Hospital surge capacity during epidemics

Added March 18, 2020

Citation: Rathnayake D, Clarke M, Jayasooriya L. Hospital surge capacity: The importance of better hospital pre-planning to cope with patient surge during dengue epidemics – A systematic review. International Journal of Healthcare Management 2019; 1-8 (published online 21 November 2019)

What is this? A major challenge for those responding to COVID-19 is the increase in demand for hospital care. This summary is of a systematic review of hospital surge capacity for epidemics of dengue, which may provide insights for the surge with COVID-19.

The authors for this systematic review searched for articles published from 2000 to 2018 on managing surge at hospital level during dengue epidemics. They restricted their search to English, French and Portuguese (because of their familiarity with these languages) and did their searches in December 2018. They identified 18 eligible studies and drew the following conclusions from them.

What works: Context specific planning of service expansion and reverse triage strategies should help hospitals cope with patient surge during epidemics of infectious disease.

The need for increasing capacity and capability were two intrinsic strategic approaches for coping with surge in most response plans. This might include training, redistribution of existing staff with extended work shifts within institutions and recruitment of staff from other institutions, the private sector or civil society.

Providing extra facilities for additional staff was important for maintaining service delivery.

The need to increase both medical and non-medical supplies was noted as key to the logistical aspects of surge capacity.

It may help to delegate the authority to take relevant decisions for organizational activities to hospital administrators, to avoid delays reported when usual protocols for logistics management are used during emergencies.

Well-functioning command and control structures should support rapid and effective action in a surge situation

Communication infrastructure for surveillance and risk communication in a hospital is vital to the control of outbreaks.

What doesn’t work: Problems have been encountered in the mobilization of the workforce due to administrative reasons, perhaps reflecting a lack of specific detail on the process for staff recruitment in an emergency.

What’s uncertain: Nothing noted.


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