Alternate site surge capacity in times of public health disaster maintains trauma center and emergency department integrity: Hurricane Katrina.
BACKGROUND
Hospital surge capacity has been advocated to accommodate large increases in demand for healthcare; however, existing urban trauma centers and emergency departments (TC/EDs) face barriers to providing timely care even at baseline patient volumes. The purpose of this study is to describe how alternate-site medical surge capacity absorbed large patient volumes while minimizing impact on routine TC/ED operations immediately after Hurricane Katrina.


METHODS
From September 1 to 16, 2005, an alternate site for medical care was established. Using an off-site space, the Dallas Convention Center Medical Unit (DCCMU) was established to meet the increased demand for care. Data were collected and compared with TC/ED patient volumes to assess impact on existing facilities.


RESULTS
During the study period, 23,231 persons displaced by Hurricane Katrina were registered to receive evacuee services in the City of Dallas, Texas. From those displaced, 10,367 visits for emergent or urgent healthcare were seen at the DCCMU. The mean number of daily visits (mean +/- SD) to the DCCMU was 619 +/- 301 visits with a peak on day 3 (n = 1,125). No patients died, 3.2% (n = 257) were observed in the DCCMU, and only 2.9% (n = 236) required transport to a TC/ED. During the same period, the mean number of TC/ED visits at the region's primary provider of indigent care (Hospital 1) was 346 +/- 36 visits. Using historical data from Hospital 1 during the same period of time (341 +/- 41), there was no significant difference in the mean number of TC/ED visits from the previous year (p = 0.26).


CONCLUSIONS
Alternate-site medical surge capacity provides for safe and effective delivery of care to a large influx of patients seeking urgent and emergent care. This protects the integrity of existing public hospital TC/ED infrastructure and ongoing operations.
Eastman
Alexander L
AL
Section of EMS, Disaster Management and Homeland Security and Division of Burns, Trauma and Critical Care, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-8890, USA. alexander.eastman@utsouthwestern.edu
Rinnert
Kathy J
KJ
Nemeth
Ira R
IR
Fowler
Raymond L
RL
Minei
Joseph P
JP
D004189:Disaster Planning; D004190:Disasters; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008145:Louisiana; D008297:Male; D008489:Medical Indigency / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D011336:Probability; D018635:Rescue Work / Q000706:statistics & numerical data; D013781:Texas; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014481:United States