Intensive Care Units (ICUs) provide care for the most critical patients in a hospital. Due to high staffing requirements and specialized equipment, they are very expensive to operate. As such, ICUs often operate at or above capacity, which leads to periods where patient demand exceeds availability. This talk will examine the impact of the timing of ICU admissions on patient outcomes. From an operational perspective, these effects have two consequences. The first is the immediate impact on the admitted patient. A second, systemic impact, can arise due to increased congestion caused by the increased care requirements for the delayed patient. In particular, the increased ICU LOS can result in delays to other patients requiring the same ICU resources, which in turn results in longer LOS for those patients, and so forth. This talk will discuss empirical and stochastic models used to develop evidence-based strategies to manage the timing of ICU admissions in order to improve the quality and efficiency of care in ICUs.