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Surge Capacity of Hospitals in Emergencies and Disasters With a Preparedness Approach: A Systematic Review

Published online by Cambridge University Press:  07 March 2017

Hojjat Sheikhbardsiri
Affiliation:
Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Ahmad Reza Raeisi*
Affiliation:
Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Mahmood Nekoei-moghadam
Affiliation:
Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
Fatemeh Rezaei
Affiliation:
Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
*
Correspondence and reprint requests to Ahmad Reza Raeisi, PhD, Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (e-mail [email protected]).

Abstract

Objective

Surge capacity is one of the most important components of hospital preparedness for responding to emergencies and disasters. The ability to provide health and medical care during a sudden increase in the number of patients or victims of disasters is a main concern of hospitals. We aimed to perform a systematic review of hospital surge capacity in emergencies and disasters with a preparedness approach.

Methods

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words “surge,” “surge capacity,” “preparedness,” “hospital emergency department,” “hospital,” “surge capability,” “emergency,” “hazard,” “disaster,” “catastrophe,” “crisis,” and “tragedy” were used in combination with the Boolean operators OR and AND. The Google Scholar, ISI Web of Science, Science Direct, PubMed, Scopus, Ovid, Pro Quest, and Wiley databases were searched.

Results

A total of 1008 articles were extracted and 17 articles were selected for final review of surge capacity based on the objective of the study. Seventeen studies (1 randomized controlled trial, 2 qualitative studies, and 14 cross-sectional studies) investigated the surge capacity of hospitals in emergencies and disasters to evaluate the best evidence to date. The results of selected articles indicated that there are various ways to increase the capacity of hospitals in 4 domains: staff, stuff, structure, and system.

Conclusion

Surge capacity is a basic element of disaster preparedness programs. Results of the current study could help health field managers in hospitals to prepare for capacity-building based on surge capacity components to improve and promote hospital preparedness programs. (Disaster Med Public Health Preparedness. 2017;11:612–620)

