1. Home
    2.  » 
  2. Learning Resource
    3.  » The 4 “S” of Surge Capacity

The 4 “S” of Surge Capacity

 

Surge capacity is defined as the “ability to evaluate and care for a markedly increased volume of patients—one that challenges or exceeds normal operating capacity.”

There are four key components of surge capacity.

Staff

Ensuring adequate staff during disaster response is critical. This is especially challenging during a time where there is a workforce shortage in healthcare. However, staffing considerations are not restricted to physicians and nurses. Pharmacists, phlebotomists, laboratory technicians, respiratory therapists, environmental services personnel, and security staff all have roles to play during a surge.

Additionally, healthcare professionals should be prepared to expand and be flexible in their roles. For example, we saw many subspecialists and trainees activated to provide care in the intensive care unit and hospital for COVID patients.

Regardless of where you work, having clear communication on who responds to a disaster and delineation of specific roles is crucial. While it may seem like having a large number of people show up to help is a good thing, too many personel may actually be detrimental and lead to unecessary crowding and inefficiency.

Stuff

Depending on the disaster, we need to be cognizant that supplies may be limited. This may be due to supply chain disruption or simply because the disaster has made it very difficult for supplies to reach the site where you are working. During the COVID-19 pandemic, we have experienced medication shortages, personal protective equipment shortages, and shortage of medical equipment including ventilators. As your healthcare facility prepares for a surge a patients, ensuring that there is adequate food, sheets, and patient beds is also important.

Structure/Space

Structure refers to the available facilities and spaces for care. To accomodate a large volume of patients during a surge, we often need to be creative in space utilization. Some examples may include:

  • converting private patient rooms to shared rooms and cohorting patients with similar disease processes
  • establishing alternate care sites (patient care areas in gymnasiums, parking garages, etc)
  • converting existing areas to accomodate patient influx
    • convert outpatient clinics to urgent cares/emergency departments
    • operating rooms with ventilators become alternative intensive care rooms

System

A clear command center should be established within your healthcare facility. Clear communication up and down the chain of command is critical for all personel to have a shared mental model.

An Incident Command System structure can be employed as there are many aspects that must be considered when responding to an emergency/disasters. Some important aspects include:

  • safety
  • public information
  • administration
  • operations
  • logistics

Outside of your immediate healthcare facility, establishing partnerships with community organizations and sites becomes invaluable as they may serve as a way to offload some of the patient surge and/or provide resources to those affected by the disaster.

 

Additional Resources: