Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-19T21:10:18.888Z Has data issue: false hasContentIssue false
  • English
  • Français

Surge Capacity Concepts for Health Care Facilities: The CO-S-TR Model for Initial Incident Assessment

Published online by Cambridge University Press:  08 April 2013

John L. Hick ,
Kristi L. Koenig ,
Donna Barbisch  and
Tareg A. Bey
Get access Rights & Permissions [Opens in a new window]

Abstract

Facility-based health care personnel often lack emergency management training and experience, making it a challenge to efficiently assess evolving incidents and rapidly mobilize appropriate resources. We propose the CO-S-TR model, a simple conceptual tool for hospital incident command personnel to prioritize initial incident actions to adequately address key components of surge capacity. There are 3 major categories in the tool, each with 4 subelements. “CO” stands for command, control, communications, and coordination and ensures that an incident management structure is implemented. “S” considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations. “TR” comprises tracking, triage, treatment, and transportation: basic patient care and patient movement functions. This comprehensive yet simple approach is designed to be implemented in the immediate aftermath of an incident, and complements the incident command system by aiding effective incident assessment and surge capacity responses at the health care facility level. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S51–S57)

Keywords

surge capacityemergency preparednesshospital preparednessemergency managementincident managementhospital incident command system
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 2 , Issue S1 , September 2008 , pp. S51 - S57
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Kaji, A, Koenig, KL, Bey, T.Surge capacity for healthcare systems: a conceptual framework. Acad Emerg Med. 13:1157–1159.CrossRefGoogle Scholar
2.Barbisch, D, Koenig, KL.Understanding surge capacity: essential elements. Acad Emerg Med. 2006;13:1098–1102.Google Scholar
3. Emergency Management Principles and Practices for Healthcare Systems. The Institute for Crisis, Disaster, and Risk Management (ICDRM) at the George Washington University (GWU). Department of Veterans Affairs Web site. 2006. http://www1.va.gov/emshg. Accessed April 20, 2007.Google Scholar
4.Barbera, J, Macintyre, A.Medical and Health Incident Management System: A Comprehensive Functional System Description for Mass Casualty Medical and Health Incident Management. Washington, DC: George Washington University Institute for Crisis, Disaster, and Risk Management; 2002.Google Scholar
5. Hospital Incident Command System. HICS IV August 2006. California Emergency Medical Services Authority Web site. http://www.emsa.ca.gov/HICS/default.asp. Accessed April 20, 2007.Google Scholar
6. National Incident Management System. Federal Emergency Management Agency-Department of Homeland Security Web site. http://www.fema.gov/emergency/nims/index.shtm. Accessed April 20, 2007.Google Scholar
7. Plourde KL, Moats J. The Incident Command System: A Process to Move our Response Stance From Reactive to Proactive. US Coast Guard Proceedings Web site. 2006; 63:11–14. http://www.uscg.mil/proceedings. Accessed April 20, 2007.Google Scholar
8.Bey, T, Moecke, Hp.Electrical blackouts in hospitals and the need for reassessment of the electrical infrastructure and more powerful standby generation. [abstract] Prehosp Disaster Med. 2007;22:S98 .Google Scholar
9.Glik, DC.Risk communication for public health emergencies. Ann Rev Public Health. 2007;28:33–54.Google Scholar
10. National Incident Management System Independent Study 701—Multi-Agency Coordination System (MACS) Course. Federal Emergency Management Agency, Emergency Management Institute 2008. Emmitsburg, MD. http://training.fema.gov/EMIWeb/IS/is701.asp. Accessed July 31, 2008.Google Scholar
