Hospital Surge Model Version 1.2: User Manual

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Step 3: Examine the Output

The output page shows you the resources required to treat the patients you specified in Steps 1 and 2.

To change one of the scenario parameters and then re-run the Hospital Surge Model, select Modify scenario..
To return to the Scenario Selection Screen, select New scenario..
To display the User Manual, select Help (note: you may need to disable your pop-up blocker to view the Help text).
To show (or hide) the graphs and tables with the output, select inside any of the four headline bars: .
To save or print a graph, right-click select anywhere on the graph. The options that appear on the menu vary according to what Web browser you are using, but they all include options for saving, copying, or printing the image.
To copy tabular data to a spreadsheet, select the cells with the mouse, right-click select in the selected area, select Copy, and then Paste the data into a spreadsheet.
To print the entire output page, select File > Print on your Web browser.

The output from a Hospital Surge Model run is organized into five sections:

Summary Results.
Casualty arrival pattern at your hospital(s).
Number of patients in your hospital(s) by day.
Number of dead and discharged patients.
Resource requirements.

Summary Results

Three summary measures from the daily results are displayed:

The actual total number of casualties arriving at your hospital(s). The number may be less than the number you specified in Step 1, due to rounding.
The day that the most casualties arrive at your hospital(s), and the number of casualties that arrive on that day.
- For the nuclear and chemical scenarios, all casualties arrive on Day 1.
- For the radiological and biological scenarios, casualties arrive as their symptoms present, which could occur over several days.
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The day that the most patients are in your hospital(s) and the number of patients that are in your hospital(s) on that day.

The screen shot below shows the output from a run in which the user specified 80 mild and 40 severe anthrax cases.

Summary Results

Screen shot shows a summary of the results from a specified scenario. In this example, the user views the scenario results of an anthrax attack in which there were 80 mild casualties and 40 severe casualties. The sample data show that Day 4 was the day of peak casualty arrival at the hospital (11 patients) and that Day 14 was the day of the peak number of patients in the hospital (60 patients). The user can expand headline bars to view additional data, including graphs or tables: Casualty Arrival Pattern at Hospital, Number of Patients in Hospital, Number of Dead and Discharged Patients, and Resources Consumed.

Select inside any of the four headlines to expand or collapse the section.

Casualty Arrival Pattern at Your Hospital(s)

When you select inside the headline bar labeled Casualty Arrival Pattern at the Hospital(s), the number of casualties arriving at your hospital(s), by day and casualty severity, following the attack is displayed in both graphic and tabular format. An illustrative casualty arrival graphic is shown below.

Casualty Arrival Pattern at the Hospital(s)

Screen shot of the casualty arrival pattern at a hospital in both graph and table form. The sample data show a rapid increase in arrivals in the first week followed by a tapering over the course of a month.

Key assumptions regarding casualty arrivals are:

The model assumes there are no capacity or resource limitations at your hospital(s).
Casualties are assumed to arrive at your hospital(s) when symptoms present. For the nuclear and chemical attacks, casualties arrive at your hospital(s) immediately after the attack; for the biological and radiological attacks, there is a delay between exposure and when symptoms present.

Go to the Hospital Surge Model Description for a complete discussion of assumptions used in the Hospital Surge Model.

Number of Patients in Your Hospital(s) By Day

When you select inside the headline bar labeled Number of Patients in the Hospital(s), the number of patients in your hospital(s), by hospital unit and by day, is displayed in a table and in a graph. The following illustrative graphic showing the number of patients in your hospital(s) is shown below.

Number of Patients in the Hospital(s)

Screen shot of the number of patients in the hospital over several weeks. The trend for this sample data shows a rapid increase in the number or patients within the first week, a steady high number of patients for about 2 weeks, and a more rapid decline in number of patients in the next 2 weeks.

Key assumptions regarding patients' stay in your hospital(s) are:

After patients are admitted to the ED, they are transferred to and from the ICU and floor as necessary. Eventually, patients either die in your hospital(s) or are discharged.
The model assumes there are ten possible "paths" that a patient can take in your hospital(s):
- ED → discharge.
- ED → death.
- ED → floor → discharge.
- ED → floor → death.
- ED → floor → ICU → death.
- ED → floor → ICU → floor → discharge.
- ED → floor → ICU → floor → death.
- ED → ICU → death.
- ED → ICU → floor → discharge.
- ED → ICU → floor → death.
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The probability that a particular patient will take each of these paths varies by scenario and the severity of their condition upon arrival at your hospital(s).
The patient's assumed length of stay in the ED, in the ICU, and on the floor also varies by scenario and severity condition.

Go to the Hospital Surge Model Description for additional information on assumptions regarding lengths of stay and patient paths.

Number of Dead and Discharged Patients

When you select the headline bar labeled Number of Dead and Discharged Patients, the number of patients in your hospital(s), the cumulative number of deaths to date, and the cumulative number of patients discharged from your hospital(s) to date are displayed in both graphical and tabular form. An illustrative graphic is shown below.

Cumulative Number of Dead and Discharged Patients

Screen shot of the number of dead and discharged patients by day in both graph and table form. The sample data show a rapid increase over the first week in hospitalized patients and deaths (cumulative). After the first 3 weeks, the number of hospitalized patients decreases quickly as the number of discharged patients increases proportionately.

Resource Requirements

While patients are in your hospital(s), they require resources (e.g., medical personnel and equipment) and consume resources (e.g., medical supplies). When you select the headline labeled Resources Consumed, the daily resource requirements for all the patients, by resource, day, and hospital unit are displayed in a table. Daily usage for an individual resource can also be graphed by selecting the graph icon on the left hand side of the page.

Resource Requirements (Tabular Form)

Screen shot shows the resource availability and total daily requirements for the hospital in a table format. The sample data are categorized by resource name, unit measure, category or subcategory, consumable, day of peak need, amount of resource needed on peak day, and daily requirements.

The Resource Availability and Total Daily Requirements table shows:

Resource name.
Resource unit. The units of the resource requirements include: FTEs, machine time, and unit of use.
- Machine time refers to the amount of time needed per patient per day on diagnostic machines (such as a CT scanner).
- Unit of use is a generic term for a daily dose or other definable amount of a consumable resource such as a medication or a set of laboratory reagents. For example, the unit of use for antibiotics for anthrax would be two 400mg doses of intravenous ciprofloxacin or two 100mg doses of intravenous doxycycline plus one or two additional antibiotics.
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Resource category and subcategory.
Consumable (yes/no).
Day of peak use. The day that the greatest amount of the resource is required.
Amount of use on peak day. The amount of the resource that is required on the peak day.
Daily requirements, as computed by the model.

Selecting on the graph symbol to the left of the resource name displays the resource requirements for that resource in a graph.

Resource Requirements (Graphic Form)

Screen shot shows a graph representing the hospital requirements for a specific resource. The sample data show the need for med/surg beds increasing rapidly for the first 10 days, remaining high for the next 2 weeks, then quickly declining over the next 2-3 weeks.

Resource requirements data are displayed until all patients are either discharged from your hospital(s) or die. The exception is for smallpox, in which case the model only considers patients arriving at your hospital(s) within 30 days of the attack. Resource data are therefore only shown up to Day 30.

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