State of Disaster Science: A Review on Management of Large-Scale Patient Surge.

The National Disaster Medical System (NDMS) is a US federally coordinated healthcare system that aims to strengthen its capacity for surge management. We conducted a literature review to aid in the development of a research landscape analysis and strategy for the ongoing NDMS Pilot Program. The review was performed to identify surge management literature published from 2001 to spring 2023. Articles were screened using eligibility criteria and selected for analysis based on a consensus process. The search yielded 504 unique articles after deduplications. After abstract screening, 100 articles were screened for relevance. The final sample included 28 articles that were analyzed using themes relevant to the NDMS Pilot Program. This article discusses lessons learned and recommendations for program leadership to optimize outcomes during a surge event. NDMS should consider methods for improving situational awareness during surge events and should include stakeholders in planning and evaluation of the NDMS Pilot Program. Priority recommendations include strengthening operational coordination and leadership, enhancing information-sharing capabilities, and addressing funding and resource allocation. Findings from this review highlight current practices in surge management as well as gaps in current operational research areas. Addressing these gaps has the potential to strengthen the capacity of the NDMS Pilot Program and health system disaster preparedness more broadly across the United States.