Bioterrorism and Other Public Health Emergencies
Tools and Models for Planning and Preparedness

Reopening Shuttered Hospitals to Expand Surge Capacity

With Detailed Appendix on Legal and Regulatory Issues

Prepared for:

Agency for Healthcare Research and Quality
IDSRN Task Order #8

Prepared by:

Abt Associates Inc.
Andrea Hassol, Project Director and Co-Investigator

Partners Healthcare System
Richard Zane, M.D., Co-Investigator

Contents

Executive Summary
1.0 Background and Introduction
   1.1 Hospital Surge Capacity
   1.2 Use of Shuttered Facilities to Expand Surge Capacity
   1.3 How Much Additional Capacity is Needed?
   1.4 Facility Selection
   1.5 Assumptions for Reopening Shuttered Hospital as a Surge Facility
   1.6 Planning Phases
   1.7 Report Organization
2.0 Facility Structure and Status
   2.1 Location and Access
   2.2 Building Security and Life Safety Systems
   2.3 Structural Components
   2.4 Utilities
   2.5 Water and Plumbing
   2.6 Containment and Wastes
   2.7 Services
   2.8 Patient Care Spaces and Patient Care Needs
   2.9 Non-Patient-Care Spaces
   2.10 IT/Communications
   2.11 Summary
   2.12 Preparing to Open a Partially-Shuttered Hospital
3.0 Equipment and Supplies
   3.1 Shuttered Hospitals' Existing Equipment
   3.2 Procuring Equipment, Supplies and Associated Support
4.0 Staffing Considerations
   4.1 Skills Needed, by Staff Type
   4.2 Federal and State Regulations on Staffing
   4.3 Staff Types Needed in a Surge Situation
   4.4 Typical Staffing Ratios and Community Hospitals and SNFs
   4.5 Staff Organization
   4.6 Staffing Based on the Modular Emergency Medical System Acute Care Center
   4.7 Preparing to Staff a Surge Facility
   4.8 Licensing, Credentials and Privileging Issues
   4.9 Orientation and Training
   4.10 Summary
5.0 Patient Transport
   5.1 Surge Facility Location and Route
   5.2 Preparing Patients for Transport
   5.3 Appropriate Transport Vehicles
   5.4 Regulatory Issues
   5.5 Preparing for Patient Transportation
6.0 Security
   6.1 Security Needs
   6.2 Preparing to Open a Shuttered Facility
7.0 Patient Information
8.0 Conclusions
References
Appendix A: List of Supplies and Equipment Needed for Operation of a Shuttered Facility
Appendix B: Preliminary "Basic" Pharmacy List
Appendix C: RN Nursing Skills for Possible Delegation
Appendix D: Legal & Regulatory Issues

AHRQ Publication No. 06-0029
Current as of February 2006

Internet Citation:

Reopening Shuttered Hospitals to Expand Surge Capacity. AHRQ Publication No. 06-0029, February 2006. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/shuttered/shuthosp.htm