Type
Systematic Review
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

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References

1. Khankeh, HR, Zavareh, DK. Why the prominent improvement in prehospital medical response in Iran couldn’t decrease the number of death related road traffic injuries. J Trauma Treat. 2012;01(04):2167. http://dx.doi.org/10.4172/2167-1222.1000e103.CrossRefGoogle Scholar
2. Mehta, S. Disaster and mass casualty management in a hospital: how well are we prepared? J Postgrad Med. 2006;52(2):89-90.Google Scholar
3. Terndrup, TE, Leaming, JM, Adams, RJ, et al. Hospital-based coalition to improve regional surge capacity. West J Emerg Med. 2012;13(5):445-452. http://dx.doi.org/10.5811/westjem.2011.10.6853.CrossRefGoogle ScholarPubMed
4. ACEP (American College of Emergency Physicians). Healthcare System Surge Capacity Recognition, Preparedness, and Response. Irving, TX: ACEP; 2006.Google Scholar
5. Dayton, C, Ibrahim, J, Augenbraun, M, et al. Integrated plan to augment surge capacity. Prehosp Disaster Med. 2008;23(2):113-119. http://dx.doi.org/10.1017/S1049023X00005719.CrossRefGoogle ScholarPubMed
6. Hick, JL, Barbera, JA, Kelen, GD. Refining surge capacity: conventional, contingency, and crisis capacity. Disaster Med Public Health Prep. 2009;3(1):S59-S67. http://dx.doi.org/10.1097/DMP.0b013e31819f1ae2.CrossRefGoogle ScholarPubMed
7. Hanley, ME, Bogdan, GM. Mechanical ventilation in mass casualty scenarios. Augmenting staff: project XTREME. Respir Care. 2008;53(2):176-189.Google ScholarPubMed
8. Khankeh, HR, Mohammadi, R, Ahmadi, F. Barriers and facilitators of health care services at natural disasters in Iran. Prehosp Disaster Med. 2007;22(2):82.Google Scholar
9. Kelen, GD, McCarthy, ML, Kraus, CK, et al. Creation of surge capacity by early discharge of hospitalized patients at low risk for untoward events. Disaster Med Public Health Prep. 2009;3(2)(suppl):S10-S16. http://dx.doi.org/10.1097/DMP.0b013e3181a5e7cd.CrossRefGoogle ScholarPubMed
10. Schultz, CH, Stratton, SJ. Improving hospital surge capacity: a new concept for emergency credentialing of volunteers. Ann Emerg Med. 2007;49(5):602-609. http://dx.doi.org/10.1016/j.annemergmed.2006.10.003.CrossRefGoogle ScholarPubMed
11. Moher, D, Liberati, A, Tetzlaff, J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264-269. http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00135.CrossRefGoogle ScholarPubMed
12. DeLia, D. Annual bed statistics give a misleading picture of hospital surge capacity. Ann Emerg Med. 2006;48(4):384-388.e2. http://dx.doi.org/10.1016/j.annemergmed.2006.01.024.CrossRefGoogle ScholarPubMed
13. Kanter, RK, Moran, JR. Hospital emergency surge capacity: an empiric New York statewide study. Ann Emerg Med. 2007;50(3):314-319. http://dx.doi.org/10.1016/j.annemergmed.2006.10.019.CrossRefGoogle ScholarPubMed
14. Kelen, GD, Kraus, CK, McCarthy, ML, et al. Inpatient disposition classification for the creation of hospital surge capacity: a multiphase study. Lancet. 2006;368(9551):1984-1990. http://dx.doi.org/10.1016/S0140-6736(06)69808-5.CrossRefGoogle ScholarPubMed
15. Bradt, DA, Aitken, P, FitzGerald, G, et al. Emergency department surge capacity: recommendations of the Australasian Surge Strategy Working Group. Acad Emerg Med. 2009;16(12):1350-1358. http://dx.doi.org/10.1111/j.1553-2712.2009.00501.x.CrossRefGoogle ScholarPubMed
16. Lee, W-H, Ghee, C, Wu, K-H, et al. Barriers to surge capacity of an overcrowded emergency department for a serious foodborne disease outbreak. Emerg Med J. 2010;27(10):779-783. Internet. http://dx.doi.org/10.1136/emj.2009.079475.CrossRefGoogle ScholarPubMed
17. Satterthwaite, PS, Atkinson, CJ. Using “reverse triage” to create hospital surge capacity: Royal Darwin Hospital’s response to the Ashmore Reef disaster. Emerg Med J. 2009;2012(29):160-162.Google Scholar
18. Kaji, A, Koenig, KL, Bey, T. Surge capacity for healthcare systems: a conceptual framework. Acad Emerg Med. 2006;13(11):1157-1159. http://dx.doi.org/10.1111/j.1553-2712.2006.tb01641.x.CrossRefGoogle ScholarPubMed
19. DeLia, D, Wood, E. The dwindling supply of empty beds: implications for hospital surge capacity. Health Aff (Millwood). 2008;27(6):1688-1694. http://dx.doi.org/10.1377/hlthaff.27.6.1688.CrossRefGoogle ScholarPubMed
20. Stratton, SJ, Tyler, RD. Characteristics of medical surge capacity demand for sudden‐impact disasters. Acad Emerg Med. 2006;13(11):1193-1197. http://dx.doi.org/10.1111/j.1553-2712.2006.tb01647.x.Google ScholarPubMed
