The COVID-19 pandemic has highlighted the importance of hospitals’ abilities to evaluate and care for an increased volume of patients exceeding normal operating capacity, known as medical surge.
All eight hospitals in a Government Accountability Office (GAO) review reported multiple challenges related to staff, supplies, space, or information. These are critical components for an effective medical surge response, according to the Department of Health and Human Services (HHS). All eight hospitals reported staffing challenges, such as a lack of staff to care for the increase in sick patients or staff becoming ill and unable to work, affecting hospital services. Hospitals took steps to address these challenges, such as supplementing staffing levels where possible or training staff on proper personal protective equipment used to prevent infection. GAO found that health care coalitions—groups of healthcare and response organizations in a defined geographic location supported by HHS funding—aided hospitals. For example, they helped coordinate patient transfers to balance hospital loads, obtain and distribute needed medical supplies, and communicate hospital needs to their states.
The government watchdog noted that HHS has programs and activities underway intended to support medical surge readiness for hospitals and other health care organizations, but added that it is too soon to know the effectiveness of these efforts. For example, HHS implemented a new medical surge exercise for coalitions in 2021 to test readiness, and plans to establish targets to measure performance. It is also considering how to use the findings and lessons learned from its 2021 assessment of coalitions during the pandemic to improve its support of coalitions and their communities. HHS is also funding the development of a regional disaster health response system, which aims to develop effective approaches to medical surge response across multiple states. This includes improving data sharing on resource and capacity issues, and developing specialized teams that can respond to a range of hazards. HHS is considering its next steps regarding the expansion of this regional system. Further, HHS is developing regional guidelines for hospitals and other facilities related to treating patients and increasing medical surge capacity during public health emergencies as required by statute. Officials did not provide a date for when the guidelines would be made publicly available.