Surge capacity concepts for health care facilities: The CO-S-TR model for initial incident assessment

John L. Hick, Kristi L. Koenig, Donna Barbisch, A. Bey Tareg

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Facility-based health care personnel often lack emergency management training and experience, making it a challenge to efficiently assess evolving incidents and rapidly mobilize appropriate resources. We propose the CO-S-TR model, a simple conceptual tool for hospital incident command personnel to prioritize initial incident actions to adequately address key components of surge capacity. There are 3 major categories in the tool, each with 4 subelements. "CO" stands for command, control, communications, and coordination and ensures that an incident management structure is implemented. "S" considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations. "TR" comprises tracking, triage, treatment, and transportation: basic patient care and patient movement functions. This comprehensive yet simple approach is designed to be implemented in the immediate aftermath of an incident, and complements the incident command system by aiding effective incident assessment and surge capacity responses at the health care facility level. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S51-S57).

Original languageEnglish (US)
Pages (from-to)S51-S57
JournalDisaster Medicine and Public Health Preparedness
Issue numberSUPPL.1
StatePublished - Sep 1 2008


  • Emergency management
  • Emergency preparedness
  • Hospital incident command system
  • Hospital preparedness
  • Incident management
  • Surge capacity


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