Development of the Alternate Care Facility Symposium: Understanding National Experiences in Planning and Operations

Health care systems face challenges with patient surge during disasters. Alternate Care Facilities (ACFs) represent one strategy for expanding health care capacity when hospitals become overwhelmed. ACF implementation guidance remains largely informed by retrospective reports and expert opinion. Recognizing that many operational lessons reside within the experiential knowledge of responders rather than the published literature, the authors developed a national symposium to systematically learn from experts with direct ACF operational experience. Informed by prior research, the symposium employed purposive recruitment, structured facilitator guides, rotating breakout groups, dedicated facilitators and note takers, and standardized discussion prompts to capture practice-based insights across operational domains. This manuscript describes the rationale, conceptual framework, planning process, and execution of the 2025 Alternate Care Facility Symposium. The methods described provide a reproducible approach for translating distributed experiential expertise into actionable knowledge to strengthen disaster preparedness. Summaries of the findings from this symposium are published separately.