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Surge Tool Kit and Facility Checklist

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Facility Checklist

Medical/Advanced Patient Care

Layout and potential use of former advanced care areas for potential general surge use. Evaluation for general surge capacity, not for original purposes.

Date: ____________  Location: _______________________  Team member: __________________________

Operating Rooms

 

Observations:  

 

Rooms

Number of floors:  
Number of rooms per floor by type:  
Single:  
Double:  
Ward:  
General layout:  
Applicability of use:  
Existing fixed and removable equipment:  
Y N Does the facility have medical gas outlets?

 

Communications

Nurse call system?  
Other?  
Telemetry system?  
Applicability for use:  

 

Medical/patient care issues:  

 

Licensing/accreditation issues:  

 

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The information on this page is archived and provided for reference purposes only.

 

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