Surge Capacity

• Key information
  • In large mass casualty situations, responding health care entities may need to increase their capacity several fold very quickly in order to serve patients. This is usually called initiating protocols for "surge capacity".
  • Hospital Surge Evaluation Tool (HHS/ASPR)
    • User-friendly, peer assessment tool to identify gaps in a hospital's surge plans and help assess its ability to respond to a mass casualty event.
    • Intended for use by hospital emergency managers, hospital administrators, and clinical staff to assess and improve their hospital's surge plans
    • Can help hospital emergency managers to make recurring tabletop exercises a reality by providing a fully developed tabletop exercise that can be used at their facilities
    • It is not an accountability tool.
  • Medical Surge Capacity: Workshop Summary, Forum on Medical and Public Health Preparedness for Catastrophic Events (Institute of Medicine, Board on Health Science Policy, January, 2010) Purchase required.
  • In mass casualty situations when there are scarce resources, it may also become necessary to implement "crisis standards of care" for medical activities. Guidance on creating, and implementing these standards has been addressed by the US Institute of Medicine in these 3 publications:
    • Crisis Standards of Care: A Toolkit of Indicators and Triggers (Institute of Medicine, July 31, 2013)
    • Crisis Standards of Care (CSC): A Systems Framework for Catastrophic Disaster Response (Institute of Medicine, March 21, 2012)
    • Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations, a Letter Report (Institute of Medicine of the National Academies, 2009).
      • Allocation of Scarce Resources During Mass Casualty Events (HHS/AHRQ, June 2012) (This report represents follow-up after the 2009 IOM report.)
  • There is much literature on this topic. Selected recent references are provided.
  
  
• HHS/AHRQ
  • Medical Surge Capacity and Capability: The Healthcare Coalition in Emergency Response and Recovery (PDF - 2.10 MB) (HHS/ASPR, May 2009)
  • Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies (PDF- 4.22 MB) (HHS/ASPR, September 2007)
    
    
  • Public Health Emergency Preparedness - Surge Capacity (HHS/AHRQ)
  • Mass Medical Care with Scarce Resources: The Essentials (HHS/AHRQ, September 2009)
  • Pediatric Hospital Surge Capacity in Public Health Emergencies (HHS/AHRQ, January 2009)
  • AHRQ Hospital Surge Model (HHS/AHRQ, September 2008)
  • Mass Medical Care with Scarce Resources: A Community Planning Guide (HHS/AHRQ, February 2007)
  • Predicting Health Care Use Resulting From Terrorism: Tools To Aid State Planning: Summary (HHS/AHRQ, January 2005)
  
  
• HHS/CDC
  • Interim Guidelines for Hospital Response to Mass Casualties from a Radiological Incident (PDF - 527 KB) (HHS/CDC, December 2003)
  
  
• Other
  • Hick JL, Barbera JA, Kelen GD. Refining surge capacity: conventional, contingency, and crisis capacity. Disaster Med Public Health Prep. 2009 Jun;3(2 Suppl):S59-67. [PubMed Citation]
  • Emergency Preparedness - States Are Planning for Medical Surge, but Could Benefit from Shared Guidance for Allocating Scarce Medical Resources (PDF - 1.06 MB) (GAO, June 2008)
  • Medical Surge Capacity, Workshop Summary, Forum on Medical and Public Health Preparedness for Catastrophic Events. (Institute of Medicine of the National Academies, 2010).
  • Bayram JD, Zuabi S, El Sayed MJ. Disaster metrics: quantitative benchmarking of hospital surge capacity in trauma-related multiple casualty events. Prehosp Disaster Med. 2012 Oct;27(5):445-51. [PubMed Citation]

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