1. Tap the space bar to advance Surge Capacity and ED Crowding: Can we have one without fixing the other? fixing the other? Susan Nedza MD, MBA, FACEP January 10, 2003

2. January 10, 2002Susan Nedza, MD, MBA, FACEP the Unimaginable Imagining the Unimaginable n September 11, 2001: The unasked question. n We are all vulnerable! n The anthrax experience n The key role of the emergency department in each community

3. January 10, 2002Susan Nedza, MD, MBA, FACEP “I’m not worried about small pox, I’m worried about a bad flu season” - ED Director, New York State Recognizing Reality

4. January 10, 2002Susan Nedza, MD, MBA, FACEP “ My Emergency Department already is at ground zero- LA is the Chernobyl of the health care system.” - ED Director Los Angeles Recognizing Reality

5. January 10, 2002Susan Nedza, MD, MBA, FACEP “ I am not sure where I will find room for the next five patients, let alone five hundred.” - ED Director, Atlanta, Georgia Atlanta, Georgia Recognizing Reality

6. January 10, 2002Susan Nedza, MD, MBA, FACEP Defining Surge Capacity n ED capacity –providing safe, quality care –bioterrorism preparedness –meeting local community needs –recognizing link to public health needs –changing medical practice –meeting the EMTALA mandate

7. January 10, 2002Susan Nedza, MD, MBA, FACEP Defining Surge Capacity n Hospital capacity –critical care capacity –nurse and other health professional staffing –capacity for changing medical practice –capacity to meet community needs –strengthening links to public health community

8. January 10, 2002Susan Nedza, MD, MBA, FACEP Defining Surge Capacity n Community capacity –meeting needs of changing demographics –partnering with other institutions –EMS system issues –geographic considerations –communicating with all stakeholders- public and private

9. January 10, 2002Susan Nedza, MD, MBA, FACEP Defining Surge Capacity n Health system capacity –meeting needs of changing demographics- “The pig in the python” –Long term care capacity –Ensuring access to care –Caring for vulnerable populations –Allocating fixed resources

10. January 10, 2002Susan Nedza, MD, MBA, FACEP Linking Surge Capacity to Quality and Safety Imperatives n The leadership imperative n Meeting local community needs n Disaster planning

11. January 10, 2002Susan Nedza, MD, MBA, FACEP Meeting the Challenge n Communications- managing demand n Increasing Efficiency- managing through-put to create capacity n Increasing supply- health policy solutions

12. January 10, 2002Susan Nedza, MD, MBA, FACEP Creating ED Capacity for the Future n The opportunity for planning n The opportunity for collaboration n The opportunity to redefine emergency care

13. January 10, 2002Susan Nedza, MD, MBA, FACEP Conclusions If we are to meet the challenge of community preparedness for bioterrorism events, we must first meet the challenges of defining, creating and managing capacity to meet the present and future needs for emergency care in every community.