Toward Building Surge Capacity: Potentially Effective Spatial Configurations in Emergency Departments

Area of Science:

• Emergency Medicine
• Healthcare Facility Design
• Disaster Preparedness

Background:

• Emergency departments (EDs) face persistent overcrowding challenges.
• Spatial configurations are proposed to enhance ED performance during overcrowding.
• Limited research exists on applying these configurations to improve surge capacity during mass casualty incidents (MCIs).

Purpose of the Study:

• To explore the potential of spatial configurations, designed for daily ED overcrowding, to improve surge capacity during MCIs.
• To assess clinician perceptions of spatial design strategies for enhancing ED resilience.

Main Methods:

• An online Likert-scale survey was administered to ED care teams.
• 11 spatial design strategies were evaluated for their potential to improve surge capacity during MCIs.
• 72 participants provided ratings and comments on the strategies.

Main Results:

• Establishing an in-house laboratory was rated as the most promising strategy for improving MCI surge capacity.
• Rapid care areas, internal waiting rooms, and in-house imaging were also highly rated.
• Separate entrances/exits and decentralized nurse stations received lower ratings with high response variance.

Conclusions:

• Clinician perspectives are crucial for implementing effective spatial configurations in EDs.
• Strategies like in-house ancillary services enhance communication, reduce turnaround times, and minimize errors.
• Rapid care and internal waiting areas improve operational flexibility for both daily operations and MCI surge events.