Biomedical Engineering Reference
In-Depth Information
can be stockpiled with medications and equipment
tailored to the specific situation.
staffing and equipment. Organizations also need to
investigate pharmaceutical reserves in local phar-
macies so they can have a ready supply of needed
medications that last until additional supplies arrive
from the Strategic National Stockpile (see p. 7
for a detailed description of the Strategic National
Stockpile). In addition, communications systems
and information technology should be in place so
that the organization can communicate with both
internal staff and outside agencies. Another funda-
mental part of the planning process is the connec-
tivity with community leaders and planning orga-
nizations to ensure compatibility with community
thinking and functional initiatives.
Project ER One
Project ER One is a prototypical emergency
care facility developed by Washington Hospital
Center in Washington, D.C., and conceived as a
chemical- and bioterrorism-ready mass casualty
facility. Intended as a model for all new emergency
departments constructed in the nation, ER One
features the following emergency-ready elements
to enable a rapid response in disaster-stricken
communities:
Treatment
areas
designed
to
thwart
cross-
contamination and cross-infection
Modular scalability to serve many patients on a
daily basis and then expand for larger numbers
in minutes
An educational training center that can also serve as
a planning hub for neighboring health care organi-
zations and for handling non-conventional threats
State-of-the-art computer information system that
can track patients and patient records in real time
The ability to share encrypted data with sanctioned
medical, public safety, military, and govern-
mental agencies
A laboratory for research and development
Evaluating the options for surge capability
When considering the surge facility options avail-
able to a health care organization, it is impor-
tant to start at the neighborhood level and work
outward. Can any closed wards be opened? Does
the organization have a satellite outpatient facility
that can be converted to inpatient use to increase
hospital capacity? What are the closest available
large-capacity venues, such as veterinary hospitals,
exhibition halls, or schools that could be used to
expand capacity?
Mobile medical facilities and portable surgical
units can also be attractive candidates to serve as
surge facilities; however, a disadvantage of using
these facilities is their considerable cost. Cash-
strapped hospitals and other health care organiza-
tions may find it difficult to dedicate huge sums of
money for infrastructure changes that may rarely,
if ever, be used. For this reason, many organiza-
tions are looking at ways to retrofit their existing
buildings to add surge capacity while controlling
costs.
in
bioterrorism and similar events
ER One embodies the hallmark principles of the
surge facility, which include dual use, scalability,
and modularity. During phase one of the project,
design specifications were developed for the emer-
gency facility at Washington Hospital Center. The
Phase II design study will put the phase one find-
ings into operation at the hospital center.
Planning for, establishing, and operating
surge hospitals
When planning for the potential use of a surge
hospital, health care institutions need to consider
their definition of
surge capacity
as more than
just the number of available hospital beds. Instead,
they need to think about their ability to handle a
public health emergency by examining two addi-
tional types of resources inside their institutions:
Design considerations for dual use in
existing buildings
Health care facilities that have one purpose, such as
a surgery suite in nonemergency circumstances, but
which can be converted to increase surge capacity
in an emergency, are called dual-use facilities.
Hospitals themselves can be equipped for dual
use during a crisis, but the cost of retrofitting a
