Emergency department surge capacity: recommendations of the Australasian Surge Strategy Working Group. 2009

David A Bradt, and Peter Aitken, and Gerry FitzGerald, and Roger Swift, and Gerard O'Reilly, and Bruce Bartley
From the Department of Emergency Medicine, Royal Melbourne Hospital (DAB), Parkville, Victoria; Anton Breinl Centre, James Cook University (PA), Townsville; the Emergency Department, The Townsville Hospital; and Queensland Emergency Medicine Research Foundation (QEMRF) (PA), Queensland; Public Health (Emergency and Disaster Management), Queensland University of Technology (GF), Brisbane, Queensland; Discipline of Emergency Medicine, University of Western Australia, and the Emergency Department, Sir Charles Gairdner Hospital (RS), Perth; The Emergency and Trauma Centre, The Alfred Hospital (GO), Melbourne, Victoria; and The Emergency Department, The Geelong Hospital (BB), Victoria, Australia.

For more than a decade, emergency medicine (EM) organizations have produced guidelines, training, and leadership for disaster management. However, to date there have been limited guidelines for emergency physicians (EPs) needing to provide a rapid response to a surge in demand. The aim of this project was to identify strategies that may guide surge management in the emergency department (ED). A working group of individuals experienced in disaster medicine from the Australasian College for Emergency Medicine Disaster Medicine Subcommittee (the Australasian Surge Strategy Working Group) was established to undertake this work. The Working Group used a modified Delphi technique to examine response actions in surge situations and identified underlying assumptions from disaster epidemiology and clinical practice. The group then characterized surge strategies from their corpus of experience; examined them through available relevant published literature; and collated these within domains of space, staff, supplies, and system operations. These recommendations detail 22 potential actions available to an EP working in the context of surge, along with detailed guidance on surge recognition, triage, patient flow through the ED, and clinical goals and practices. The article also identifies areas that merit future research, including the measurement of surge capacity, constraints to strategy implementation, validation of surge strategies, and measurement of strategy impacts on throughput, cost, and quality of care.

UI MeSH Term Description Entries
D009874 Operations Research A group of techniques developed to apply scientific methods and tools to solve the problems of DECISION MAKING in complex organizations and systems. Operations research searches for optimal solutions in situations of conflicting GOALS and makes use of mathematical models from which solutions for actual problems may be derived. (From Psychiatric Dictionary, 6th ed) Operational Research,Research, Operational,Research, Operations
D003697 Delphi Technique An iterative questionnaire designed to measure consensus among individual responses. In the classic Delphi approach, there is no interaction between responder and interviewer. Delphi Method,Delphi Studies,Delphi Technic,Delphi Methods,Delphi Study,Delphi Technics,Delphi Techniques,Method, Delphi,Methods, Delphi,Studies, Delphi,Study, Delphi,Technic, Delphi,Technics, Delphi,Technique, Delphi,Techniques, Delphi
D004636 Emergency Service, Hospital Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient. Emergency Outpatient Unit,Emergency Services Utilization,Hospital Emergency Room,Hospital Emergency Service,Hospital Emergency Services Utilization,Accident and Emergency Department,Emergency Departments,Emergency Hospital Service,Emergency Room,Emergency Units,Emergency Ward,Hospital Service Emergency,Service, Hospital Emergency,Department, Emergency,Departments, Emergency,Emergencies, Hospital Service,Emergency Department,Emergency Hospital Services,Emergency Outpatient Units,Emergency Room, Hospital,Emergency Rooms,Emergency Rooms, Hospital,Emergency Services, Hospital,Emergency Unit,Emergency Wards,Emergency, Hospital Service,Hospital Emergency Rooms,Hospital Emergency Services,Hospital Service Emergencies,Hospital Service, Emergency,Hospital Services, Emergency,Outpatient Unit, Emergency,Outpatient Units, Emergency,Room, Emergency,Room, Hospital Emergency,Rooms, Emergency,Rooms, Hospital Emergency,Service Emergencies, Hospital,Service Emergency, Hospital,Service, Emergency Hospital,Services Utilization, Emergency,Services Utilizations, Emergency,Services, Emergency Hospital,Services, Hospital Emergency,Unit, Emergency,Unit, Emergency Outpatient,Units, Emergency,Units, Emergency Outpatient,Utilization, Emergency Services,Ward, Emergency,Wards, Emergency
D006752 Hospital Planning Areawide planning for hospitals or planning of a particular hospital unit on the basis of projected consumer need. This does not include hospital design and construction or architectural plans. Regional Hospital Planning,Regional Hospital Plannings,Hospital Planning, Regional,Hospital Plannings, Regional,Planning, Hospital,Plannings, Hospital,Planning, Regional Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D044362 Australasia Australia, New Zealand and neighboring islands in the South Pacific Ocean. (Random House Unabridged Dictionary, 2d ed.)
D055872 Surge Capacity A health care system's ability to rapidly mobilize to meet an increased demand, to rapidly expand beyond normal services levels to meet the increased demand in the event of large-scale DISASTERS or public health emergencies. Capacities, Surge,Capacity, Surge,Surge Capacities
D026683 Advisory Committees Groups set up to advise governmental bodies, societies, or other institutions on policy. (Bioethics Thesaurus) Governmental Commissions,Review Committees,Task Forces,Advisory Committee,Commission, Governmental,Commissions, Governmental,Committee, Advisory,Committee, Review,Committees, Advisory,Committees, Review,Governmental Commission,Review Committee,Task Force

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