Essay Sample on Planning for Hospital Surge

Introduction

Many medical institutions and healthcare coalitions are faced with harsh challenges even after natural or human-caused problems. Therefore, planning for a survey is one of the key techniques for such institutions' emergency plans and response units. Through surge planning, they can better respond and focus on creating viable preparedness program cooperative agreement. A surge can be noted as a significant event or circumstance affecting an institution resulting over demand over capacity in medical institutions, community care clinics, public health departments, as well as other care procedures and medical services. Through planning, there can be an accommodation of the large volumes of patients and various patient groups with different injuries such as burns, the pediatrics, and the orthopedics, among others (Curran, Howley & Duggan, 2016). For instance, in the pediatric surge planning tactic, various measures can be considered. There should be a good plan for the influx of children, where thelocal nuanced local analyses can be sought.

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A surge plan is important in improving the emergency departments of hospitals in regards to overcrowding. Such improvements may call for hospital-wide efforts. Many hospitals are unable to transfer admitted patients into inpatient beds hence, the cause of overcrowding. The consequences of overcrowding would involve high death rates among the boarded patients, some long working hours especially in ambulance diversion, and some high elopement rates, which are the rates of leaves by patients from the emergency department without treatment. Surges would start the boarding of patients, which in turn would lead to exacerbates emergency department crowding as well as lengthening the wait times (Khademipour, Bardsiri, Mohammadian & Moghadam, 2016). Creating a good surge plan would mobilize a medical institution and assist it in decompressing the emergency departments (Curran, Howley & Duggan, 2016). The surge criteria would include a number of considerations such as the total patients in the emergency department, the total number of beds at the emergency department, the total hospital beds, number of admissions, the longest waiting time at the waiting room as well as boarding time for admitted patients, and the number of ventilated patients in the emergency department. Through such considerations, there can be defined various categories efficiencies regarding score.

Additionally, communication is an important factor in creating a successful surge plan. Some surge codes are communicated by the hospital-wide communication systems such as alerts and emails. Through the surge plan, communication pathways for hospital seniors can also be designated easily, for instance, having a notification reach an emergency department staff such as an emergency department director and house supervisor as soon as a particular level is reached. In its action plan, the surge plan defines a detailed set of interventions for each of the categories. Some of these plans may include inpatient boarding, where a certain number of admitted patients who are waiting for a bed are transferred to the hallway for the inpatient units. Additionally, the utilization of overflow areas can be a method towards the action plan where the boarded patients at the ICU are transferred to another unit such as the observation unit and radiology areas where they can; therefore, consume unused space. The prioritization by ancillary services is also a good action plan, where the housekeeping, labs, and radiology departments are involved. Such hospital units are prioritized to let the case management focus more on inpatient discharges and transfers. Finally, resource funneling can be a good plan of action where the staffing office relocates the available personnel, and notifies on-call staff and enhance some human resources. The directors at the department tend to relocate available staff and equipment to the emergency department.

Presently, preparedness for disaster mainly focuses on the surge-in-place strategies, which encompass the modification of actions to permit care to be provided to an increased number of patients by the existing health care operations. However, a scope of event or time is not considered between the onset of a surge and the local proclamation of a disaster (Hameed, Almas, Ahmed & Khan, 2016). Therefore, the surge planners should consider various factors such as the gubernatorial waiver of the existing regulations, the No gubernatorial waiver of the regulations, and the surge plan options. Through a concise surge plan, some measures such as the average length of stay for admitted patients and the discharged ones can be better traced hence the reduction of overcrowding at the hospitals. Another additional advantage is the improvement of the turnaround times amongst the discharged and admitted patients. A good surge plan can not only be effective in enhancing the throughput but can also spark some positive cultural changes in a medical institution (Hameed, Almas, Ahmed & Khan, 2016). More specifically, there would be a decrease in the inpatient floors. Through a surge plan, the unit staff can become more proactive at anticipating bed turnover and taking note of the admitted patients. Many hospitals are implementing the best surge plans hence, rare to find an emergency department patient boarding other units within the hospital.

Surge plans should be able to address the internal and external communication models being adopted by the medical institutions about the present emergency status. The best plan is that which has adequate detail on to allow implementation by staff that would not be familiar with the surge plan. In case of a surge incident, policy and background information and documentation should be properly referenced and made readily available, even though should not serve as the primacy resources providing directions. A surge plan should be in compliance with the state and federal requirements as well as with the standards that are set by the accreditation organizations.

Good management can implement and follow a medical surge planning checklist, which is important before the commencement of any action. Some of the considerations include an incident command system for crisis management, the available personnel of all types, the critical equipment and supplies, the patient care items, and medications, as well as the mechanism for evaluation and a good critique of response. During planning, a good hospital should make various assumptions such as the fact that the incident would consume all the existing resources and leave a little of the same.

Surge planning as a homeland security issue can be perceived within the creation of the surge capacity section of the hospital surge plan check. Such would require an immediate response from the necessary staff regarding an issue presented with (Khademipour, Bardsiri, Mohammadian & Moghadam, 2016). The homeland security staff can plan to activate and perform its activities or triage actions at specific locations during a surge event. Additionally, various activation triggers can be used for the establishment of alternative triage areas that can be defined. A surge plan should be able to cater for the primary and alternate triage areas such as the event type, the facility damage, and outside triage areas where there are clear definitions of the responsibility and processes for set-up and operation. A good communications plan should also be available in the surge plan, especially between triage areas, the emergency department, and other affected departments. Decontamination is also another issue to consider while making a surge plan for homeland security. Through the act of decontamination, the plan can be used for the activation and performance of the action where necessary.

A surge plan should be able to cater for the areas where possible, plan for the segregation and prioritization of individuals from the action and encompass all possible methods for directing patients to the decontamination areas such as stations, cones, and signage. The surge plan should also be able to cater for the holding areas where there should be a concise plan for activation and operation for patients who await triage, treatment, admission, discharge or transport to other areas of care. There should also be a responsibility for the setting up of the holding areas by the entire plan. Treatment areas should also be considered in the surge plan where a clear plan for activation and operation of additional treatment areas to include capacity and responsibility hence; incorporate the operation of the emergency departments to focus on patients at higher acuity (Khademipour, Bardsiri, Mohammadian & Moghadam, 2016). In regards to security-facility access, there should be plans that secure and limit the facility access during a surge event. In that case, security assessment that has plans to address vulnerabilities should be provided within the surge plan.

There should be a plan to control traffic control measures and activate them in case a particular facility needs to be used. In that case, there should be a good roadmap to outline the ingress, egress, and traffic controls during surge event, and specific staffing assignments that include the who, what, and how during any surge event. There should also be a concise plan to start lock-down procedures hence, limit access and entry to areas where a surge event is seen. Again, communication ought to be maintained between the security, handled access points and other relevant staff to make sure that closed entrances are monitored well. Direct patient care areas should be provided in a surge plan which encompasses the specific protocols followed for the creation of surge capacity to care for a significant surge of disastrous patients. Cancellation can, therefore, be planned immediately for activities such as clinic visits, inpatient admissions, and diagnostic services when there are direct patient care areas. Some other considerations would include ambulatory care capacity where ambulatory care patients are considered, and the ancillary and support services (Khademipour, Bardsiri, Mohammadian & Moghadam, 2016). Mass facility management is also an important consideration for the management and disposition of deceased patients.

Some of the barriers to this approach may include the concentration into the pediatric areas and specialty centers, the non-prioritization of planning, and the maintenance of readiness, which is not incentivized (Kelen, Sauer, Clattenburg, Lewis-Newby & Fackler, 2015). However, in such a case, some of the key considerations may include the security and safety of children in a chaotic setting, the unaccompanied minors, the social supports offered, as well as physiological first aid for the psychological health of children. Such resources tend to highlight the most recent cases in detail, the lessons learned from the case studies and the practices regarding planning and improvement of response to surge events with their main focus on the capacity for mass casualties.

It is, therefore, evident that a surge plan in regards to homeland security is an important measure in improving various challenges such as the emergency departments. Additionally, overcrowding can be prevented through the implementation of various surge plans. Creating a good surge plan through the consideration of various factors would mobilize any hospital and assist it in the decompressing of emergency departments.

References

Curran, M., Howley, E., & Duggan, J. (2016, April). An Analytics Framework to Support Surge Capacity Planning for Emerging Epidemics. In Proceedings of the 6th International Conference on Digital Health Conference (pp. 151-155). ACM.

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