11. Barbera J, McIntyre A. Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies. CNA Corporation Web site. 2004. http://www.cna.org/documents/mscc_aug2004.pdf. Accessed May 22, 2006.Google Scholar
12.Healthcare at the Crossroads: Strategies for Creating and Sustaining Community-wide Emergency Preparedness Systems. Oak Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations; 2004.Google Scholar
13.Cone, DC, Weir, SD, Bogucki, S.Convergent volunteerism. Ann Emerg Med. 2003;41:457–462.Google Scholar
14.Comprehensive Accreditation Manual for Hospitals. Medical Staff Section MS.5.14.4.1. Disaster Privileging Standard. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations; 2003.Google Scholar
15. Department of Health and Human Services. Medical Reserve Corps Web site. http://www.medicalreservecorps.gov. Accessed January 16, 2004.Google Scholar
16. National Disaster Medical System. Department of Health and Human Services Web site. http://ndms.dhhs.gov. Accessed May 22, 2006.Google Scholar
17.Schultz, CH, Stratton, SJ.Improving hospital surge capacity: a new concept for emergency credentialing of volunteers. Ann Emerg Med. 2007;49:602–609.Google Scholar
18.Auf Der Heide, E.The importance of evidence-based disaster planning. Ann Emerg Med. 2006;47:34–49.Google Scholar
19. Phillips SJ, Knebel A. eds. Providing Mass Medical Care with Scarce Resources: A Community Planning Guide. Rockville, MD: Agency for Healthcare Research and Quality; 2006.Google Scholar
20. Emergency Preparedness and Response—Strategic National Stockpile—April 14, 2005. Centers for Disease Control and Prevention Web site. http://www.bt.cdc.gov/stockpile. Accessed May 30, 2007.Google Scholar
21.Rubinson, L, Nuzzo, JB, Talmor, DS, et alAugmentation of hospital critical care capacity after bioterrorist attacks or epidemics: recommendations of the Working Group on Emergency Mass Critical Care. Crit Care Med. 2005;33:2393–2403.Google Scholar
22.Hick, JL, Hanfling, D, Burstein, JL, et alHealthcare facility and community strategies for patient care surge capacity. Ann Emerg Med. 2004;44:253–261.Google Scholar
23. Church J. Modular Emergency Medical System—Expanding Local Healthcare Structure in a Mass Casualty Terrorism Event. Department of Defense Web site. 2002. http://www.nnemmrs.org/documents. Accessed May 22, 2006.Google Scholar
24. Skidmore S, Wall W, Church J. Modular Emergency Medical System Concept of Operation for the Acute Care Center: Mass Casualty Strategy for a Biological Terror Incident. Department of Defense Web site. 2003. http://www.nnemmrs.org/documents. Accessed May 22, 2006.Google Scholar
25. Surge Hospitals: Providing Safe Care in Emergencies. Joint Commission on Accreditation of Healthcare Facilities Web site. 2006. http://www.jcrinc.com/generic.asp?durki=11627&site=11&return=http://www.ahrq.gov/research/altstand/405. Accessed May 22, 2006.Google Scholar
26.Koenig, KL, Goans, RE, Hatchett, RJ, et alMedical treatment of radiological casualties: current concepts. Ann Emerg Med. 2005;45:643–652.Google Scholar
27.Cone, DC, Koenig, KL.Mass casualty triage in the chemical, biological, radiological, or nuclear environment. Eur J Emerg Med. 2005;12:287–302.Google Scholar
28.Koenig, KL, Boatright, CJ, Hancock, JA, et alHealth care facilities' “war on terrorism”: a deliberate process for recommending personal protective equipment. Am J Emerg Med. 2007;25:185–195.Google Scholar
29.Hick, JL, Thorne, CT. Personal protective equipment. In: Ciottone G, ed. Disaster Medicine. St Louis: Mosby; 2005.Google Scholar
30.Benson, M, Koenig, KL, Schultz, CH.Disaster triage: START, then SAVE—a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med. 1996;11:117–124.Google Scholar
31.Tanabe, P, Travers, D, Gilboy, N, et alRefining emergency severity index triage criteria. Acad Emerg Med. 2005;12:497–501.Google Scholar
32.Tanabe, P, Gimbel, R, Yarnold, PR, et alReliability and validity of scores on the Emergency Severity Index version 3. Acad Emerg Med. 2004;11: 59–65.Google Scholar
33.Dacey, MJ.Tragedy and response—the Rhode Island nightclub disaster. N Engl J Med. 2003;349: 1990–1991.Google Scholar