Emergency Department Surge Capacity: Recommendations of the Australasian Surge Strategy Working Group
Article first published online: 12 NOV 2009
© 2009 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 16, Issue 12, pages 1350–1358, December 2009
How to Cite
Bradt, D. A., Aitken, P., FitzGerald, G., Swift, R., O’Reilly, G. and Bartley, B. (2009), Emergency Department Surge Capacity: Recommendations of the Australasian Surge Strategy Working Group. Academic Emergency Medicine, 16: 1350–1358. doi: 10.1111/j.1553-2712.2009.00501.x
- Issue published online: 1 DEC 2009
- Article first published online: 12 NOV 2009
- Received March 24, 2009; revisions received May 14 and May 22, 2009; accepted May 26, 2009.
- emergency medicine;
- disaster management;
- surge capacity
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.