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A Simple Graphical Method for Quantification of Disaster Management Surge Capacity Using Computer Simulation and

Jeffrey Michael Franc¹, Pier Luigi Ingrassia², Manuela Verde²

¹1Emergency Medicine,University of Alberta,Edmonton,Alberta,Canada.

Prehospital and Disaster Medicine

|November 20, 2014

Summary

This summary is machine-generated.

Quantifying hospital surge capacity is challenging. This study developed a simulation method using patient volume and length-of-stay metrics to objectively measure emergency department surge capacity during mass-casualty incidents.

Keywords:

1Q first quartile 3Q third quartile CTAS Canadian triage and acuity scale ED emergency department EMDM European Master in Disaster Medicine IQR interquartile range LOS length-of-stay MD medical doctor PV patient volume START Simple Triage and Rapid Treatment surge capacity

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Area of Science:

Disaster medicine and hospital preparedness.
Quantitative methods in healthcare management.
Emergency medicine and patient flow analysis.

Background:

Hospital surge capacity is crucial for managing mass-casualty incidents but lacks standardized measurement.
Current methods for quantifying surge capacity are difficult and lack universal standards.
Computer simulation offers a viable approach to measure surge capacity due to the rarity of mass-casualty events.

Purpose of the Study:

To develop a statistical method for quantifying hospital surge capacity.
To utilize computer simulation combined with process-control statistical tools.
To establish objective benchmarks for emergency department (ED) response using length-of-stay (LOS) and patient volume (PV) metrics.

Main Methods:

A derivation phase involved 357 participants across five countries conducting 62 ED mass-casualty incident simulations.
Benchmarks for ED response, including LOS and PV metrics for key processes, were derived from these simulations.
An application phase used 13 European Master in Disaster Medicine students to test the derived benchmarks against their simulation results.

Main Results:

Key patient volume metrics (triage, bed assignment, physician assessment, disposition) and length-of-stay metrics were established.
Process-control statistical tools and graphical methods were employed to compare simulation results against derived benchmarks.
The application group did not meet the established standard for length-of-stay from admission to disposition decision.

Conclusions:

Simulation software can objectively derive benchmarks for ED surge capacity using PV and LOS metrics.
These objective metrics, applied via process-control tools, provide a numerical measure of surge capacity.
Repeated simulation of actual EDs can objectively quantify disaster management surge capacity, offering a simple, reusable statistical method for researchers.