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Facility Checklist

Gas and Ventilation/Surge Capacity Potential

Partially Shuttered Hospital Facility Walk-through

Date:
Location:
Team member:
Title:
Affiliation:

Overall Findings and Recommendations

For each of the statements below, circle the scenario(s)—if any—for which the statement is true.

Scenario A = Non-critical medical/surgical patients are moved to this facility to create space for critical patients/incident victims at the major hospitals.

Scenario B = This entire facility becomes a quarantine/isolation facility for victims.

The plan is for the shuttered facility to be brought up to active status within 3 to 7 days of a major terrorist incident or public health emergency. There is no intention to set up surgical facilities at the facility under either scenario.

Based on the walk-through, my finding is:

Scenario
A	B	No potential for surge capacity use.
A	B	Potential for consolidation (i.e., facility may not be returned to full original capacity, but could be made usable for a certain number of beds by consolidating equipment in current space).
A	B	Potential for surge capacity use with extensive refitting/renovation.
A	B	Potential for surge capacity use with moderate refitting/renovation.
A	B	Potential for surge capacity use with limited refitting/renovation.

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