{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:37:43Z","timestamp":1792096663763,"version":"4.4.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:p>\n                    The congressionally authorized National Disaster Medical System Pilot Program was created in December 2019 to strengthen the medical surge capability, capacity, and interoperability of affiliated healthcare facilities in 5 regions across the United States. The COVID-19 pandemic provided an unprecedented opportunity to learn how participating healthcare facilities handled medical surge events during an active public health emergency. We applied a modified version of the Barbisch and Koenig 4-S framework (\n                    <jats:italic toggle=\"yes\">staff, stuff, space, systems<\/jats:italic>\n                    ) to analyze COVID-19 surge management practices implemented by healthcare stakeholders at 5 pilot sites. In total, 32 notable practices were identified to increase surge capacity during the COVID-19 pandemic that have potential applications for other healthcare facilities. We found that\n                    <jats:italic toggle=\"yes\">systems<\/jats:italic>\n                    was the most prevalent domain of surge capacity among the identified practices.\n                    <jats:italic toggle=\"yes\">Systems<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">staff<\/jats:italic>\n                    were discussed across all 5 pilot sites and were the 2 domains co-occurring most often within each surge management practice. These results can inform strategies for scaling up and optimizing medical surge capability, capacity, and interoperability of healthcare facilities nationwide. This study also specifies areas of surge capacity worthy of strategic focus in the pilot's planning and implementation efforts while more broadly informing the US healthcare system's response to future large-scale, medical surge events.\n                  <\/jats:p>","DOI":"10.1089\/hs.2023.0019","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T15:27:10Z","timestamp":1691508430000},"page":"333-340","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["A Multisite Investigation of Areas for Improvement in COVID-19 Surge Capacity Management"],"prefix":"10.1177","volume":"21","author":[{"given":"Emily R.","family":"Post","sequence":"first","affiliation":[{"name":"Emily R. Post, PhD, is a Research Associate, at The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, supporting The National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena","family":"Sethi","sequence":"additional","affiliation":[{"name":"Reena Sethi, DrPH, MHS, is a Senior Public Health Lead Researcher, at The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, supporting The National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeteju A.","family":"Adeniji","sequence":"additional","affiliation":[{"name":"Adeteju A. Adeniji, MPH, is a Research Project Administrator, at The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, supporting The National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clark J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Clark J. Lee, JD, MPH, is a Research Associate, at The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, supporting The National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Shea","sequence":"additional","affiliation":[{"name":"Sophia Shea, MPH, is a Project Manager, Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Metcalf","sequence":"additional","affiliation":[{"name":"Rebecca Metcalf, MPP, is a Senior Manager, Deloitte Consulting LPP, Arlington, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Gaynes","sequence":"additional","affiliation":[{"name":"Jamie Gaynes, MPH, is a Manager, Deloitte Consulting LPP, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kila","family":"Tripp","sequence":"additional","affiliation":[{"name":"Kila Tripp is a Consultant, Deloitte Consulting LPP, Arlington, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Kirsch","sequence":"additional","affiliation":[{"name":"Thomas D. Kirsch, MD, MPH, FACEP, was Director (Retired), at The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, supporting The National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.04.011"},{"key":"e_1_3_3_3_2","unstructured":"Barbera JA Macintyre AG. Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies. 2nd ed. Arlington VA: The CNA Corporation Institute for Public Research; 2007. Accessed May11 2023. https:\/\/www.phe.gov\/preparedness\/planning\/mscc\/handbook\/documents\/mscc080626.pdf"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3912\/OJIN.Vol14No02PPT03"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7046a5"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijdrr.2021.102317"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2020-111426"},{"issue":"5","key":"e_1_3_3_8_2","first-page":"455","article-title":"Designing a National Disaster Medical System","volume":"100","author":"Brandt EN","year":"1985","unstructured":"Brandt EN Jr, , Mayer WN, , Mason JO, , Brown DEJr, , Mahoney LE. Designing a