Hospital surge capacity: The importance of better hospital pre-planning to cope with patient surge during dengue epidemics – A systematic review

Background: Hospitals managers have affected with intensified stress due to insufficient surge capacity as greater numbers of patients attending hospitals during recent dengue epidemics.

Purpose: An evidence-based approach to emergency preparedness should help healthcare administrators enhance the surge capacity of hospitals during dengue epidemics.

Study Design – In this systematic review, we searched PubMed, Google Scholar and Lilacs for articles published from 2000 to 2018 on managing surge at facility level during dengue epidemics.

Findings: Eighteen papers were eligible. All included surge activities in relation to different management functions to increase hospital surge capacity, but the scope of these varied. Countries in which dengue is endemic tend to have strategies for seasonal surges at the hospital level, using operations to temporary expansion of services to cope. In non-endemic countries, surge is more likely to be based on reverse triage as part of public health emergencies such as those arising from climate change or a bioterrorist attack.

Conclusions: Generic response plans enhancing surge to implement at hospital level find that their contents are not specific enough to operationalize adequately. Context specific improved planning of both expansion and reverse triage strategies, including specific approaches for organizational matters should help hospitals cope with patient surge during dengue epidemics.