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        Medical Surge & Alternate Care Site
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        Medical Surge & Alternate Care Site Planning

        Medical Surge is the capability to rapidly expand the capacity of the existing healthcare system in response to an increased patient volume that would otherwise severely challenge or exceed the current scope of the facility.  It applies to many types of events such as the day-to-day acute, temporary demand for services as well as the response to emergent events such as multiple casualty incidents, infectious disease outbreaks, or natural disasters resulting in injury/illness.

        The Medical Surge & Alternate Care Site Plan augments the hospital’s existing Emergency Operations Plan and incorporates the fundamental principles of all-hazards emergency management.  The Medical Surge & Alternate Care Site Plan establishes policy for managing emergency department overcrowding and creating internal and external surge capabilities. This plan applies to hospital staff in all organizational components and describes how the facility prepares for and manages the various key aspects of a medical surge operation.  Strategies outlined in this plan will provide the hospital with options that promote institutional resiliency to respond to an event that results in a rapid patient influx or a sustained patient surge.


        The hospital forms a cross-functional, mulch-disciplinary planning team that can be actively engaged for the duration of the project. The Medical Surge & Alternate Care Site Plan development process leverages a self-directed proprietary medical surge planning template supported by DQE through a series of remote and/or on-site consultation that focuses on:

        • Emergency Department crowding and enhanced use of inpatient space
        • Expansion of emergency department, outpatient services, and inpatient areas to accommodate an influx of patients
        • Adjustment of personnel roles and responsibilities to maximize patient care services
        • Rapid discharge of existing patients
        • Degradation of services
        • Altered standards of care
        • Alternate care site operations


        The Hospital Medical Surge Plan addresses:

        • Mitigation measures, preparedness activities, response actions, and recovery strategies
        • Plan Activation Criteria and Advanced Preparations Actions (general, internal and external surge)
        • Incident Management and Surge Operations Procedures
        • Customized agreements, protocols and documentation forms to include:
          • External Support Agreements
          • Altered Standards of Care
          • Strategies to Enhance Surge Capacity
          • Degradation of Services
          • Rapid Discharge Protocol
          • Internal Bed Expansion/Non-Traditional use of space
          • Alternate Care Site Operations
          • Job Action Sheets
          • ESF #8 Support Activities
        • Surge Capacity Response Guide