National Disaster Medical System. Public Health Rep. 1985; 100(5):455-461.","journal-title":"Public Health Rep"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003703"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/bsp.2007.0049"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2021.0221"},{"key":"e_1_3_3_12_2","unstructured":"Administration for Strategic Preparedness and Response. Definitive care: National Disaster Medical System. Accessed September20 2021. https:\/\/www.phe.gov\/Preparedness\/responders\/ndms\/definitive-care\/Pages\/default.aspx"},{"key":"e_1_3_3_13_2","unstructured":"National Defense Authorization Act for Fiscal Year 2020 Pub L No. 116-92 133 Stat 1465-1466 \u00a7740 (2019). Accessed April21 2022. https:\/\/www.govinfo.gov\/content\/pkg\/PLAW-116publ92\/pdf\/PLAW-116publ92.pdf"},{"key":"e_1_3_3_14_2","unstructured":"William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021 Pub L No. 116-283 134 Stat 3705-3707 \u00a7741 (2021). Accessed April21 2022. https:\/\/www.govinfo.gov\/content\/pkg\/PLAW-116publ283\/pdf\/PLAW-116publ283.pdf"},{"key":"e_1_3_3_15_2","unstructured":"National Center for Disaster Medicine and Public Health. NDMS Pilot Program partners. Accessed January10 2023. https:\/\/ncdmph.usuhs.edu\/ndms-pilot\/partners"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3539"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2004064117"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2006.06.041"},{"issue":"11","key":"e_1_3_3_19_2","first-page":"1153","article-title":"State of research in high-consequence hospital surge capacity","volume":"13","author":"Schultz CH","year":"2006","unstructured":"Schultz CH, , Koenig KL. State of research in high-consequence hospital surge capacity. Acad Emerg Med. 2006; 13(11):1153-1156.","journal-title":"Acad Emerg Med"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2006.07.016"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/milq.12003"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/DMP.0b013e31819f1ae2"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2691"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2011.02003.x"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2006.08.011"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1089\/bsp.2009.0020"},{"key":"e_1_3_3_27_2","unstructured":"Deloitte Joint Commission Resources (JCR). COVID-19 Lessons Learned: A Resource for Recovery. Oak Brook Terrace IL: JCR; 2020. Accessed July11 2023. https:\/\/www.jcrinc.com\/products-and-services\/covid-19-lessons-learned-a-resource-for-recovery\/"},{"key":"e_1_3_3_28_2","unstructured":"Federal Emergency Management Agency (FEMA). National Incident Management System. 3rd ed. Washington DC: FEMA; 2017. Accessed May31 2023. https:\/\/www.fema.gov\/sites\/default\/files\/2020-07\/fema_nims_doctrine-2017.pdf"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/jti086"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.27.6.1688"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.3912\/OJIN.Vol17No02PPT02"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1446.2010.00877.x"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0734"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2021.116"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2155-8256(21)00114-9"},{"issue":"9","key":"e_1_3_3_36_2","first-page":"4","article-title":"A comparison of consensus, consistency, and measurement approaches to estimating interrater reliability","volume":"9","author":"Stemler SE.","year":"2004","unstructured":"Stemler SE. A comparison of consensus, consistency, and measurement approaches to estimating interrater reliability. Pract Assess, Res Eval. 2004; 9(9):4.","journal-title":"Pract Assess, Res Eval"},{"key":"#cr-split#-e_1_3_3_37_2.1","unstructured":"Gamm LD Castillo G Pittman S. Access to quality health services in rural areas-primary care. In: Gamm LD Hutchison LL Dabney BJ Dorsey AM eds. Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 1. College Station TX: The Texas A&M University System Health Science Center School of Rural Public Health Southwest Rural Health Research Center"},{"key":"#cr-split#-e_1_3_3_37_2.2","unstructured":"2003:45-51. Accessed July11 2023. https:\/\/www.ruralhealthresearch.org\/mirror\/1\/194\/rhp-2010-volume1.pdf"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.928"}],"container-title":["Health Security"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/hs.2023.0019","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2023.0019","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2023.0019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:41:07Z","timestamp":1777452067000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/hs.2023.0019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,26]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10,1]]}},"alternative-id":["10.1089\/hs.2023.0019"],"URL":"https:\/\/doi.org\/10.1089\/hs.2023.0019","relation":{},"ISSN":["2326-5094","2326-5108"],"issn-type":[{"value":"2326-5094","type":"print"},{"value":"2326-5108","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,26]]}}}