Medical surge
Patient volumes challenging or exceeding hospital servicing capacity.
A medical surge happens when the number of patients strains or exceeds what a hospital can handle, often—but not always—linked to a crowded emergency room. Such surges can follow a mass casualty event. A 2018 poll by the American College of Emergency Physicians found that 93% of doctors felt their U.S. emergency rooms were not fully ready for a surge, while 6% said they were fully prepared.
Hospital readiness for managing patient volume increases has gained attention due to both natural and man-made disasters. The COVID-19 pandemic is a recent, well-known example that significantly influenced preparedness efforts. However, hospital disaster planning has been documented at least since World War II. Some hospitals, like San Francisco General Hospital, run medical surge drills to train staff.
In February 2019, the American Hospital Association identified medical surge capacity as one of four major challenges threatening rural hospitals' ability to deliver care, alongside the opioid epidemic, community violence, and cyber threats. Surge capacity is defined as the ability to expand care capabilities in response to sudden or prolonged demand. This may extend beyond direct patient care to include tasks like extensive lab work or epidemiological investigations. It involves identifying the numbers of hospital beds, personnel, supplies, and equipment needed—often referred to as the “4 S’s”: Staff, Stuff, Structure, and Systems.
Medical surge capability, according to the U.S. Department of Health & Human Services, requires special interventions to protect medical providers, other patients, and the healthcare organization’s integrity. It also means being able to manage patients needing specialized care, as seen with influxes of SARS patients.
- definition
- Patient volumes that challenge or exceed a hospital's servicing capacity
- common_cause
- Mass casualty incidents or high emergency room volume
- preparedness_poll
- 93% of doctors said US emergency rooms were not fully prepared (ACEP, May 2018)
- key_components
- Staff, Stuff, Structure, Systems (the 4S)
- major_challenge
- One of four major threats to rural hospitals' ability to provide care (AHA, Feb 2019)
- capability_example
- Managing patients requiring specialized care, such as SARS influxes
Lore & Background
Medical surges are often tied to high patient volumes in emergency rooms and can follow mass casualty incidents. In a May 2018 poll by the American College of Emergency Physicians, 93% of doctors reported that their US emergency rooms were not fully prepared for such surges, while only 6% said they were fully prepared. Hospital disaster preparation for surges has been described since at least the Second World War, and some hospitals, such as San Francisco General Hospital, conduct medical surge exercises to train staff.
Reader's Guide
Medical surge capacity is defined as the ability to expand care capabilities in response to sudden or more prolonged demand, extending beyond direct patient care to include tasks like extensive laboratory studies or epidemiological investigations. The American Hospital Association, in a February 2019 report, identified medical surge capacity as one of four major challenges threatening rural hospitals' ability to provide care, alongside the opioid epidemic, community violence, and cyber threats. Key factors in surge capacity are often described as the 4S: Staff, Stuff, Structure, and Systems. Medical surge capability, according to the U.S. Department of Health & Human Services, involves special interventions to protect medical providers, other patients, and the integrity of the healthcare organization, as seen with influxes of patients with SARS. The Covid-19 pandemic has recently highlighted the importance of preparedness work for medical surges.
Did You Know?
- In a May 2018 poll by the American College of Emergency Physicians, 93% of doctors said their US emergency rooms were not fully prepared for medical surges.
- Hospital disaster preparation for medical surges has been described since at least the Second World War.
- San Francisco General Hospital conducts medical surge exercises to train staff.
- The American Hospital Association, in February 2019, listed medical surge capacity as one of four major challenges threatening rural hospitals.
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