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Biosecurity BriefingGAO Releases Results of Study on Medical Surge and Allocating Scarce Resources By Brooke Courtney, July 18, 2008 On July 14, 2008, the U.S. Government Accountability Office (GAO) released a report entitled Emergency Preparedness: States Are Planning for Medical Surge, but Could Benefit from Shared Guidance for Allocating Scarce Medical Resources. The report was issued at the request of Congress to study the nation’s preparedness for mass casualty events.1 Even though many states have reported challenges in planning for medical surge, GAO found that many states have made efforts related to three key components of surge: increasing hospital capacity, identifying alternate care sites, and registering medical volunteers. However, fewer states were found to have made progress with planning for altering standards of care, an additional key component of medical surge preparedness.1 For the study, GAO was tasked with examining: 1) assistance the federal government has provided to help states prepare for medical surge; 2) state efforts to prepare for medical surge; and 3) state concerns related to medical surge. The approach to answering these questions included analyzing federal and state government reports and policies, reviewing emergency preparedness planning documents that focused on medical surge from 20 states [2 states from each of the 10 U.S. Department of Health and Human Services (HHS) geographic regions], and interviewing officials responsible for surge planning from those states. The GAO identified four key components of preparing for medical surge events:
Of the 20 states examined, all were found to be making efforts to expand hospital capacity, such as by developing systems for bed reporting, and most were coordinating with Department of Defense (DOD) and Veterans Affairs hospitals to expand capacity. Eighteen states reported being in the process of selecting alternate care sites, and 15 had started registering volunteers in electronic registries.1 In contrast, only 7 of the 20 states had adopted or were drafting altered standards of medical care for a mass casualty event and only 3 of those 7 states had adopted some altered standards of care guidelines. In addition, state officials “expressed concerns related to all four key components of medical surge.”1 Based on the findings, the GAO recommends that the Secretary of HHS “ensure[s] that the department serves as a clearinghouse for sharing among the states altered standards of care guidelines developed by individual states or medical experts.”1 While HHS and the departments of Homeland Security, Veterans Affairs, and Defense concurred with the study’s findings, HHS did not comment on the altered standards of care recommendations.1 References
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