Chapter 4. Manpower. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.
Staffing needs during a health emergency
To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on manpower.Methods: Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including manpower.Results: Key recommendations include: (1) plan to access, coordinate and increase labor resources for continued and expanded ICU care including increasing critical care specialists and expanded practice for non-critical care personnel; (2) develop an education, awareness, preparation and communication program to ensure a well-protected and prepared workforce with coordinated rapid manpower expansion; (3) maintain a central inventory of all clinical and non-clinical staff with their current roles along with possible emergency re-training possibilities; (4) coordinate all clinical and non-clinical staffing requirements and determine the hospital's daily needs including a sick and no-show list together with ICU requirements; (5) provide clinical care to patients only with clinical staff and not with non-clinical staff; (6) delegate duties not within the scope of workers' practice under crisis conditions with proper supervision and support from experienced clinicians to ensure patient safety; (7) intensivists should supervise nonintensivist physicians to expand the workforce if patient surge exceeds the number of available ICU-trained specialists.Conclusions: Judicious planning and adoption of protocols for providing adequate manpower are necessary to optimize outcomes during a pandemic.
  • Licensure flexibility
  • Back-fill solutions for staff moving to front-lines
  • Cross-sector staff deployments
  • Task shifting/delegation
  • New roles
  • Cross-sector deployment
  • Expanded roles
  • Medical Imaging Workers
  • Medical Laboratory Technologists
  • Nurse Practitioners*
  • Nurse Specialists*
  • Nurses - Licensed Practical
  • Nurses - Registered
  • Paramedics
  • Pharmacy Workers
  • Physicians - Emergency
  • Physicians - Intensive Care
  • Physicians - Primary/Family
  • Physicians - Specialists
  • Respiratory Therapists
  • Volunteers
  • Other Health Care Workers
Intensive care units and hospitals during a pandemic
  • Emergency Medical Services
  • Hospitals
Plan has not yet been implemented- what COULD help is the adoption of this plan by hospitals
Informal Strategy
Sandrock, C. (2010). Chapter 4. Manpower. Intensive Care Medicine, 36(S1), 32–37.
Christian Sandrock
UC Davis School of Medicine
United States
Published Literature

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