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<td height="30px"><span class="title"><a name="h1" id="h1"></a> Reopening Shuttered Hospitals to Expand Surge Capacity</span></td>
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<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
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<h3>Table 8. Estimated Staffing Levels for Surge Facility Scenarios</h3>
<table width="100%" cellspacing="0" cellpadding="2" border="1">
<tr>
<th scope="col">Staff Type</th>
<th scope="col">Staff</th>
<th scope="col">Scenario 1: Medical/ Surgical</th>
<th scope="col">Scenario 2: Infectious Disease</th>
<th scope="col">Discussion</th>
</tr>
<tr valign="top">
<td scope="row" rowspan="5"><strong>Physician and Physician Extenders</strong></td>
<td>Chief Medical Officer</td>
<td>1</td>
<td>1</td>
<td>One person responsible for medical care 24 hours per day/ 7 days per week. Physically onsite 8 hours/ day, M-F, available off-shift and weekends.</td>
</tr>
<tr valign="top">
<td scope="row">Internist</td>
<td>3-7 FTEs/ 7 AM-7 PM<br />
1 FTE/ 7 PM-7 AM</td>
<td>3-7 FTEs/ 7 AM-7 PM<br />
1 FTE/ 7 PM-7 AM</td>
<td>Each MD, assuming 10-15 minutes per patient, could see 48-72 patients over 12 hours (7A-7P) plus at least one person for night coverage (7P-7A). </td>
</tr>
<tr valign="top">
<td scope="row">Radiologist</td>
<td>As needed</td>
<td>As needed</td>
<td>Adjust according to patient acuity. May be an increased need with an infectious disease population.</td>
</tr>
<tr valign="top">
<td scope="row">Infectious Disease Specialist</td>
<td>As needed</td>
<td>As needed</td>
<td>Likely only needed for infectious disease population.</td>
</tr>
<tr valign="top">
<td scope="row">Nurse Practitioner/ Physician Asst</td>
<td>As needed to supplement internists or nurses</td>
<td>As needed to supplement internists or nurses</td>
<td>Must work under the supervision of an MD, could supplement internist coverage if adequate number of physicians not available or supplement nursing coverage (supervisor or RN). </td>
</tr>
<tr valign="top">
<td scope="row" rowspan="5"><strong>Nursing</strong></td>
<td>Nursing Director</td>
<td>1 RN </td>
<td>1 RN</td>
<td>One person responsible for nursing care 24 hours per day/ 7 days per week. Physically onsite 8 hours/ day, M-F, available off-shift and weekends. </td>
</tr>
<tr valign="top">
<td scope="row">Supervisor</td>
<td>1 RN per shift</td>
<td>1 RN per shift</td>
<td>Prefer RN supervisor, but if none available, an experienced LPN would suffice.</td>
</tr>
<tr valign="top">
<td scope="row">RN </td>
<td>1:5-1:15<br />
RN to patient ratios</td>
<td>1:5-1:15<br />
RN to patient ratios</td>
<td>Could go as high a 1:40 with adequate LPN, nurse aide and ancillary staff coverage, but highly dependent on patient acuity. Precaution procedures in an infectious disease scenario would require increased staffing levels to accommodate the additional time needed for gowning, disposal of infectious waste, etc. </td>
</tr>
<tr valign="top">
<td scope="row">LPN</td>
<td>1:5-1:15<br />LPN to patient ratios</td>
<td>1:5-1:15<br />LPN to patient ratios</td>
<td>Could go as high as 1:40 on off-shifts with adequate nurse aide and ancillary staff coverage but highly dependent on patient acuity. Precaution procedures in an infectious disease scenario would require increased staffing levels to accommodate the additional time needed for gowning, disposal of infectious waste, etc. </td>
</tr>
<tr valign="top">
<td scope="row">Nurse Aide </td>
<td>1:6 (day shift)<br />
1:8 (eve shift)<br />
1:15 (night shift)<br />
NA to patient ratios</td>
<td>1:6 (day shift)<br />
1:8 (eve shift)<br />
1:15 (night shift)<br />
NA to patient ratios</td>
<td>Adjust nurse aides up or down according to licensed nurse coverage and ancillary staff support. Precaution procedures in an infectious disease scenario would require increased staffing levels to accommodate the additional time needed for gowning, disposal of infectious waste, etc.</td>
</tr>
<tr valign="top">
<td scope="row" rowspan="11"><strong>Allied Health</strong></td>
<td>Dietitian</td>
<td>1 FTE RD </td>
<td>1 FTE RD </td>
<td>Dependent on the level of supervision needed in Dietary Department, number of admissions and discharges, level of patient acuity. </td>
</tr>
<tr valign="top">
<td scope="row">Discharge Planner</td>
<td>2-4 FTEs (M-F normal business hours)<br />
Discharge planners or social workers</td>
<td>2-4 FTEs (M-F normal business hours)<br />
Discharge planners or social workers</td>
<td>Adjust up as needed according to number of admissions and discharges. Assumed one SW per two units (80 beds)</td>
</tr>
<tr valign="top">
<td scope="row">EKG Technician</td>
<td>1 FTE to cover 7 AM-3 PM, M-F</td>
<td>1 FTE to cover 7 AM-3 PM, M-F</td>
<td>If no EKG tech available, EKGs may be done by nurses, NP/PAs, physicians, EMTs. Interpretation done by physician or interpretive software program if available. </td>
</tr>
<tr valign="top">
<td scope="row">Laboratory Technician</td>
<td>2.1 FTEs (7 AM-7 PM, 7 days/week) One person to run basic hematology, chemistry, urinalysis, bacteriology tests.<br />
Assume no blood bank, no type and x-match needed. </td>
<td>2.1 FTEs (7 AM-7 PM, 7 days/week) One person to run basic hematology, chemistry, urinalysis, bacteriology tests. Assume no blood bank, no type and x-match needed.</td>
<td>Adjust up according to the number of specimens to be processed. May not be needed if specimens are sent out. Nursing able to perform certain screens (e.g., dipstick urine, hemoccult) on the unit. </td>
</tr>
<tr valign="top">
<td scope="row">Medical Records</td>
<td>1 FTE </td>
<td>1 FTE</td>
<td>Adjust up according to the number of admissions and discharges.</td>
</tr>
<tr valign="top">
<td scope="row">Mental Health Worker/Social Worker</td>
<td>2-4 FTEs <br />
(M-F, 8 AM-4 PM)</td>
<td>2-4 FTEs<br />
(M-F, 8 AM-4 PM)</td>
<td>Adjust up according to patient, family and staff needs. Assumed one SW per two units (80 beds)</td>
</tr>
<tr valign="top">
<td scope="row">Pharmacist</td>
<td>2.1 FTEs RPh <br />
(7 AM-7 PM, 7 days/week) </td>
<td>2.1 FTEs RPh<br />
(7 AM-7 PM, 7 days/week) </td>
<td>Adjust up according to patient needs. If drugs were supplied from another location, would not be needed.</td>
</tr>
<tr valign="top">
<td scope="row">Pharmacy Technician</td>
<td>1-2 FTEs CPhTs</td>
<td>1-2 FTEs CPhTs</td>
<td>Adjust up according to patient needs. Must be supervised by pharmacist.</td>
</tr>
<tr valign="top">
<td scope="row">Phlebotomist</td>
<td>1 FTE able to perform venipuncture<br />
7 AM-3 PM, M-F</td>
<td>1 FTE able to perform venipuncture<br />
7 AM-3 PM, M-F</td>
<td>If not available, some nurses, NP/PAs, physicians, and EMTs would be able to draw blood.</td>
</tr>
<tr valign="top">
<td scope="row">Respiratory Therapist</td>
<td>1 FTE RT needed primarily to set up, monitor and troubleshot problems with ventilators</td>
<td>1 FTE RT needed primarily to set up, monitor and trouble shoot problems with ventilators</td>
<td>Adjust according to patient needs. Nurses/physicians/NP/PAs and EMTs are able to assess lung sounds, provide chest physical therapy.</td>
</tr>
<tr valign="top">
<td scope="row">X-Ray Technician</td>
<td>1 FTE</td>
<td>1 FTE</td>
<td>May not be needed on a daily basis, but requires specialized skills. It's likely that coverage would not be available from other staff types.</td>
</tr>
<tr valign="top">
<td scope="row" rowspan="16"><strong>All Other Types of Staff</strong></td>
<td>Administrative Support</td>
<td>3-6 FTEs <br />
(8 AM-4 PM, M-F)</td>
<td>3-6 FTEs<br />
(8 AM-4 PM, M-F)</td>
