A process known as reverse triage may hold the key to ensuring a hospital has enough bed capacity to handle a surge of patients after a disaster situation, according to a study published today in the American Medical Associations journal Disaster Medicine and Public Health Preparedness.
Researchers at the Johns Hopkins University School of Medicine Department of Emergency Medicine and two other institutions performed a randomized 19-week study of patients at three representative facilitieswhich included an academic, teaching-affiliated and community hospitalto see if patients who did not require a previously defined critical intervention within four days were suitable for early discharge.
They found that of 3,491 patients, 44% could be released if their beds were needed in an emergency. (Intensive care, pediatric and nursery units were excluded from the study.) For the three institutions, after factoring the likely continuance of nondisaster victim emergency admissions, surge capacity was estimated at 66%, 71% and 81%, respectively, with beds made available by reverse triage accounting for 50%, 55% and 59%, respectively, of the available surge capacity. The other available beds came from routine discharges and full use of staff and unstaffed licensed beds.
The researchers concluded that Hospital surge capacity for standard inpatient beds may be greater than previously believed.