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The challenge was not presented by a high volume of patients, but rather by the specialty requirements of caring for a few patients with a highly contagious illness that demonstrated particular transmissibility in the healthcare setting. Surge capability also includes patient problems that require special intervention to protect medical providers, other patients, and the integrity of the HCO.īasic example: Many hospitals encountered difficulties with the arrival of patients with symptoms of severe acute respiratory syndrome (SARS). Surge requirements span the range of specialized medical services (expertise, information, procedures, equipment, or personnel) that are not normally available at the location where they are needed (e.g., pediatric care provided at non-pediatric facilities). Medical surge capability refers to the ability to manage patients requiring unusual or very specialized medical evaluation and care. When addressing an overall medical surge strategy, it is recommended that guidance be delineated prospectively for maximizing the use of existing resources before resorting to the use of alternate care facilities and standards of care appropriate to the austere conditions of a disaster. If the hospital establishes a mutual aid and/or cooperative agreement with regional hospitals, it might be able to rely on neighboring hospitals to loan respirators and credentialed staff and, therefore, might need to invest in only a few standby items (e.g., extra critical care beds), minimizing purchase and maintenance of expensive equipment that generate no income except during rare emergency situations. This would provide an important component of that capacity (other critical care equipment and staff would also be needed), but it would also be very expensive for the facility. Thus, medical surge capacity is primarily about the systems and processes that influence specific asset quantity.īasic example: If a hospital wishes to have the capacity to medically manage 10 additional patients on respirators, it could buy, store, and maintain 10 respirators. Moreover, the integration of additional resources (whether standby, mutual aid, State or Federal aid) is difficult without adequate management systems. In other words, fewer standby resources are necessary if systems are in place to maximize the abilities of existing operational resources.
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The surge requirements may extend beyond direct patient care to include such tasks as extensive laboratory studies or epidemiological investigations.īecause of its relation to patient volume, most current initiatives to address surge capacity focus on identifying adequate numbers of hospital beds, personnel, pharmaceuticals, supplies, and equipment. Medical surge capacity refers to the ability to evaluate and care for a markedly increased volume of patients-one that challenges or exceeds normal operating capacity. The first step in doing so, however, is to distinguish surge capacity from surge capability. It encompasses the ability of HCOs to survive a hazard impact and maintain or rapidly recover operations that were compromised (a concept known as medical system resiliency).īeyond this rather simple explanation, medical surge is an extraordinarily complex topic that is difficult to comprehensively describe. Medical surge describes the ability to provide adequate medical evaluation and care during events that exceed the limits of the normal medical infrastructure of an affected community.
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It is important, therefore, to define this term before analyzing solutions for the overall needs of mass casualty or mass effect incidents. The concept of medical surge forms the cornerstone of preparedness planning efforts for major medical incidents.