Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study

Area of Science:

• Disaster medicine
• Healthcare management
• Simulation modeling

Background:

• Major incidents challenge hospital surge capacity (SC).
• Accurate SC assessment is crucial for effective disaster response.
• Previous methods may not fully capture dynamic SC limitations.

Purpose of the Study:

• To evaluate a simulation model for assessing hospital surge capacity (SC).
• To test SC in a major hospital using a realistic mass casualty incident scenario.
• To identify capacity-limiting factors in a simulated disaster response.

Main Methods:

• A simulation model using magnetic boards and casualty cards depicted hospital resources, staff, and patients.
• The model incorporated real-time resource consumption and procedural data.
• A scenario based on a real mass casualty incident was used for the simulation.

Main Results:

• The emergency department's resuscitation team capacity was the initial limiting factor, necessitating patient transfers.
• Lack of intensive care unit (ICU) ventilators became the primary long-term SC limitation.
• Significant surgical operating room (OR) capacity remained unused due to ICU limitations.

Conclusions:

• The simulation model is a validated tool for determining hospital surge capacity (SC).
• Hospital SC is a complex interplay of multiple functions, with different factors limiting capacity at various stages.
• Comprehensive, integrated testing is essential for understanding and managing hospital SC during mass casualty incidents.