Planning for the Unprecedented: The Importance of an MSP During Surge Capacity Planning

Encapsulated within a closed system that relies on order and balance, healthcare facilities operate similarly to an ecosystem. There must be a healthy ratio of patients to hospital personnel with enough space, supplies, and information to sustain both. 

When this ecosystem becomes unbalanced, the system begins to collapse. Facilities have their routine procedures for operation to ensure stability, but surges in patient numbers may compromise standard order.

Surge capacity planning is a practice that helps medical facilities prepare for instances where there is a rapid or progressive surge in patient intake. The article explores this topic to identify the importance, elements, and examples of surge capacity planning. 

Table of Contents

• Understanding the Need for Surge Capacity Planning
• Why Is Surge Capacity Planning Vital for Hospitals and Healthcare Organizations?
• What Can We Learn From the COVID-19 Pandemic and Surge Capacity Planning for Hospitals?
• The Importance of Having a Healthcare MSP in Place Prior to a Medical Surge
• What Are the Major Capacity Considerations for Hospitals?
• How Should Hospitals Best Plan for Staffing When Looking at Surge Capacity Planning?
• Put Your Surge Capacity Planning Into Action With Trusted Managed Services

Understanding the Need for Surge Capacity Planning

Surge capacity is defined by the American College of Emergency Physicians (ACEP) as “a healthcare system’s ability to manage a sudden or rapidly progressive influx of patients within the currently available resources at a given amount of time.” 

Surges can be caused by routine events such as influenza season, a gastroenteritis outbreak, or a random variation in the number of patients. Unusual events like manmade or natural disasters can jeopardize surge capacity. 

The need for surge capacity planning transcends all departments but particularly is vital to emergency, trauma, and intensive care units. Surge capacity planning is the ability of hospitals to rapidly augment and expand resources to accommodate a sudden and large influx of patients. 

Why Is Surge Capacity Planning Vital for Hospitals and Healthcare Organizations?

When patient volumes challenge or exceed a hospital’s servicing capacity, the spillover can overwhelm the system’s capabilities. When a healthcare establishment is providing care and services with limited faculty and resources, patient outcomes may become threatened. 

Potential consequences resulting from depleted surge capacity include:

• Restrictions on admittance
• Delayed treatments
• Rationed supplies and care

These consequences could compromise patient morbidity rates, organization reputations, and more. Proper surge capacity planning allows hospitals and facilities to provide adequate care for all patients without overburdening staff or available resources. 

After the mass casualty incident that occurred on September 11th, 2001, medical facilities began restructuring their surge capacity planning to accommodate large instances of injury and fatality due to terrorist activity. Facilities were spurred to develop measures to accommodate sudden and large-scale patient surges. 

The initiation of surge capacity planning has successfully saved lives. On April 15th, 2013, two IEDs were used during the Boston Marathon which resulted in 3 deaths and 264 injured individuals. Hospitals treated 140 of the survivors, who all survived as a result of the surge capacity planning in place. 

What Can We Learn From the COVID-19 Pandemic and Surge Capacity Planning for Hospitals?

During the COVID-19 surge, hospital representatives reported shortages of staff, supplies, space, and information. The Department of Health and Human Services assisted hospitals in addressing these challenges, but due to the rapid progression of the virus, facilities and staff remained overburdened. 

The coronavirus pandemic revealed that the amount of mass casualty incident planning facilities operated on in years prior was not sufficient.  

An analysis and chart collection performed in the early days of the pandemic found that the U.S. had fewer beds and practicing physicians per capita than similarly structured countries. The report established that the U.S. hospitals only had 2.6 physicians for every 1,000 people compared to Italy at 4.0 and Germany at 4.3. When examining the amount of available beds, it was discovered that the U.S. only had 2.8 beds per 1,000 people. Comparing this to South Korea (12 beds per 1,000 people), it becomes glaringly clear that facilities in the United States had no backup for a large-scale country-wide surge. 

In the early months of the pandemic, healthcare professionals had little information on the symptoms of the disease, how the disease was transmitted, and how to adjust surge capacity protocols. 

Non-COVID care processes were severely compromised. Hospitals reported canceling or postponing elective surgeries (96.7%) and nonsurgical procedures (94.8%). Staffing ratios and roles were augmented to fulfill gaps in departments. One study found that 48% of U.S. facilities implemented tiered staffing models, 49% supplemented staffing disparities with temporary staff, and 30% modified their patient-to-staff ratios. The study also found that trainees were deployed earlier than typical, and ICU staff had to train non-ICU staff on the spot. This augmentation and repurposing of staff was suggested to lead to poorer quality care and an increased likelihood of poor patient outcomes.

