Excerpt

The Hospital Preparedness Program (HPP) in HHS’s ASPR sponsored the workshop on medical surge capacity. HPP’s mission is to help prepare the nation’s healthcare system to respond appropriately to mass-casualty incidents, whether due to bioterrorism, natural disaster, or other public health emergencies. Ultimately, this effort comes down to preparedness and efficiency—health systems must develop a disaster medical capability that is rapid, flexible, sustainable, integrated, and coordinated, and that can deliver appropriate treatment in the most ethical manner with the resources and capabilities available. The workshop, held in Washington, DC, on June 10–11, 2009, featured presentations and discussions on the following topics, including the role of HPP in facilitating each of these efforts: Definitions of medical surge, standards, and metrics; Creating an integrated approach to an alternate care system, and establishing alternate care facilities; The capability and tools available to local, state, territorial, tribal, and federal government entities to provide situational awareness during operations, and to assess the current status of preparedness for medical surge operations; Strategies to facilitate public- and private-sector work to improve surge capability for victims and the distressed, including vulnerable populations; and Issues related to financing surge and preparedness.

Contents

• The National Academies
• Workshop Planning Committee
• Forum on Medical and Public Health Preparedness for Catastrophic Events
• Reviewers
• Workshop Summary: Introduction
• Goals and Objectives
  • About This Summary
• The Communications Challenge: Definitions, Standards, and Metrics
  • Medical Surge Capacity: Conventional, Contingency, and Crisis Capacity
  • The Problem of (and Need for) Standards and Metrics
• Legal Authorities and Government Support
  • Declaring Federal Disasters: Implications for Public Health Emergencies
  • Licensing and Interstate Credentialing
  • The Role of Public Health in Medical Surge
  • Hospital Surge Capacity Is Not Ideal
• An Integrated Approach to Alternate Care
  • Emergency Medical Services
  • Healthcare Coalitions: Spreading the Load
  • An Alternate Approach: The Israeli System
• Establishing Alternate Care Facilities
  • Demobilization
  • In-Home Care
  • Barriers to In-Home Care
  • Call Centers
  • Leveraging Technology
• Creating Situational Awareness: A systems Approach
  • The National Need
  • Early Successes
  • Alabama’s Medicaid Electronic Health Record
  • Alabama Incident Management System
  • Boston’s Partnership for Effective Emergency Response (PEER)
  • Seattle Healthcare Coalition
  • The Hippocrates Project—New Jersey’s Integrated Situational Awareness System
• At-Risk Populations: Behavioral Health Effects and Medical Needs
  • Children
  • H1N1 and Children
  • The New York Approach
  • Older Adults
  • Unique Challenges
  • The Chronically Ill
  • Psychological Impact
• Fatality Management Strategies
  • Family Assistance Centers
  • Duties and Jurisdiction of Medical Examiners
  • Federal Resources for Fatality Management
  • Department of Defense
  • Disaster Mortuary Operational Response Team
  • Private-Sector Resources
  • Future Needs
• Ramping Down and Recovery from a Mass-Casualty Incident
  • What Does It Mean to Recover?
  • Planning to Recover—Lessons Learned from Hurricane Recovery Efforts
  • Scope of Recovery
  • Facilities and Supplies
  • Emergency Departments
  • Staff Considerations
  • Repatriation
• Financing Surge Capacity and Preparedness
  • Centers for Medicare & Medicaid Services
  • Private Insurance Plans
  • Funding EMS Surge—A Gap in Planning?
  • Funding Alternatives
  • Looking Ahead
• Conclusions
• Appendixes
  • A. References
  • B. Agenda
  • C. Registered Attendees
  • D. Surge Medical Response Capability: What Is It? How Do We Get It? How Do We Know When We Have It?
  • E. Alternate Care Systems: Stratification of Care
  • F. Creating Situational Awareness: A Systems Approach
  • G. Vulnerable Populations in Disasters: Health Effects and Needs
  • H. Fatalities Management Strategies
  • I. Financing Surge Capacity and Preparedness

Bruce M Altevogt, Clare Stroud, Lori Nadig, and Matthew Hougan, Rapporteurs.

Suggested citation:

IOM (Institute of Medicine). 2010. Medical surge capacity: Workshop summary. Washington, DC: The National Academies Press.

The views presented in this publication are those of the editors and attributing authors and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.