Medical Surge Capacity Workshop Summary (2010) / Chapter Skim
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Appendix E: Alternate Care Systems: Stratification of Care
Appendix E: Alternate Care Systems: Stratification of Care
Pages 113-122
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From page 113... ...
Communities across the nation must be prepared to manage such a surge in demand for patient care services, and might be faced with the prospect of having to implement an "alternate care system" that incorporates a stratification of care ranging from home health service delivery to hospitalized care. The last decade of planning for catastrophic disaster response in the United States has led to the development of a number of surge response capabilities supported by the federal government, particularly the Department of Health and Human Services, and the Department of Homeland Security.
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From page 114... ...
The Centers for Disease Control and Prevention has adopted such an approach to surge capacity planning, emphasizing the importance of coordinating public health and healthcare-related planning for pandemic influenza under the umbrella of a community Alternate Care System (ACS) , composed of select community partners who are essential to delivering care in the setting of a surge response to disaster.
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From page 115... ...
The components of a stratified model of healthcare delivery, implemented in order to meet a surge in demand for healthcare service delivery in a disaster event, can be subdivided into the four broad categories below. Delivery of Hospital and Healthcare Facility Services The foundation of any community's healthcare surge planning must be based on solid, fundamental healthcare service delivery at the hospital.
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From page 116... ...
Staffing models will need to include a combination of resources, including hospital staff, Medical Reserve Corp staff, public school registered nurses, and staff from a select number of urgent care facilities in the community. Implementation of an out-of-hospital solution to surge capacity also requires resolution of legal and financial impediments currently limiting such efforts.
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From page 117... ...
Based on supply and demand definitions of healthcare facility surge capacity management, research efforts examining the creation of additional care capacity in the hospital have been conducted, particularly focused on strategies meant to expedite early patient discharge.5 A
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From page 118... ...
Conventional, contingency, and crisis surge capacity strategies, along with corresponding conventional, contingency, or crisis standards of care, may be one such way to mark the triggers required to implement a community-based approach to surge response.6 Delineating such levels may allow for response planning based on the recognition that not all disaster events will require the same degree of response, thus suggesting a scaled approach to surge capacity implementation in the hospital and surrounding community. For example, a number of decisions can be made to support conventional care that are outside the normal operations of daily patient care delivery, such as doubling up beds in single-patient rooms and canceling elective procedures, that have minimal impact on patient outcomes.
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From page 119... ...
Such efforts must include clearly delineated plans for the step-wise expansion of healthcare service delivery that maximizes available resources within the hospital, and creates capability outside of the traditional hospital setting in a way that provides the highest level of service care delivery sustained over as long a period of time as possible. POTENTIAL AREAS OF FUTURE FUNDING PRIORITIES Commitment to planning, increased costs for additional materiel stockpiling, training and staffing, existing regulatory, legal, and financial impediments, and the overarching complexity of coordinating such operations are but some of the barriers to getting this accomplished.
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From page 120... ...
Developing an expanded information management platform that allows medical information exchange, "just-in-time" training modalities, and direct patient care delivery should be a part of future grant funding opportunities. How can the stratification of care model be supported by existing capabilities within the Department of Veterans Affairs and Department of Defense (Northcomm)
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From page 121... ...
However, current restrictions regarding the grant funding process restrict closer coordination in planning with the private healthcare community. It is important to identify the manner by which such coordination, including access to available resources, could be maximized if surge capacity strategies need to be implemented.
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