21. Welzel, TB, Koenig, KL, Bey, T, et al. Effect of hospital staff surge capacity on preparedness for a conventional mass casualty event. West J Emerg Med. 2010;11(2):189-196.Google ScholarPubMed
22. Takahashi, A, Ishii, N, Kawashima, T, et al. Assessment of medical response capacity in the time of disaster: the estimated formula of Hospital Treatment Capacity (HTC), the maximum receivable number of patients in hospital. Kobe J Med Sci. 2007;53(5):189-198.Google ScholarPubMed
23. Hick, JL, Christian, MD, Sprung, CL. Surge capacity and infrastructure considerations for mass critical care. Intensive Care Med. 2010;36(1):11-20. http://dx.doi.org/10.1007/s00134-010-1761-4.CrossRefGoogle ScholarPubMed
24. Abir, M, Davis, MM, Sankar, P, et al. Design of a model to predict surge capacity bottlenecks for burn mass casualties at a large academic medical center. Prehosp Disaster Med. 2013;28(01):23-32. http://dx.doi.org/10.1017/S1049023X12001513.Google Scholar
25. Traub, M, Bradt, DA, Joseph, AP. The Surge Capacity for People in Emergencies (SCOPE) study in Australasian hospitals. Med J Aust. 2007;186(8):394.CrossRefGoogle ScholarPubMed
26. National Center for Injury Prevention and Control, Coordinating Center for Environmental Health and Injury Prevention, US Department of Health and Human Services. In a Moment’s Notice: Surge Capacity For Terrorist Bombings—Challenges And Proposed Solutions. https://emergency.cdc.gov/masscasualties/pdf/surgecapacity.pdf. Published April 2007. Accessed January 16, 2017.Google Scholar
27. Nager, AL, Khanna, K. Emergency department surge: models and practical implications. J Trauma. 2009;67(2 suppl):S96-S99. http://dx.doi.org/10.1097/TA.0b013e3181ad2aaa.Google ScholarPubMed
28. Schultz, C, Koenig, K. State of research in high-consequence hospital surge capacity. Acad Emerg Med. 2006;13(11):1153-1156. http://dx.doi.org/10.1111/j.1553-2712.2006.tb01640.x.Google ScholarPubMed
29. Welzel, TB, Koenig, KL, Bey, T, et al. Effect of hospital staff surge capacity on preparedness for a conventional mass casualty event. West J Emerg Med. 2010;11:189-196.Google ScholarPubMed
30. Hota, S, Fried, E, Burry, L, et al. Preparing your intensive care unit for the second wave of H1N1 and future surges. Crit Care Med. 2010;38:E110-E119. http://dx.doi.org/10.1097/CCM.0b013e3181c66940.CrossRefGoogle ScholarPubMed
31. Hotchkin, DL, Rubinson, L. Modified critical care and treatment space considerations for mass casualty critical illness and injury. Respir Care. 2008;53:67-74.Google ScholarPubMed
32. Reilly MJ, Markenson DS. Health Care Emergency Management: Principles and Practice. Burlington, MA: Jones & Bartlett; 2010.Google Scholar
33. Barbisch, DF, Koenig, KL. Understanding surge capacity: essential elements. Acad Emerg Med. 2006;13(11):1098-1102. http://dx.doi.org/10.1111/j.1553-2712.2006.tb01630.x.CrossRefGoogle ScholarPubMed
34. Hick, JL, 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. http://dx.doi.org/10.1016/j.annemergmed.2004.04.011.Google ScholarPubMed
35. New Jersey Department of Health and Senior Services. Instructions to the New Jersey Acute Care Hospital Cost Reports. Trenton, NJ: New Jersey Department of Health and Senior Services; 2003.Google Scholar
36. American College of Emergency Physicians. On-call specialist coverage in US emergency departments. Irving, TX: American College of Emergency Physicians; 2006.Google Scholar
37. Mahoney, EJ, Harrington, DT, Biffl, WL, et al. Lessons learned from a nightclub fire: institutional disaster preparedness. J Trauma Acute Care Surg. 2005;58(3):487-491. http://dx.doi.org/10.1097/01.TA.0000153939.17932.E7.CrossRefGoogle ScholarPubMed
38. Peleg, K, Kellermann, AL. Enhancing hospital surge capacity for mass casualty events. JAMA. 2009;302(5):565-567. http://dx.doi.org/10.1001/jama.2009.1119.CrossRefGoogle ScholarPubMed
39. Ministry of Health, The National Supreme Health Authority. Lessons Learned From Hospital Drills. Tel Aviv, Israel: Ministry of Health, The National Supreme Health Authority; January 19, 2006. Document no. 00535006.Google Scholar
40. Bloch, YH, Schwartz, D, Pinkert, M, et al. Distribution of casualties in a mass casualty incident with three local hospitals in the periphery of a densely populated area: lessons learned from the medical management of a terrorist attack. Prehosp Disaster Med. 2007;22(3):186-192. http://dx.doi.org/10.1017/S1049023X00004635.CrossRefGoogle Scholar
41. US Centers for Disease Control and Prevention. Fiscal year 2006 justification of estimates for appropriations committee. http://www.cdc.gov/fmo/FY2006cdccj.pdf. Accessed July 12, 2005.Google Scholar