PA DOH Health and Medical Services Surge Capacity Planning - Phases I and II

The Challenge
In June 2008 and again in February 2009, the Pennsylvania Department of Health (PA DOH) engaged Delta to develop a series of statewide, jurisdiction-based guidance documents addressing the topic of Health and Medical Services Surge Capacity. The aim was to assist local communities across the Commonwealth in developing a consistent approach to surge capacity planning and preparedness. Additionally, PA DOH had a need to conduct outreach to key stakeholders, build strategic partnerships, and form coalitions to help in advancing this critical initiative

The Solution
Delta’s first step was to form a joint, multidisciplinary, and interagency planning committee to provide guidance, direction, and expertise to the process. This committee was formed with members from within PA DOH, the Pennsylvania Emergency Management Agency, local Emergency Management Agencies, and hospital and healthcare representatives from urban and rural, resource-rich and resource-challenged areas of the Commonwealth. Delta’s next step was to map a strategic, time-phased approach to tackling the myriad of issues associated with surge capacity planning. Delta designed a jurisdiction-based model for addressing surge capacity, based on nationally recognized best practices that may be adapted and applied in any community regardless of size, geography, population, or resource availability. The resulting product is the Pennsylvania Modular Emergency Medical System (PA-MEMS). This system describes an alternate strategy for addressing increased health and medical care demands with scarce resources. Based upon maximizing the use of existing healthcare infrastructure in a given jurisdiction and an expandable patient care system, this model provides a layered and multifaceted approach to managing catastrophic health and medical events that require a surge response. The nine guidance documents include:

• Volume I: A Systems Approach – A comprehensive overview

• Volume II: Management System – The seamless integration of multiple levels of medical direction, control, communications, and coordination

• Volume III: Alternate Care Sites – The use of triage, patient care, and morgue sites to maximize load sharing and reduce surg e pressures

• Volume IV: Modified Delivery of Healthcare with Scarce Resources – Providing the best possible medical care to the largest number possible

• Volume V: Transportation System – Building depth and redundancy for Emergency Medical Services (EMS), mortuary affairs, and vendor managed materiel movement throughout the system and among MEMS patient care facilities

• Volume VI: Resource Management – Interim measures to ensure protracted and sustained operations of healthcare organizations and alternate care sites

• Volume VII: Mass Fatality Management System – Leveraging jurisdictional mortuary affairs assets for the dignified and environmentally safe handling and disposition of decedent and remains

• Volume VIII: Community Outreach and Public Education – Coordinating a mutually supportive public information network and campaign to achieve desired results

• Volume IX: Managing Behavioral Health Needs – Providing comfort and psychological care to responders, casualties, and families

Upon completion, each document was presented to a review panel for validation and approval. Comments, and varying viewpoints and perspectives from subject matter experts were incorporated and documents were finalized.

The Result
The nine volumes in the Medical Surge Management Series provides a large audience of stakeholders with a framework through which to begin planning at the local level in a manner that is consistent with the strategic direction of PA DOH. It establishes common terminology, concepts, and an easily adaptable, jurisdiction-based model while maintaining a level of statewide standardization. In short, it provides the foundation on which local-level surge planning may be based. This foundation provides guidance to emergency management and public safety officials, health and medical practitioners, volunteer organizations active in disasters, and other agencies and stakeholders in the process.