SURGE CAPACITY OF CURATIVE SECTOR HEALTHCARE INSTITUTIONS FOR THE MANAGEMENT OF DISASTERS FOLLOWING DISEASE EPIDEMIC IN SRI LANKA
Authors: Rajapaksha R. M. Nayani Umesha , Abeysena Chrishantha , Balasuriya Aindralal , Wijesinghe Millawage Supun Dilara , Manilgama Suranga 
Published: September 2023

AbstractBackgroundThe ability to obtain adequate staff, supplies, structures, and systems to provide sufficient care to meet the immediate needs of an influx of patients is defined as surge capacity. The research aimed to describe the surge capacity of curative-healthcare institutions for disaster management at disease endemic district of Sri Lanka.MethodsFrom May to September 2019, a descriptive cross-sectional study was conducted among all curative-healthcare institutions (n=46) with inward-care facilities for patient care in the Kurunegala district, Sri Lanka. The ’Science of Surge Theory’ was used to develop an interviewer-administered tool. The medical administrator of the institution collected the data from a designated employee for disaster management in the institution. For the criteria of overall surge capacity for medical disaster management, the levels have been categorized as basic (26-50%), moderate (51-75%), and high (>75%).ResultsResponse-rate was 93.5% (n=43). The higher proportion of the institutions had (55.8%; n=24), inadequate staff capacity, and lack of equipment. Of the equipped institutions, 13.3% (n=4), 38.7% (n=12), 40.9% (n=9), and 30.2% (n=13) had an adequate number of adjustable beds, infusion pumps, saturation monitors, and oxygen cylinders, respectively. The higher proportion of the institutions had designated emergency treatment units (90.7%; n=39). The least proportion of the institutions had X-ray services (11.6%, n=5), Ultrasound (USS) (9.3%; n=4) and blood bank services (9.3%; n=4). The higher proportion (69.8%; n=30) had inadequate overall surge capacity. The Provincial General Hospitals and 75% (n=3) of the Base-hospitals had moderate-level and higher proportion of the District Hospitals (76.3%; n=29) had basic level overall surge capacity for disaster management.ConclusionThe overall surge capacity was inadequate and there is a need for improvement of surge capacity of the curative-healthcare institutions in the district for disease outbreak management. The capacity development programmes need to be initiated to improve the preparedness.What is already known on this topicSurge capacity refers to a healthcare system’s ability to respond to a sudden increase in patient care demands. Furthermore, surge capacity is a measurable representation of ability to manage a sudden influx of patients following emergencies and it depends on a well-functioning incident management system. The capacity assessments are more important than encouraging stakeholders for management during response. Therefore, capacity assessment and outbreak response planning should be aligned as a measure of outbreak preparedness.What this study addsThe research aimed to describe the surge capacity of curative-healthcare institutions for disaster management following a disease epidemic in a disease-endemic major district of Sri Lanka. The overall surge capacity was inadequate and there is a need for improvement of surge capacity of the curative-healthcare institutions in the district for disease outbreak management. The capacity development programmes need to be initiated to improve the preparedness to face future epidemics/disasters.How this study might affect research, practice or policyThe results of this study have many implications for practice, education, and research. With improving need of the rising population, there is increased risk of disasters including disease outbreaks. During such situations, healthcare institutions need to play a significant role. Assessing the surge capacity is the first step to obtaining baseline data about their capacity to respond to future disasters in their institutions. The findings of this study have determined critical areas of adequacy of staff, disaster planning and preparedness, adequacy of equipment, services, availability of guidelines, capabilities of risk communication to address the needs of healthcare providers in public sector institution for efficient and timely disaster response.