Facility Checklist

Medical/Advanced Patient Care

Layout and potential use of former advanced care areas for potential general surge use. Evaluation for general surge capacity, not for original purposes.

Date: ____________  Location: _______________________  Team member: __________________________

Operating Rooms

 

Observations:

 

Rooms

Number of floors:
Number of rooms per floor by type:
Single:
Double:
Ward:
General layout:
Applicability of use:
Existing fixed and removable equipment:

Y

N

Does the facility have medical gas outlets?

 

Communications

Nurse call system?
Other?
Telemetry system?
Applicability for use:

 

Medical/patient care issues:

 

Licensing/accreditation issues:

 

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