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Building Community-Based Surge Capacity through a Public Health and Academic Collaboration: The Role of Community Health Centers

To improve national emergency preparedness, multiple levels of the public health system require strengthening. One major area is surge capacity,1 defined by the Agency for Healthcare Research and Quality (AHRQ) as “a health care system’s ability to rapidly expand beyond normal services to meet the increased demand for qualified personnel, medical care, and public health in the event of bioterrorism or other large-scale public health emergencies or disasters.”2 The aftermath of Hurricane Katrina and increasing concerns about a possible avian flu pandemic have focused more attention on this issue, especially regarding disadvantaged and special needs populations.3 While national agencies such as AHRQ, the Centers for Disease Control and Prevention (CDC), and Health Resources Services Administration (HRSA) have cited surge capacity as a priority “focus area,” current published literature is sparse. A MEDLINE search yielded few relevant resources, and those focus primarily on hospital settings.4,5 Non-hospital settings, such as community health centers (CHCs), also offer potential. In this article, we describe a collaboration among CHCs, government agencies, and academia that initiated the growth of community-based surge capacity in the Boston area. DEFINING THE DIMENSIONS OF SURGE CAPACITY