Not Just Hot Air

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A multitude of disaster threats, from hurricanes to pandemics to terrorist attacks, have prompted many hospital leaders to renew their focus on developing plans for handling unexpected capacity surges. After witnessing the backlog of patients experienced by facilities in Louisiana and Texas following Hurricane Katrina, officials at 710-licensed-bed Harris Methodist Fort Worth Hospital and 36-licensed-bed Harris Methodist Northwest Hospital decided they needed to find a new way to accommodate an unexpected flood of patients.

Their collective solution was unique among U.S. hospitals. Late last year, the two Texas Health Resources facilities became the nation’s first hospitals to privately own a non-military inflatable, portable surge capacity unit. Capable of handling 40 additional patients, the unit marks the culmination of several years of exploring capacity surge response, says Barclay E. Berdan, senior executive vice president of Texas Health Resources, one of the largest faith-based, nonprofit healthcare delivery systems in the United States. “Even without an unexpected surge in capacity, the facilities are full a lot of the time, so we looked at our experiences responding to some of the natural disasters, such as Katrina. We decided we had to do something to begin to develop a plan to respond to anything that could cause a surge in capacity,” says Berdan.

After receiving a federal grant of about $442,000 to support hospital bioterrorism initiatives, officials at the two hospitals located in Fort Worth and Azle, TX, decided to purchase the portable surge capacity unit with the help of an additional $235,580 of federal Health Resources and Services Administration grant funds contributed by 13 other Texas Health Resources hospitals.

In a disaster scenario, the 2,700-square-foot facility would be used primarily as supplemental capacity by being inflated adjacent to a full-service hospital, Berdan says. Although it is equipped with 26 medical-surgical beds, 10 triage beds and four intensive care unit beds, the unit would be best used for emergency or triage care until space at the hospital becomes available, he says. When deflated, the unit can be transported to other locations in two mid-size trailers.

“They become quite mobile. When I say trailer, I’m talking the kind that can be towed behind a pickup truck. One of the most appealing aspects of this unit is that it is flexible, and its design is such that we could grow it by attaching it to another unit,” says Berdan, adding that Texas Health Resources’ Arlington Memorial Hospital is in the process of acquiring a unit of its own.

Officials at the hospitals say they plan to eventually apply for additional federal funds to help pay for upkeep of the surge tent and staff training, which primarily consists of inflating the unit and setting up and testing equipment. The unit features self-sustained generators for inflation and electrical capacity for medical equipment, as well as negative-pressure airflow, which provides isolation wards for patients who have infectious or communicable diseases. The unit also includes insulated siding and climate-controlled temperatures.

Most of the costs associated with the unit are “people costs” like education and training, Berdan says. “There will be some maintenance costs along the way, but we are primarily concerned with keeping our staff proficient in its use. The response time for erecting it has already come down, and we have a crew on the clinical side who are trained in variety of conditions from infectious disease to management of patients exposed to radiation. We have to anticipate a range of scenarios to keep patients and staff safe,” says Berdan.

Although the unit is owned and maintained by the Harris Methodist hospitals, Berdan says it would be available to other providers who may need it in an emergency. “We really consider this a community asset. All us of hope that we won’t have to use it, but the entire community can take some comfort knowing it’s here if it is needed.”

—Kathryn Mackenzie




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