Adapting when faced with a beyond-surge capacity incident is essential for effective disaster response. Studies of sudden-onset, no-notice disaster show that emergency departments and hospitals engage in a massive ad hoc effort to generate adequate resources. They have to mobilize and reconfigure response capacity despite overload, uncertainty, and time pressure. The hospital’s ability to adapt effectively is based on anticipation in the face of uncertainty and on new forms coordination across roles and units to keep pace with the dynamic demands produced by the incident.
The anticipatory ability of individuals or an organization looks ahead to read the signs that its adaptive capacity, as it currently is configured and performs, is becoming inadequate to meet the demands it will or could encounter in the future. This produces interventions involving multiple parts of the care system to resolve resource limitations in real time.
Covid-19 moves across the world as a series of rolling outbreaks. This means different parts of the world do have time to replan ahead of whatever patient surge they will experience. I’ll cover how hospital systems are adapting ahead to generate and mobilize the response capabilities to keep pace with increasing stresses produced by the pandemic.
Among many studies of emergency medicine in mass casualty events see Sheuwen Chuang’s papers.
- Coping With a Mass Casualty: Insights into a Hospital’s Emergency Response and Adaptations After the Formosa Fun Coast Dust Explosion
- Beyond surge: Coping with mass burn casualty in the closest hospital to the Formosa Fun Coast Dust Explosion
For an example of how the different levels of an organization adapt to handle the risks from a large scale extreme weather event see Dave Deary’s work.
These results follow the general stress-strain relationship from 2006/2008 (which provides a new way to represent adaptive landscapes). See: