Security guards sitting

**The 2018 Coalition Surge Test was held on April 5th. What follows is the overview provided to the coalition prior to the exercise.**


The Northwest Healthcare Response Network (the Network) will conduct a 4-hour, no-notice exercise sometime during the first two weeks of April 2018. The exercise is designed to measure our Coalition’s ability to work collaboratively during a simulated evacuation of 20% of our region’s acute-care hospital bed capacity. For King, Kitsap, and Pierce counties, 20% roughly equates to 1300 acute care patients. There will be no actual movement of patients.

The Coalition Surge Test is a new requirement for healthcare Coalitions that receive funding through the U.S. Department of Health and Human Services. While this requirement specifically applies to the Network, the actions and functions that must be tested will directly drive our Coalition’s capability to respond to a large-scale patient surge. The implications of this exercise will benefit the entire community that comprises our local healthcare Coalition.

Key Details:

  • Healthcare facilities will not know if they will play as evacuating hospitals, receiving facilities, or support facilities prior to the exercise. Evacuating hospitals will be selected by a Coalition Surge Assessment Team (or Assessment Team). Non-healthcare partners (e.g., patient transport agencies, public health, emergency management, etc.) may be notified and asked to participate as exercise play progresses.
  • The Coalition Surge Test is divided into four phases:
    • Notice (60 minutes): Hospitals selected to evacuate will be notified by the Assessment Team they have 60 minutes to activate their hospital command elements before the exercise begins.
    • Phase 1 Part 1 (90 minutes): Evacuating hospitals are instructed to take a current patient census and work (using whatever communication mechanisms they would use during a real evacuation) to find appropriate destination(s) and transportation for each patient.
    • Phase 1 Part 2 (90 minutes): All playing facilities, as well as any partners who would like to observe, will participate in a facilitated discussion via webinar to discuss the actions conducted during Phase 1 Part 1.
    • Phase 2 After Action Review (30-45 minutes): The After Action Review will occur on a separate day after the exercise. This meeting will provide an opportunity for our Coalition to discuss an assessment of strengths, weaknesses, and corrective action planning identified during the Coalition Surge Test. Participants will consist primarily of executives and emergency managers representing those facilities that played in the exercise. Additional information regarding the After Action Review is forthcoming.
  • Exercise play will be limited to our three-county Coalition (King, Pierce, Kitsap).
  • We will conduct this exercise sometime during the first two weeks of April 2018. We cannot disclose the exact date or time of the exercise.
  • The arrangement of patient destinations and transport will be considered complete once evacuating hospitals receive a verbal or written (e-mail) confirmation that receiving hospitals/patient transportation units can take/move patients. There will be absolutely no patient movement during this exercise.

With this exercise, we are seeking to test the following activities:

  • The ability of evacuating hospitals and Coalition partners to rapidly activate hospital command.
  • Whether evacuating hospitals know who to contact upon learning of the need to evacuate, and whether evacuating hospitals can notify partners quickly.
  • Coalition members’ ability to communicate and coordinate quickly to find and match available beds and transportation resources for evacuating patients (involving an activated Disaster Medical Control Center [DMCC]).
  • Hospitals’ ability to perform these tasks without excessive guidance or prompting.


Frequently Asked Questions:

How can I volunteer my organization to participate in the Coalition Surge Test?

Unfortunately, due to the no-notice requirement of this exercise, healthcare organizations cannot volunteer their facility to play as an evacuating hospital or a receiving facility during the exercise, nor can healthcare organizations request to play. Evacuating facilities will be notified by the Coalition Surge Assessment Team that they have been selected to play as an evacuating facility 60 minutes before the exercise begins. Evacuating facilities will then use whatever communication mechanisms they would use during a real evacuation to notify partners of the scenario, as well as coordinating the placement and movement of their patients.


How will I know if my facility is participating in the exercise?

If your facility is selected to be an evacuating hospital, the Coalition Surge Assessment Team will contact your Emergency Manager 60 minutes before the start of the exercise. Once the exercise begins, other healthcare facilities may receive communications from the evacuating hospitals to support patient placement. All other players (e.g., patient transport agencies, public health, emergency management, etc.) will be notified that the exercise has started through the normal communication pathways that would be followed during a real-world scenario. We ask that all receiving facilities and other partners be prepared to handle these communications as you would in a real-world event.

Additionally, once exercise play has started, the Coalition Surge Assessment Team will notify all Coalition partners regarding the details for calling into Phase 1 Part 2 of the exercise.


If selected, can I decline the invitation to play as an evacuating facility?

Hospitals selected as evacuating hospitals may decline the invitation to play as an evacuating facility; however, the decision to opt out has several implications. First, the hospital would miss an opportunity to practice preparing for a hospital evacuation in a low-stress, no-fault environment. Second, a potential evacuating hospital’s decision not to play could jeopardize the Coalition’s ability to meet the 20% acute care patient exercise requirement. This exercise serves as a valuable opportunity to test existing tools, plans, and procedures that would support hospital surge in our region, thus facilities are enthusiastically encouraged to take this chance to practice.


What is the Coalition Surge Assessment Team?

The Coalition Surge Assessment Team, assembled by the Network, consists of representation from healthcare facilities, public health, patient transport agencies, and the Network. This team will be responsible for planning and conducting the design components of the Coalition Surge Test. Furthermore, the Assessment Team will deploy assessors to evacuating facilities during the exercise to observe and assess how players respond to the surge test.