Staff was not the only resource to be recycled to meet the depleted surge capacity prompted by the pandemic. Only 63% of hospitals had the space available to dedicate an intensive care unit specifically for COVID-19, 51% repurposed step-down units as ICUs, 33% used non-ICU intended space to treat COVID patients, 24% had to repurpose med/surg units, and 13% created space that was previously not suited for ICU patients. 

During the pandemic, supplies, especially beds and ventilators, were in high demand and short supply. One study found that 40% of COVID patients were admitted to surge capacity beds. Roughly 71% of hospitals had to borrow or buy extra ventilators. Almost no hospitals (5.6%) had protocols for rationing ventilators, and few hospitals had protocols in place for connecting multiple patients to a single ventilator (4.8%).

The Importance of Having a Healthcare MSP in Place Prior to a Medical Surge

A healthcare MSP may not be able to assist facilities with shortages of supplies, space, or systems. However, healthcare MSPs can remedy staffing shortages with the deployment of contingent staff. 

The COVID-19 pandemic demonstrated that the healthcare industry must be prepared for the worst. The world had not yet seen a medical surge of that same urgency or capacity. Rethinking how the field of healthcare addresses personnel shortages means utilizing contingent staff to avoid the negative outcomes associated with augmenting and repurposing staff and supplies. 

Coordinating with a healthcare MSP does not only allocate staff to meet adequate patient-to-personnel ratios. Healthcare MSPs can also help your administrators save time and money that could be used to buy more emergency resources. 

Healthcare MSPs can also help facilities:

• Identify potential candidates faster
• Gain Insights on the most important metrics during the hiring process
• Increase efficiency
• Spend less on temporary employees
• Stay in regulatory compliance
• Focus more on employee retention
• Ensure patient safety and enhance their reputation

Trusted Managed Services understands the continued staffing strain that developed as a consequence of systemic issues and was aggravated by the pandemic. We offer healthcare facilities the opportunity to leave this issue up to us. 

We help hospitals reduce the need for augmenting staff, supply workers in times of surges and absenteeism, and meet their surge capacity planning needs. Learn more about how our services can help your facility prepare for medical surges.

What Are the Major Capacity Considerations for Hospitals?

Surge capacity is not defined by a general standard. However, it does exist as generally agreed components. 

Surge capacity planning has four elements:

1. Staff (all individuals employed by the facility)
2. Stuff (equipment, supplies, medicine, blood, etc.)
3. Structures (hospitals)
4. Systems (the coordination and management of various levels of the healthcare system)

All elements should be considered contingent on each other. An abundance of structure, space, or systems will only provide enough support if there are available staff to delegate it all. 

#1: Staff

Staff may be one of the more important major capacity considerations in the world of healthcare. Facilities can stock up on resources, beds can be arranged in FEMA tents, equipment can be imported, etc, but highly-trained clinical personnel cannot be manufactured or bought in bulk. If there is not enough staff to use excess supplies and equipment, all of the surge capacity preparedness becomes defunct. 

Staff roles that are a part of surge capacity planning include:

• Nurses
• Physicians 
• Pharmacists
• Surgeons
• Respiratory therapists
• Security specialists
• Physical plant specialists

Unlike tangible resources, labor resources like staff can become mentally exhausted. Psychological stress is a symptom of depleted surge capacity. Without clear surge capacity protocols that provide an adequate amount of space and supplies, the staff becomes de facto allocators of life-saving care, which could lead to moral and ethical distress. 

As we previously mentioned, hospitals alone cannot meet the surge capacity requirements to help alleviate overwhelming patient numbers or excessive absenteeism. Outside help like contingent staffing vendors can help hospitals immediately remediate staffing shortages to ensure that patient-to-clinician ratios remain stable. 

Trusted Managed Services helps facilities connect with contingent workers to ensure patient needs are adequately met and permanent staff is properly supported. With our help, your facility can:

• Reduce burnout 
• Retain permanent employees
• Help hospitals decrease their temporary staffing budget
• Access a larger talent pool
• And more

#2: Supplies

Healthcare supplies include equipment and consumable supplies. 

