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Concepts in Disaster Medicine

Surge Capacity Concepts for Health Care Facilities: The CO-S-TR Model for Initial Incident Assessment

John L. Hick, MD, Kristi L. Koenig, MD, Donna Barbisch, DHA, MPH and Tareg A. Bey, MD

Address correspondence to John L. Hick, MD, Emergency Medicine MC 825, Hennepin County Medical Center, 701 Park Ave S, Minneapolis, MN 55415 (e-mail: john.hick{at}hcmed.org).

Facility-based health care personnel often lack emergency management training and experience, making it a challenge to efficiently assess evolving incidents and rapidly mobilize appropriate resources. We propose the CO-S-TR model, a simple conceptual tool for hospital incident command personnel to prioritize initial incident actions to adequately address key components of surge capacity. There are 3 major categories in the tool, each with 4 subelements. "CO" stands for command, control, communications, and coordination and ensures that an incident management structure is implemented. "S" considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations. "TR" comprises tracking, triage, treatment, and transportation: basic patient care and patient movement functions. This comprehensive yet simple approach is designed to be implemented in the immediate aftermath of an incident, and complements the incident command system by aiding effective incident assessment and surge capacity responses at the health care facility level.

Key Words: surge capacity • emergency preparedness • hospital preparedness • emergency management • incident management • hospital incident command system




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J. L. Hick, J. A. Barbera, and G. D. Kelen
Refining Surge Capacity: Conventional, Contingency, and Crisis Capacity
Disaster Med Public Health Preparedness, June 1, 2009; 3(Supplement_1): S59 - S67.
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