<td>Includes payroll (1 person), billing (1 person) and 1-4 people to assist with unit clerk-level work. </td>
</tr>
<tr valign="top">
<td scope="row">Biomedical Engineering</td>
<td>1 FTE<br />
7 AM-3 PM, M-F and on-call</td>
<td>1 FTE<br />
7 AM-3 PM, M-F and on-call</td>
<td>As needed to deal wit problems associated with medical monitoring equipment.</td>
</tr>
<tr valign="top">
<td scope="row">Central Supply/Materials Mgt</td>
<td>2-4 FTEs<br />
1-2 people covering 7 AM-7 PM, 7 days/week</td>
<td>2-4 FTEs<br />
1-2 people covering 7 AM-7 PM, 7 days/week</td>
<td>To oversee ordering, distribution of supplies. Adjust up as needed based on acuity of patients.</td>
</tr>
<tr valign="top">
<td scope="row">Food Service Supervisor</td>
<td>1 FTE<br />
(M-F, 8 AM-4 PM)</td>
<td>1 FTE<br />
(M-F, 8 AM-4 PM)</td>
<td>To oversee the dietary department, order food and supplies, schedule dietary staff.</td>
</tr>
<tr valign="top">
<td scope="row">Cook</td>
<td>2-4 per meal</td>
<td>2-4 per meal</td>
<td>Food Service Supervisor may also act as cook.</td>
</tr>
<tr valign="top">
<td scope="row">Food Service Workers</td>
<td>4-6 per meal</td>
<td>4-6 per meal</td>
<td>Increased staff needed at peak meal times. </td>
</tr>
<tr valign="top">
<td scope="row">Housekeeping</td>
<td>5-9 people 7 AM-7 PM<br />
1-2 people 7 PM-7 AM</td>
<td>5-9 people 7 AM-7 PM<br />
1-2 people 7 PM-7 AM</td>
<td>Assuming one person per unit (40 beds) plus one person for common areas, trash from 7 AM- 7 PM. One-two people 7 PM-7 AM.</td>
</tr>
<tr valign="top">
<td scope="row">Human Resources</td>
<td>1 FTE<br />
(M-F, 8 AM-4 PM)</td>
<td>1 FTE<br />
(M-F, 8 AM-4 PM)</td>
<td>Assist with staff support/dependent care. May need to recruit dependent care staff/volunteers to cover all shifts as needed.</td>
</tr>
<tr valign="top">
<td scope="row">Laundry</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>Adjust depending on equipment available and acuity of patients. Assuming three complete bed changes per day.</td>
</tr>
<tr valign="top">
<td scope="row">Maintenance</td>
<td>3-4 FTEs<br />
(1-3 people, 8 AM-4 PM, 7 days per week)</td>
<td>3-4 FTEs<br />
(1-3 people, 8 AM-4 PM, 7 days per week)</td>
<td>May assist with housekeeping, safety and security as needed.</td>
</tr>
<tr valign="top">
<td scope="row">Morgue Worker</td>
<td>1 FTE</td>
<td>1 FTE</td>
<td>As needed.</td>
</tr>
<tr valign="top">
<td scope="row">Public Information Specialist</td>
<td>1 FTE</td>
<td>1-2 FTEs</td>
<td>An infectious disease scenario would likely require more communication with media, families, etc.</td>
</tr>
<tr valign="top">
<td scope="row">Safety Manager</td>
<td>1 FTE</td>
<td>1 FTE</td>
<td>May have maintenance responsibilities also.</td>
</tr>
<tr valign="top">
<td scope="row">Security</td>
<td>8-12 FTEs<br />
(1-3 people per shift, 7 days per week, 24 hours per day)</td>
<td>8-12 FTEs<br />
(1-3 people per shift, 7 days per week, 24 hours per day)</td>
<td>Adjust according to scenario, number of entrances, facility location. </td>
</tr>
<tr valign="top">
<td scope="row">Transport</td>
<td>1.5-3 FTEs<br />
(1-2 people covering M-F, 7 AM-7 PM)</td>
<td>1.5-3 FTEs<br />
(1-2 people covering M-F, 7 AM-7 PM)</td>
<td>Adjust according to staff availability. All staff capable of transport.</td>
</tr>
<tr valign="top">
<td scope="row">Volunteers</td>
<td>As available</td>
<td>As available</td>
<td>Assist with transport, delivery of supplies and meals, administrative/clerical functions, dependent care, etc.</td>
</tr>
</table>
<p class="size2">FTE = full-time employee</p>
<p class="size2"><a href="shuthosp4.htm#Tab7">Return to Document</a></p>
<p>&nbsp;</p>
<div class="footnote">
<p> The information on this page is archived and provided for reference purposes only.</p></div>
<p>&nbsp;</p>
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