ACEP ED Staging Data Elements
Data Element | Description | Value range | Source | Evidence |
Stage^ | Numeric value assigned based on criteria for and values in related data elements | 0-6 | Derived from other data elements |
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Stage Name | Term that aligns with numeric stage value | baseline, initial phase, stressed, saturated, extreme, disaster, recovery | Determined by ACEP and assigned to stage |
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ED Capacity | Relative range of occupancy for given ED capacity | open, full (>35% Inpatient), saturated (>65% inpatient), saturated (100% inpatient), improving | Data that is reported to public health departments or through hospital reporting system | -ED throughput data (queueing theory) -See if there is an 85% capacity rule in the evidence -See also hospital overcrowding |
Inpatient Capacity | Relative range of occupancy for given Inpatient capacity | open, full, >100% saturated, over saturated, improving | Data that is reported to public health departments or through hospital reporting system | -physical space (typically greater than staff avail) -staffing (need to consider nurse to patient ratio; 6-8 patients per nurse?) |
Staff | Proportion of actual available staff to total available staff | available, minor shortages, shortages, serious shortages, improving | health system or is there some type of public data on this? | -bodies and skill sets (is the alignment right?) -for smaller EDs, smallest ratio between MD and pop is 5 (based on 2080 hours per year which is 52 weeks x 40 hours per week) -nurses per bed and total number of units |
Supplies* | Proportion of actual available supplies to total available supplies | available, minor shortages, shortages, unavailable, improving | supply chain systems and health system | -check on this with supply chain orgs -dispensaries or log files (electronic or paper/manual) -labs are more managed -way to calculate with modeling |
Equipment* | Proportion of actual available equipment to total available equipment | available, minor shortages, shortages, unavailable, improving | supply chain systems and health system | -central supply chain with requisition access
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*Need to be defined on the basis of the situation
^Staging Details are in the table below
Stage | Description | Response | Evidence |
0 | Typical operations with seasonal fluctuations | Normal operation |
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1 | Local cases emerge but handled in normal course of business | Preparation |
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2 | Usual inpatient resources full | Full capacity protocol |
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3 | Use of ancillary spaces for inpatient, e.g. post-op, surgical suites, OP areas | Expanded full capacity protocol; ED mostly cares for sick patients, MASH tents |
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4 | Inpatient overflow into ED >65% impacting ED ops; scarce resources | FEMA response, use of alternative sites (e.g. Guard Armory); utilize military/National Guard personnel |
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5 | System failure, no capacity for additional patients, resources exhausted | Comfort care, may decide to abandon pandemic cases to care for others |
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6 | Drop in new cases, most of population has been infected | Begin to restore resources |
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