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Hospital congestion is an interconnected operational phenomenon in which local delays can cascade across emergency, inpatient, diagnostic, pharmacy, and consultative services. Prediction has often been organized around individual departments rather than the hospital as a coupled system. Current forecasting approaches do not sufficiently represent dynamic dependencies among units, including patient transfers, service requests, staffing availability, and real-time capacity. This limits their ability to anticipate how pressure in one department could propagate into another. This article proposes a temporal graph transformer for forecasting interdepartmental workflow congestion across a hospital network. The model is designed to learn from time-varying departmental relationships and produce forward-looking congestion estimates for operational decision support. The proposed framework represents hospital units as graph nodes annotated with capacity, queue, and staffing signals. Directed edges are weighted by patient movement and service request dependencies, and a temporal graph transformer processes graph sequences to estimate future congestion probabilities for each unit. Conceptually, the model would be expected to identify building pressure before it appears as visible delay. Such forecasts could support proactive coordination, including staff redeployment, transfer prioritization, and service sequencing. A graph-based temporal perspective could shift hospital congestion management from reactive firefighting toward coordinated, predictive flow control. The proposed model provides a conceptual foundation for future prospective evaluation in real-time operational settings.

Foundation models pre-trained on massive, multimodal data have transformed several areas of artificial intelligence. Their adaptation to healthcare operations analytics is an emerging frontier because hospital workflows generate dense streams of structured, textual, temporal, and administrative data. This systematic review examined applications of foundation models to patient flow prediction, documentation burden estimation, resource allocation, and operational risk forecasting from 2017 to 2026. The review focused on multimodal pretraining, transfer learning, downstream adaptation, validation, and implementation maturity. A PRISMA 2020-compliant search was designed for PubMed, Scopus, IEEE Xplore, and Web of Science. Records were screened by two reviewers, and eligible studies were synthesized narratively by operational domain, model architecture, data modality, and maturity level. A small but rapidly growing body of work suggests that pre-trained multimodal models may support operational prediction tasks across healthcare systems. Evidence was concentrated in patient flow and resource allocation, while documentation burden estimation and operational risk forecasting were less frequently studied. Foundation models show potential to unify operational analytics across hospital systems. The field remains immature, with limited external validation, few prospective implementation studies, and no widely adopted benchmarks for operational foundation models.