Emergency department surge capacity: Recommendations of the Australasian surge strategy working group

David A. Bradt, Peter Aitken, Gerry FitzGerald, Roger Swift, Gerard O'Reilly, Bruce Bartley

Research output: Contribution to journalReview articlepeer-review

Abstract

For more than a decade, emergency medicine (EM) organizations have produced guidelines, training, and leadership for disaster management. However, to date there have been limited guidelines for emergency physicians (EPs) needing to provide a rapid response to a surge in demand. The aim of this project was to identify strategies that may guide surge management in the emergency department (ED). A working group of individuals experienced in disaster medicine from the Australasian College for Emergency Medicine Disaster Medicine Subcommittee (the Australasian Surge Strategy Working Group) was established to undertake this work. The Working Group used a modified Delphi technique to examine response actions in surge situations and identified underlying assumptions from disaster epidemiology and clinical practice. The group then characterized surge strategies from their corpus of experience; examined them through available relevant published literature; and collated these within domains of space, staff, supplies, and system operations. These recommendations detail 22 potential actions available to an EP working in the context of surge, along with detailed guidance on surge recognition, triage, patient flow through the ED, and clinical goals and practices. The article also identifies areas that merit future research, including the measurement of surge capacity, constraints to strategy implementation, validation of surge strategies, and measurement of strategy impacts on throughput, cost, and quality of care.

Original languageEnglish (US)
Pages (from-to)1350-1358
Number of pages9
JournalAcademic Emergency Medicine
Volume16
Issue number12
DOIs
StatePublished - Dec 2009
Externally publishedYes

Keywords

  • Disaster management
  • Emergency medicine
  • Surge capacity

ASJC Scopus subject areas

  • Emergency Medicine

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