Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T12:37:02.405Z Has data issue: false hasContentIssue false
  • English
  • Français

Integrated Plan to Augment Surge Capacity

Published online by Cambridge University Press:  28 June 2012

Christopher Dayton ,
Jamil Ibrahim ,
Michael Augenbraun ,
Steven Brooks ,
Kiaran Mody ,
Donald Holford ,
Patricia Roblin  and
Bonnie Arquilla
Christopher Dayton*
Affiliation:
University Hospital Brooklyn, SUNY Downstate Medical Center, Brooklyn, New York, USA
Jamil Ibrahim
Affiliation:
Kings County Hospital Center, Brooklyn, New York, USA
Michael Augenbraun
Affiliation:
University Hospital Brooklyn, SUNY Downstate Medical Center, Brooklyn, New York, USA Kings County Hospital Center, Brooklyn, New York, USA
Steven Brooks
Affiliation:
Kingsbrook Jewish Medical Center, Brooklyn, New York, USA
Kiaran Mody
Affiliation:
Kingsbrook Jewish Medical Center, Brooklyn, New York, USA
Donald Holford
Affiliation:
Kingsboro Psychiatric Center, Brooklyn, New York, USA
Patricia Roblin
Affiliation:
University Hospital Brooklyn, SUNY Downstate Medical Center, Brooklyn, New York, USA
Bonnie Arquilla
Affiliation:
Kings County Hospital Center, Brooklyn, New York, USA
*
Bioterrorism Hospital Preparedness Program, c/o NYC Department of Health and Mental Hygiene, 125 Worth Street, Room 222, Box 22A New York, New York 10013 USA E-mail: beaconshadow@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Surge capacity is defined as a healthcare system's ability to rapidly expand beyond normal services to meet the increased demand for appropriate space, qualified personnel, medical care, and public health in the event of bioterrorism, disaster, or other large-scale, public health emergencies. There are many individuals and agencies, including policy makers, planners, administrators, and staff at the federal, state, and local level, involved in the process of planning for and executing policy in respect to a surge in the medical requirements of a population. They are responsible to ensure there is sufficient surge capacity within their own jurisdiction.

Problem:

The [US] federal government has required New York State to create a system of hospital bed surge capacity that provides for 500 adult and pediatric patients per 1 million population, which has been estimated to be an increase of 15–20% in bed availability. In response, the New York City Department of Health and Mental Hygiene (NYC DOH) has requested that area hospitals take an inventory of available beds and set a goal to provide for a 20% surge capacity to be available during a mass-casualty event or other conditions calling for increased inpatient bed availability.

Methods:

In 2003, under the auspices of the NYC DOH, the New York Institute of All Hazard Preparedness (NYIHP) was formed from four unaffiliated, healthcare facilities in Central Brooklyn to address this and other goals.

Results:

The NYIHP hospitals have developed a surge capacity plan to provide necessary space and utilities. As these plans have been applied, a bed surge capacity of approximately 25% was identified and created for Central Brooklyn to provide for the increased demand on the medical care system that may accompany a disaster. Through the process of developing an integrated plan that would engage a public health incident, the facilities of NYIHP demonstrate that a model of cooperation may be applied to an inherently fractioned medical system.

Keywords

integrated plansurge capacity
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 2 , April 2008 , pp. 113 - 119
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. US Department of Health and Human Services, Health Resources and Services Administration, Special Programs Bureau: National Bioterrorism Hospital Preparedness Program, Catalog of Federal Domestic Assistance (CFDA) 2004; 93.003.Google Scholar
2. Alston, R: Testimony before the House Committee on Homeland Security, Subcommittee on Prevention of Nuclear and Biological Attack. 20 October 2005.Google Scholar
3. Dacey, M: Tragedy and response—The Rhode Island Nightclub Fire. N Engl J Med 2003;349:1990–1992.CrossRefGoogle ScholarPubMed
4. Mahoney, EJ, Harrington, DT, Biffl, WL, et al. : Lessons learned from a nightclub fire: Institutional disaster preparedness. J Trauma 2005;58:487–491.CrossRefGoogle ScholarPubMed
5. Hoard, M, Homer, J, Manley, W, et al. : Systems modeling in support of evidence-based disaster planning for rural areas. Int J Hyg Environ Health 2005;208:117–125.CrossRefGoogle ScholarPubMed
6. Khana, R, Olsen, L; Hassan, A: Storm evacuation elderly were left with weak safety net. Houston Chronicle 10 December 2005.Google Scholar
7. Lubyansky, A: A system dynamics model of health care surge capacity.Available at http://www.albany.edu/cpr/sds/conf2005/proceed/papers/LUBYA208.pdf Accessed 18 November 2006.Google Scholar
8. SARS Expert Committee: SARS in Hong Kong: From experience to action. Surge Capacity 2003;11:121–125.Google Scholar
9. Loutfy, MR, Wallington, T, Rutledge, T, et al. : Hospital preparedness and SARS. Emerg Infect Dis 2004; 10:771–776.CrossRefGoogle ScholarPubMed
10. Hick, J, Hanfling, D, Burstein, JL, et al. : Health care facility and community strategies for patient care surge capacity. Ann Emerg Med 2004;44(3):253–261.CrossRefGoogle ScholarPubMed
11. SARS Key Learnings. The perspective of University Health Network. Notes for the Campbell Commission. Available at http://www.uhn.ca/uhn/corpo rate/community/docs/campbell_presentation_100103.pdf. Accessed 01 June 2006.Google Scholar
12. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health: Guidance for filtration and air-cleaning systems to protect building environments from airborne chemical, biological, or radiological attacks; 2003. Available at http://www.cdc.gov/niosh/docs/2003-136/.Google Scholar
13. Barbisch, D: Terrorism preparedness and response. National Defense Industrial Association, Hospitals and Healthcare Systems, 03 June 2003.Google Scholar
14. New York State Department of Health: Environmental Control Measures for Airborne Infection Isolation Surge Capacity Planning in Health Care Facilities for Smallpox, SARS or Other Infections Potentially Transmitted via Airborne Droplet Nuclei. Appendix 2I. 18 December 2003.Google Scholar
15. Svodboda, T, Henry, B. Shulman, L, et al. : Public measure to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto. N Engl J Med 2004; 350:2352–2361.CrossRefGoogle Scholar
16. Bell, JAH, Hyland, S, , DePellergrin, et al. : SARS and hospital priority setting: A qualitative case study and evaluation. BMC Health Serv Res 2004;4(36):1–7.CrossRefGoogle ScholarPubMed
17. Derlet, R, Richards, J, Kravitz, R: Frequent overcrowding in US emergency departments. Acad Emerg Med 2001;8:151–155.CrossRefGoogle ScholarPubMed
18. Lim, S, Closson, T, Howard, G, Gardam, M: Collateral damage: The unforeseen effects of emergency outbreak policies. Lancet Infect Dis 2004;4:697–703.CrossRefGoogle ScholarPubMed
19. Romano, M: At capacity and beyond. Ideas such as ‘surge’ hospitals are getting a more careful look as healthcare wrestles with planning for large-scale disasters. Mod Healthc 2005; 35:6–7.Google ScholarPubMed
20. Voelker, R: Mobile hospital raises questions about hospital surge capacity. JAMA 2006;295:1499–1503.CrossRefGoogle ScholarPubMed
21. Davis, DP, Poste, JC, Hicks, T, et al. : Hospital bed surge capacity in the event of a mass-casualty incident. Prehospital Disast Med 2005;20:169–176.CrossRefGoogle ScholarPubMed
22. Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies. The CNA Corporation 2004.Google Scholar