Advisory 1 - Changes in Available Bed Status Reporting and Hospital
Capacity (Diversion) Website
Chief Executive Officers
EMS Regional Directors
Nancy Ridley, Associate Commissioner, MDPH
Paul Dreyer, Associate Commissioner, MDPH
Dr. Lisa Stone, Acting Director, Office of Emergency Preparedness,
Karen S. Nelson, MPA, RN, Senior V.P. of Clinical Affairs, MHA
March 15, 2007 - HAvBED bed category definitions will be used for
Level 1 bed counts.
April 6, 2007 - 1st statewide drill of the HAvBED bed categories.
April 16, 2007 - use of the MDPH system during the Boston
May 4, 2007 - 1st of a regular monthly bed count drills.
To inform hospitals, Regional EMS Directors and C-MEDs of the changes
in bed categories and enhancements to the Hospital Capacity Website -
Following the events of September 11, 2001 and Hurricane Katrina, the
federal government has emphasized the importance of hospitals and health
care partners preparing for and responding to public health emergencies.
Hospitals, particularly emergency departments, provide a critical role
in the provision of care during a catastrophic disaster. Emergency
department diversion, bed, mass decontamination, operating room and
ventilator status are some of the essential components of emergency
preparedness that the federal government has instructed MDPH to
coordinate with hospitals and emergency medical services.
The federal government, through advisory group advice and consensus,
has issued basic bed categories and accompanying definitions that each
state's bed tracking system must collect and eventually report into a
national system, HAvBED. The minimum set of collectable categories and
definitions appear at the end of this memo.
MDPH completed programming to comply with these federal requirements.
Simultaneously, MDPH developed new features that local officials
identified as necessary to facilitate the management of an emergency,
particularly medical surge. These additional features include:
The capacity to add/modify/change countable categories, such as bed
availability, on the fly;
The ability of hospitals to report surge bed availability for
specific timeframes. MDPH can collect surge bed data on a regional or
statewide level. The surge area of the website addresses the hospital,
regional and statewide ability to handle the influx of casualties during
mass-casualty incidents or disease outbreak. MDPH based this feature on
Boston's Surge Bed Matrix;
EMS Regional Administrators and their C-MEDs capability to define
and request their own bed types, equipment and supplies, in addition to
the HAvBED categories and any MDPH pre-defined types;
C-MEDs ability to update diversion, bed and equipment status for
all hospitals in their region should hospitals be in a situation where
they experience difficulties accessing or entering data in the online
The ability of the State Emergency Operations Center (SEOC) and
City of Boston's WebEOC to link to the MDPH system. If a hospital logs
on to the Boston WebEOC system to enter bed data, that data will
automatically populate the MDPH Hospital Capacity Website data fields
Hospitals can enter the number of pre-identified medical supplies
and equipment when asked by MDPH or their regional C-MED. In turn, the
hospitals can also report their need for supplies.
Starting April 6, 2007, MDPH will add a statewide bed count drill to
its monthly schedule of hospital emergency preparedness communications
drills (satellite phone, HHAN Hospital Emergency Notification role).
MDPH will push a message via the HHAN and listserv that it is requesting
a bed count. Various aspects of the updated site will be tested each
month. This regular drill schedule will allow MDPH to troubleshoot any
issues with the system and will keep hospital and C-MED users proficient
in responding to a request and entering data.
MDPH and BEMA partners have set April 16, 2007, the Boston Marathon,
as a goal date for the Region IV hospitals to exercise the enhancements
to the MDPH Hospital Capacity Website.
Please enable pop-up screens for full functionality of this
Dana Ohannessian at firstname.lastname@example.org or 617-624-5015 to
establish/confirm website user IDs and passwords. Regional C-MEDs will
maintain a list of hospital user IDs and passwords.
HAvBED Hospital Bed and Other Category Definitions
Requirements - the State's bed tracking systems must possess
the following capabilities:
Be able to report aggregate State level data to the HHS Secretary's
Operation Center (SOC) no more often than twice daily when requested.
The frequency of data required from the hospitals is dependent on the
incident. The time necessary for data entry must be minimized so that it
does not interfere with the other work responsibilities of the hospital
staff during an MCI. Daily and weekly fluctuations in bed capacity.
Ideally, all institutions would enter data at the same time on similar
days in order to reduce variability due to these fluctuations.
Possess the following Hospital Identification Information:
Name of Chief Administrator
Local Telephone Number
Staffed Vacant / Available Bed
Intensive Care Unit (ICU)
Medical and Surgical
Emergency Department (ED)
Negative Pressure Isolation
Emergency Department Divert
Physically Available Beds: Beds that are licensed
physically set up, and available for use. These are beds regularly
maintained in the hospital for the use of patients, which furnish
accommodations with supporting services (such as food, laundry, and
housekeeping). These beds may or may not be staffed but are physically
Staffed Beds: Beds that are licensed and physically
available for which staff members are available to attend to the patient
who occupies the bed. Staffed beds include those that are occupied and
those that are vacant.
Vacant/Available Beds: Beds that are vacant and to
which patients can be transported immediately. These must include
supporting space, equipment, medical material, ancillary and support
services, and staff to operate under normal circumstances. These beds
are licensed, physically available, and have staff on hand to attend to
the patient who occupies the bed.
Adult Intensive Care (ICU): Can support critically
ill/injured patients, including ventilator support.
Medical/Surgical: Also thought of as "Ward"
Burn or Burn ICU: Either approved by the American
Burn Association or self designated. (These beds should not be included
in other ICU bed counts)
Pediatric ICU: The same as adult ICU, but for
patients 17 years and younger.
Pediatrics: Ward medical/surgical beds for patients
17 and younger.
Psychiatric: Ward beds on a closed/locked
psychiatric unit or ward beds where a patient will be attended by a
Negative Pressure/Isolation: Beds provided with
negative airflow, providing respiratory isolation. Note: This value may
represent available beds included in the counts of other types.
Operating Rooms: An operating room that is equipped
and staffed and could be made available for patient care in a short
Surge Bed Level Definitions
Level 1 Surge Bed: Routinely available. The total
number of staffed and equipped beds available on a routine basis.
Level 2 Surge Bed: Readily available (within 12 - 24
hours) if an event exceeds the Level 1 capacity. The total number of
staffed and equipped beds that could be made available by discharging or
transferring patients, canceling elective procedures, using endoscopy
and other similar beds.
Level 3 Surge Bed: Unstaffed beds that could be made
available in 72 hours.
Level 4 Surge Bed: The number of vacant beds
(staffed, unoccupied) for each bed type that could be added within your
hospital using non traditional patient care areas where there are no
headwalls or gasses such as lobbies, cafeterias, waiting rooms,
conference rooms when regional, state or federal materials and personnel
resources are made available through DMAT, MMRS, SNS, etc. NOTE: These
values are NOT included in column totals. Further information on the
HAVeBED system can be found at www.ahrq.gov/research/havbed/
Use of these standardized definitions and estimates of future bed
availability will provide greater consistency among hospitals in
reporting bed availability information.