The durable equipment may be supplies like:

• Cardiac monitors
• Defibrillators
• Intravenous (IV) pumps
• Blood glucose monitors
• Wheelchairs
• Beds

Consumable supplies include:

• Medications
• Blood
• Oxygen
• Sterile dressings
• Intravenous fluids
• IV catheters
• Syringes
• Sutures
• Personal protective equipment (PPE)

Supply shortages caused by depleted surge capacity create a negative environment for quality care. 

Supply shortages prompted by poor surge capacity planning lead to:

• Rationing of life-saving procedures
• Increased chance of medical error
• Treatment delays

#3: Structure

Structures are needed to provide relevant patient care. A hospital may be the main structure itself, but each department has units specifically designed for certain care. Other structures may also be on or off campus that are necessary for operation. Such buildings may include:

• Extended care facilities
• Community health centers
• Laboratories
• Pharmacies
• Public health departments
• Buildings of opportunity

During a surge, space may become depleted. As the pandemic demonstrated, lack of space often requires improvisation. This improvisation usually involves repurposing spaces to provide necessary care which could result in adverse patient outcomes if the rooms are not properly suited for intensive care. 

#4: Systems

Systems for healthcare organizations include:

• Policies that link departments within a healthcare facility
• Procedures that link the facilities to other aspects of healthcare like:
  • Emergency medical services
  • Home healthcare
  • Physician offices
• Analysis protocols for population health

The Joint Commission calls for cooperation with all healthcare-related organizations to enhance surge capacity in the event of a disaster. Systems must be expanded to include cooperative agreements between all organizations. 

Systems may be one of the more overlooked elements of surge capacity planning, but they are essential for all surge policies and procedures. Information during the 2020 pandemic led to mishandling of the situation. Creating systems to competently distribute and handle important surge-related information can help organizations and healthcare facilities coordinate plans to prepare for surges. 

How Should Hospitals Best Plan for Staffing When Looking at Surge Capacity Planning?

Hospitals cannot manage surges alone. Agencies have been created to relieve some of the burden when planning for surge capacity. Institutions like healthcare MSPs are valued for their ability to provide staff during shortages better than hospitals or other healthcare facilities.

Have a Staffing Contingency Plan in Place

Having one less problem to deal with during a surge gives facilities the advantage of preparedness. A staffing contingency plan helps facilities maintain operations in the event of a staffing emergency. 

There are twelve components you should consider when formulating a staffing contingency plan which are:

1. Risk assessment and identification of triggers
2. Chain of command and communication protocols
3. Staffing resource pool
4. Cross-training and redeployment strategies 
5. Volunteer registry 
6. Overtime and incentive programs
7. Resource allocation and prioritization
8. Child and dependent care support
9. Housing and transportation
10. Regular plan testing and training
11. Legal and regulatory considerations
12. Continuous evaluation and improvement

Hire a Healthcare MSP

Healthcare MSPs have the power to shuffle labor resources through your facility doors in real time. By utilizing a healthcare MSP, there is one less thing for your healthcare providers to worry about in the event of a surge.  

Along with providing staff, healthcare MSPs can also enhance healthcare leaders’ insights toward future staffing needs. Trusted Managed Services can help facilities overcome surge capacity staffing shortages and ensure that healthcare leaders have a clear comprehension of:

• Any disparities in staffing
• The hours needed to keep facilities properly staffed
• The cost of hiring new healthcare providers
• And more

Put Your Surge Capacity Planning Into Action With Trusted Managed Services

Trusted Managed Services provides healthcare facilities with a roadmap to navigating challenges presented in the healthcare workforce landscape. 

Our purpose is to help facilities access contingent workers in a time of great need. 

Time is a vital resource in the healthcare industry. Healthcare MSPs, like Trusted Managed Services, help healthcare facilities repurpose their time. 

Our custom digital solutions will help strengthen your facility’s management capabilities by streamlining the contingent hiring process. Your administrators and permanent staff can then allocate more time and resources to other important tasks that can improve patient outcomes, create a work environment that fosters retention, and reduce associated labor costs. 

By utilizing our first-class services and technology, Trusted Managed Services can help empower your facility through:

• Streamlined onboarding
• Superior analytics
• Customizable reports
• Negotiable conversion fees
• Vendor neutrality
• Auto offers
• Integrations
• Recruitment processing outsourcing

If you’re looking to implement a healthcare MSP as a part of your surge capacity planning, you should implement a healthcare MSP that you can trust. Trusted Managed Services is one of the most trusted.