Use of "shuttered" hospitals to expand surge capacity.
BACKGROUND
With limited available hospital beds in most urban areas, there are very few options when trying to relocate patients already within the hospital to make room for incoming patients from a mass-casualty incident (MCI) or epidemic (a patient surge). This study investigates the possibility and process for utilizing shuttered (closed or former) hospitals to accept medically stable, ambulatory patients transferred from a tertiary medical facility.


METHODS
Two recently closed, acute care hospitals were evaluated critically to determine if they could be made ready to accept inpatients within 3-7 days of a MCI. This surge facility ideally would be able to support 200-300 patients/beds. Two generic scenarios were used for planning: (1) a patient surge (including one caused by conventional war or terrorism, weapons of mass destruction, or a disaster caused by natural hazards) requiring transfer of ambulatory, medically-stable inpatients to another facility in an effort to increase capacity at existing hospitals; and (2) a bio-event or epidemic where a shuttered hospital could be used as an isolation facility.


RESULTS
Both recently closed hospitals had significant, but different challenges to reopening, although with careful planning and resource allocation it would be possible to reopen them within 3-7 days. Planning was the most conclusive recommendation. It does not appear possible to reopen shuttered hospitals with major structural deterioration or a complete lack of current mission (i.e., no current utilities). Staffing would represent the most challenging issue as a surge facility would represent an incremental additional need for existing and scarce human resources.


CONCLUSIONS
With careful planning, a shuttered hospital could be reopened and ready to accept patients within 3-7 days of a MCI or epidemic.
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. rzane@partners.org
Richard D
RD
Zane
Paul
P
Biddinger
Lyndsley
L
Ide
Sally
S
Phillips
Donna
D
Hurd
Louisa
L
Buatti
Hilary
H
Eustace
Matthew
M
Amsden
Darcy
D
Carr
Andrea
A
Hassol
D004189:Disaster Planning; D004636:Emergency Service, Hospital; D006271:Health Facility Closure; D006295:Health Resources / Q000600:supply & distribution*; D006742:Hospital Bed Capacity; D006752:Hospital Planning; D006801:Humans; D054527:Mass Casualty Incidents; D020380:Needs Assessment; D014187:Transportation of Patients