The benefits of designing a stratification system for New York City pediatric intensive care units for use in regional surge capacity planning and management.

Accurate assessment of New York City (NYC) pediatric intensive care unit (PICU) resources and the ability to surge them during a disaster has been recognized as an important citywide emergency preparedness activity. However, while NYC hospitals with PICUs may be expected to surge in a disaster, few of them have detailed surge capacity plans. This will likely make it difficult for them to realize their full surge capacity both on individual and regional levels. If the pediatric resources that each NYC PICU hospital has can be identified prior to a disaster, this information can be used to both determine appropriate surge capacity goals for each PICU hospital and the additional resources needed to reach those goals. City agencies can then focus citywide planning efforts on making these resources available and more easily anticipate what a hospital will need during a disaster. Communication of this hospital information both prior to and during a surge situation will be aided by a stratification system familiar to both city planners and hospitals. The goal of this project was to design a NYC PICU surge stratification system that would aid physicians, hospitals and city agencies in regional surge capacity planning for critical pediatric patients. This goal was demonstrated through two objectives. The first identified major factors to consider when designing a stratification system. The second devised a preliminary system of PICU stratification based on clinical criteria and resources.