The primary objective of this task order was to review, revise, and enhance the alternate care site selection tool that was developed under AHRQ Contract No. 290-00-0014 Task Order No. 5, titled "The Rocky Mountain Regional Model for Bioterrorist Events".1 During a mass casualty surge event, current hospital capacity will not meet immediate resource demand. This facility selection tool has important implications for health, disaster response, and public health emergency planners in that it allows a straightforward approach to pre-selecting potential ACFs. This facility selection tool provides a quantitative, customized, and simple methodology for identifying the "best" facility based on a relative ranking process. The refinement of this tool is of particular interest based on lessons learned during hurricanes Katrina and Rita at the Louisiana Superdome, the New Orleans Convention Center, and other locations, including Federal Medical Stations and other mobile assets. This enhanced tool will be of use to States and local communities as they work to identify potential mass care sites.
An additional objective was the development of a template for an operations manual for an ACF. This template is intended to be used as a starting point in the development of a concept of operations manual for a specific iteration of any ACF.
We have also attempted to develop some general guidelines on staffing requirements for an ACF. Creating the optimum plan for staffing is challenging because a one-size-fits-all recommendation for ACF staffing is not possible. The potential scenarios requiring the use of an ACF can vary dramatically; consequently, the function that a given ACF will perform and the physical form that it takes will vary greatly, which will have a significant impact on the staffing needs for the ACF under consideration.
In certain situations, a community may choose to use an ACF to decompress one or more nearby hospitals. In this case, less ill patients who are not yet ready for discharge to home may be selected for transfer to an ACF, providing additional surge capacity for that hospital. To assist in the patient selection process, an initial algorithm ("Patient Selection Tool") has been developed to assist health care providers in deciding which patients may be appropriate for either early discharge or transfer to an ACF for continuation of their care.
Equipping and supplying an ACF is an additional major challenge, especially since the scope of care provided may vary widely from ACF to ACF. It is therefore not possible to provide a definitive list of equipment and supplies. Instead, based on expert advice and the experiences of those who have operated alternate care facilities, lists of supplies and equipment were developed that may serve as a starting point.
Section Reference
1. Rocky Mountain Regional Care Model for Bioterrorist Events: Locate Alternate Care Sites During an Emergency. December 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/altsites.htm.
