Disaster medicine and public health preparedness
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Disaster Med Public Health Prep · Jun 2009
Creation of surge capacity by early discharge of hospitalized patients at low risk for untoward events.
US hospitals are expected to function without external aid for up to 96 hours during a disaster; however, concern exists that there is insufficient capacity in hospitals to absorb large numbers of acute casualties. The aim of the study was to determine the potential for creation of inpatient bed surge capacity from the early discharge (reverse triage) of hospital inpatients at low risk of untoward events for up to 96 hours. ⋯ Hospital surge capacity for standard inpatient beds may be greater than previously believed. Reverse triage, if appropriately harnessed, can be a major contributor to surge capacity.
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Disaster Med Public Health Prep · Jun 2009
Refining surge capacity: conventional, contingency, and crisis capacity.
Health care facility surge capacity has received significant planning attention recently, but there is no commonly accepted framework for detailed, phased surge capacity categorization and implementation. This article proposes a taxonomy within surge capacity of conventional capacity (implemented in major mass casualty incidents and representing care as usually provided at the institution), contingency capacity (using adaptations to medical care spaces, staffing constraints, and supply shortages without significant impact on delivered medical care), and crisis capacity (implemented in catastrophic situations with a significant impact on standard of care). Suggested measurements used to gauge a quantifiable component of surge capacity and adaptive strategies for staff and supply challenges are proposed. The use of refined definitions of surge capacity as it relates to space, staffing, and supply concerns during a mass casualty incident may aid phased implementation of surge capacity plans at health care facilities and enhance the consistency of terminology and data collection between facilities and regions.
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Disaster Med Public Health Prep · Jun 2009
Health care emergency management: establishing the science of managing mass casualty and mass effect incidents.
Particularly since 2001, the health care industry has witnessed many independent and often competing efforts to address mitigation and preparedness for emergencies. Clinicians, health care administrators, engineers, safety and security personnel, and others have each developed relatively independent efforts to improve emergency response. ⋯ This approach could also promote health care integration into the larger community emergency response system. The case for a formally defined health care emergency management profession is presented with discussion points outlining the advantages of this approach.