Emergency Preparedness: States Are Planning for Medical Surge, but Could Benefit from Shared Guidance for Allocating Scarce Medical Resources

GAO-08-668 Published: Jun 13, 2008. Publicly Released: Jul 14, 2008.
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Potential terrorist attacks and the possibility of naturally occurring disease outbreaks have raised concerns about the "surge capacity" of the nation's health care systems to respond to mass casualty events. GAO identified four key components of preparing for medical surge: (1) increasing hospital capacity, (2) identifying alternate care sites, (3) registering medical volunteers, and (4) planning for altering established standards of care. The Department of Health and Human Services (HHS) is the primary agency for hospital preparedness, including medical surge. GAO was asked to examine (1) what assistance the federal government has provided to help states prepare for medical surge, (2) what states have done to prepare for medical surge, and (3) concerns states have identified related to medical surge. GAO reviewed documents from the 50 states and federal agencies. GAO also interviewed officials from a judgmental sample of 20 states and from federal agencies, as well as emergency preparedness experts.

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Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Health and Human Services To further assist states in determining how they will allocate scarce medical resources in a mass casualty event, the Secretary of HHS should ensure that the department serve as a clearinghouse for sharing among the states altered standards of care guidelines that have been developed by individual states or medical experts.
Closed – Implemented
In response to our recommendation, HHS/Office of the Assistant Secretary for Preparedness and Response (ASPR) has taken steps to develop a Communities of Interest (COI) SharePoint web site (formerly known as a clearinghouse) in order to better share information and manage documents; share promising practices and ideas; and provide a workspace where users from inside and outside HHS/ASPR can share documents and ideas regarding the allocation of scarce resources and crisis standards of care. In June 2012, HHS/ASPR awarded a contract to build the COI SharePoint web site and the agency anticipates having the project finished by the second quarter of FY 2013. In addition, according to agency officials, as of July 2012, ASPR's research librarian had identified over 200 relevant articles to place on the COI SharePoint web site.

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