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Hospital Surge Capacity Plan

Team Comments Providers Target 7am Rounding Census Before Calling Census Backup Surge Capacity Plan
Orange Red Purple Black

Riven Teams

Team Comments Providers Target 7am Rounding Census Before Calling Census Backup Orange Red Purple Black
Riven
Riven 1 Traditional; 12hr shift; Attending paired with APP; combined census target of 18 Attending 18 18 18 18 19 20
Riven 1 APP APP
Riven 2 Traditional; 12hr shift; Attending paired with APP; combined census target of 18 Attending 18 18 18 18 19 20
Riven 2 APP APP
Riven 3 Traditional; 10hr shift Attending 12 12 12 12 12 13
Riven 4 PaCT; 10hr shift Attending 12 12 12 13 13 14
Riven 5 PaCT; 10hr shift; may have a med student Attending 12 12 12 13 13 14
Riven 6 PaCT; 10hr shift; may have a resident; combined R6 + R6 Resident census target of 12 Attending 12 12 12 13 13 14
Riven 6 Resident Resident
Riven 7 Geriatrics PaCT; 10hr shift; age >75 years preferred Attending and APP 17 17 17 18 18 18
Riven 8 PaCT; 10hr shift Attending 12 12 12 12 13 14
Riven 9 PaCT; 10hr shift Attending 12 12 12 12 13 14
Riven 10 PaCT; 10hr shift Attending 12 12 12 12 13 14
PaCT Staging Team 1 ED boarders in queue for PaCT units Attending 9 9 9 10 10 11
PaCT Staging Team 2 ED boarders in queue for PaCT units Attending 9 9 9 10 10 11

Riven Observation

Team Comments Providers Target 7am Rounding Census Before Calling Census Backup Orange Red Purple Black
Riven Observation
OBS A Traditional; 10hr shift APP 10 10 10 10 10 11
OBS B Traditional; 10hr shift APP 10 10 10 10 10 11
OBS MD Traditional; 10hr shift; new Obs admissions Attending 0 0 0 0 0 0

VICP

Team Comments Providers Target 7am Rounding Census Before Calling Census Backup Orange Red Purple Black
VICP
VICP A PaCT; 12hr shift; VICP panel Attending 10 12 12 12 12 13
VICP B PaCT; 12hr shift; VICP panel; clinic M-F APP 6 6 6 6 6 7

Morgan Aux

Team Comments Providers Target 7am Rounding Census Before Calling Census Backup Orange Red Purple Black
Morgan Aux
Morgan 3 Aux Side service of Morgan 3 attg Attending 0 0 0 0 3 3
Morgan 4 Aux Side service of Morgan 4 attg Attending 0 0 0 0 3 3
Morgan 5 Aux Side service of Morgan 5 attg Attending 0 0 0 0 3 3
Morgan 6 Aux Side service of Morgan 6 attg (also procedure backup) Attending 0 0 0 0 0 3

Backup Teams

Team Comments Providers Target 7am Rounding Census Before Calling Census Backup Orange Red Purple Black
Census Backup Backup attending for overflow mgmt Attending 0 0 10 12 12 12
Jeopardy Backup Backup attending for emergency coverage Attending 0 0 0 0 0 10

Total Capacity

Metric Target Before Backup Orange Red Purple Black
TOTAL Capacity 191 193 203 211
Thresholds when there is no census backup (skip orange and subtract 12 from red/purple/black) 191 193 193 199

NOTES:

Goal: All teams should be maintained at target census until at least Red level of surge, with the exception of VICP (which should be at 18 or higher before triggering surge plan).

VICP Operations: VICP has 16 PaCT beds in the RW but may take up to 2 VICP panel patients outside of RW and perform VICP admissions/consults.

Important: DO NOT PLACE PATIENTS ON CENSUS BACKUP UNTIL ALL PRIMARY TEAMS ARE AT TARGET CENSUS. Before implementing any phases of the surge plan, ensure that all teams are at their target census (even if that means that localized teams temporarily have non-localized patients, e.g. if beds on a localized unit are temporarily closed).

Notifications: MAC, TMO administrator on call, and Pharmacy should be notified when overflow services (Census Backup, Morgan aux, Jeopardy Backup) are activated.

No Census Backup: When there is no Census Backup on the schedule, skip Orange level and go straight to Red.

Surge Level Protocols:

Yellow: Once all teams are at target rounding capacity (regardless of localization): Flex up VICP to 18 patients.

Orange: Once thresholds are met (total HM census >193 patients), activate Census Backup with census of up to 10 patients. Double check that all teams are at target census first.

Red: Flex up in order: 1. Riven Census Backup to 12 (after day 1, if day 1 stay at 10 and move to next step) 2. R4-R6 to 13 regardless of location (ideally place in flex beds on 5RW) 3. R7 to 18 regardless of location (ideally place in flex beds on 5RW) 4. PaCT Staging to 10 each

Purple: Flex up in order: 1. Riven 1 and Riven 2 to 19 patients each 2. Morgan Aux 3/4/5 to 3 patients each (9 total) 3. Fill R8-10 to 13 regardless of location

Black: Flex up in order: 1. R1 and R2 to 20 2. R3 to 13 3. R4-6 to 14 regardless of location 4. Obs A and B to 11 5. VICP to 20 6. Staging 1 and 2 to 11 7. R8-10 to 14 regardless of location 8. Morgan Aux 6 to 3 9. Jeopardy Back-up to 10

Additional Surge Options: Additional potential surge mechanisms, including utilizing Page Campbell HM, adjusting the responsibilities of other on-campus providers, or employing other DOM resources, can be considered under the direction of the AOD.