experienced during the Covid-19 pandemic. However, there is only little understanding of the nature of capacity limitations in a hospital, which is essential for effective tactical capacity planning.

We report a detailed analysis of capacity limitations at a Norwegian tertiary public hospital and conducted 22 in-depth interviews. The informants participated in capacity planning and decision-making during the Covid-19 pandemic. Data are clustered into categories of capacity limitations and a correspondence analysis provides additional insights.

Personnel and information were the most mentioned types of capacity limitations, and middle management and organizational functions providing specialized treatment felt most exposed to capacity limitations. Further analysis reveals that capacity limitations are dynamic and vary across hierarchical levels and organizational functions.

Future research on tactical capacity planning should take interdisciplinary patient pathways better into account as capacity limitations are dynamic and systematically different for organizational functions and hierarchical levels.

We argue that our study possesses common characteristics of tertiary public hospitals, including professional silos and fragmentation of responsibilities along patient pathways. Therefore, we recommend operations managers in hospitals to focus more on intra-organizational information flows to increase the agility of their organization.

Our detailed capacity limitation analysis at a tertiary public hospital in Norway during the Covid-19 pandemic provides novel insights into the nature of capacity limitations, which may enhance tactical capacity planning.

The history of special education has been influenced by changing societal and philosophical beliefs about the extent to which individuals with disabilities should be feared, segregated, categorized, and educated. Prior to the 1700s, individuals with exceptionalities were largely ignored or subjected to inhumane treatment, ridicule, isolation, and at times put to death (D'Antonio, 2004; Winzer, 1993, 1998). However, the sixteenth and seventeenth centuries ushered in rational philosophical beliefs about human dignity, which led to changes in the treatment and societal perceptions of individuals with exceptionalities (Winzer, 1998). These changes also were supported by efforts of pioneering special educators and advocates who began to experiment with various individually designed approaches to educating individuals with exceptionalities and to disseminate their work to others (Winzer, 1993).