Added 2023.04.27         Hospitals.  Mass Casualty Hospital Capacity Expansion Toolkit

Why is this Toolkit Needed? Mass casualty incidents (MCIs) generally occur without warning. A concise, scalable surge response template can be a helpful quick reference to the hospital personnel tasked with expanding care capacity in the first hours of an incident and can minimize ad hoc and potentially conflicting decisions about prioritization of space and strategies. Hospital leadership can complete this toolkit as paper or electronic quick-reference templates for use by the emergency department (ED), nursing supervisors, and other leaders during an incident. This toolkit can help staff take actions specific to capacity expansion tailored to the scope of the incident (e.g., “If I need to accommodate 40 casualties, 20 of whom need ICU care, what are my best options?”)

What is Included in this Toolkit? This optional toolkit includes four sections to guide ED, general inpatient, and critical care space expansion and basic additional staffing needs in the event of patient surge. The toolkit is designed around MCIs and trauma/critical care incidents that require a reactive, rapid response as opposed to those that evolve more slowly (e.g., an infectious disease outbreak) or with warning (e.g., hurricane) that can be addressed proactively over time. The four sections include color-coded templates to reflect conventional (green), contingency (yellow), and crisis (red) operations that can help users prioritize the optimal initial and sequential strategies for a surge of patients based on available resources.1 Each section includes text regarding key additional actions or considerations that should be addressed to ensure appropriate use of the toolkit.

The following are links to useful resources and references for Coalition members and stakeholders, including

  • federal grant guidance
  • accreditation and regulatory agencies
  • laws and regulations
  • subject-matter experts
  • professional associations


Primary Guidance and  Funding Sources
Hospital Preparedness Program (HPP)
Public Health Emergency Preparedness (PHEP)
National Accreditation & Federal Regulatory Agencies
Centers for Medicare and Medicaid Services (CMS)
Environmental Protection Agency (EPA)
Federal Drug Administration (FDA)- Food
Federal Drug Administration (FDA)- Medical Devices
Health Resources & Services Administration (HRSA)
Joint Commission
National Fire Protection Association (NFPA)
National Registry of Emergency Medical Technicians (NR-EMT)
Occupational Health and Safety Administration (OSHA)
Federal Register
RI General Assembly
Regional Subject Matter Experts 
Connecticut Department of Health
Massachusetts Department of Health
Local Subject Matter Experts 
Rhode Island Association of Emergency Managers (RIAEM)
Rhode Island Department of Environmental Management (RI-DEM)
Rhode Island Department of Health (RIDOH)
Rhode Island Emergency Management Agency (RIEMA)
Rhode Island Fire Marshal (OSFM)
Rhode Island Fusion Center
RI Responds/Medical Reserve Corps
National Subject Matter Experts 
American Red Cross (ARC)
Centers for Disease Control & Prevention (CDC)
Federal Emergency Management Agency (FEMA)
National Ebola Training and Education Center (NETEC)
Radiation Injury Treatment Network (RITN)
Technical Resources, Assistance Center, and Information Exchange (TRACIE)
World Health Organization (WHO)
Professional Associations
Advisory Committee on Immunization Practices (ACIP)
American Health Care Association (AHCA)
American Hospital Association (AHA)
American Public Health Association (APHA)
American Society for Health Care Engineering (ASHE)
Association of Healthcare Emergency Preparedness Professionals (AHEPP)
Association for Professionals in Infection Control and Epidemiology (APIC)
Association of State and Territorial Health Officials (ASTHO)
ESRD Network
International Association of Emergency Managers (IAEM)
National Association for Homecare and Hospice (NAHC)
National Association of County and City Health Officials (NACCHO)
National Association of State EMS Officials
National Center for Assisted Living
National Emergency Medical Services Information System (NEMSIS)
Society for Healthcare Epidemiology of America (SHEA)