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Hospital Surge Capacity: A Web-Based Simulation Tool for Emergency Planners

Published online by Cambridge University Press:  18 October 2017

Matthew F. Toerper ,
Gabor D. Kelen ,
Lauren M. Sauer ,
Jamil D. Bayram ,
Christina Catlett  and
Scott Levin
Matthew F. Toerper*
Affiliation:
Johns Hopkins Department of Emergency Medicine, Baltimore, Maryland
Gabor D. Kelen
Affiliation:
Johns Hopkins Department of Emergency Medicine, Baltimore, Maryland
Lauren M. Sauer
Affiliation:
Johns Hopkins Department of Emergency Medicine, Baltimore, Maryland
Jamil D. Bayram
Affiliation:
Johns Hopkins Department of Emergency Medicine, Baltimore, Maryland
Christina Catlett
Affiliation:
Johns Hopkins Department of Emergency Medicine, Baltimore, Maryland
Scott Levin
Affiliation:
Johns Hopkins Department of Emergency Medicine, Baltimore, Maryland
*
Correspondence and reprint requests to Matthew Toerper, Johns Hopkins Department of Emergency Medicine, 5801 Smith Avenue, Davis Building, 2nd floor, Baltimore, MD 21209 (e-mail: mtoerper@jhu.edu).
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Abstract

The National Center for the Study of Preparedness and Catastrophic Event Response (PACER) has created a publicly available simulation tool called Surge (accessible at http://www.pacerapps.org) to estimate surge capacity for user-defined hospitals. Based on user input, a Monte Carlo simulation algorithm forecasts available hospital bed capacity over a 7-day period and iteratively assesses the ability to accommodate disaster patients. Currently, the tool can simulate bed capacity for acute mass casualty events (such as explosions) only and does not specifically simulate staff and supply inventory. Strategies to expand hospital capacity, such as (1) opening unlicensed beds, (2) canceling elective admissions, and (3) implementing reverse triage, can be interactively evaluated. In the present application of the tool, various response strategies were systematically investigated for 3 nationally representative hospital settings (large urban, midsize community, small rural). The simulation experiments estimated baseline surge capacity between 7% (large hospitals) and 22% (small hospitals) of staffed beds. Combining all response strategies simulated surge capacity between 30% and 40% of staffed beds. Response strategies were more impactful in the large urban hospital simulation owing to higher baseline occupancy and greater proportion of elective admissions. The publicly available Surge tool enables proactive assessment of hospital surge capacity to support improved decision-making for disaster response. (Disaster Med Public Health Preparedness. 2018;12:513–522)

Keywords

surge capacitydisaster medicinehospital
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 4 , August 2018 , pp. 513 - 522
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

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