The impact of hospital surge capacity during the 2009 influenza pandemic on patient safety: A systematic review

Inge Dhamanti, Auliya Abdurrohim Suwantika, Nur Atika, Benny Tjahjono

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During severe influenza pandemics, healthcare demand often exceeds clinical capacity forroutine care. This systematic study examined secondary and tertiary hospital surge capacityinterventions and outcomes during the H1N1 pandemic. We searched seven databases fororiginal research on hospital, acute, secondary, and tertiary patient safety outcomes duringthe 2009–2020 influenza pandemic. A descriptive narrative synthesis assessed influenza-related data. We used the JBI Critical Appraisal Checklist for Cross-Sectional Studies toevaluate each study’s methodology. The study found hospitals use various methods tomanage their workforce during an influenza pandemic. All hospitals’surge capacity plansmodified staff, resources, structure, and system which contributed to improve patient safety,patient and family satisfaction, fewer adverse events, shorter wait times, and better patientflow. Surge capacity strategies improved patient safety by influencing variables such asadverse events, patient and family satisfaction, wait times, and the number of patients wholeft without being seen. Thefindings highlight the significance of incorporating surgecapacity strategies into healthcare pandemic planning. However, more research in a varietyof settings and countries is required to strengthen the evidence base
Original languageEnglish
Pages (from-to)(In-Press)
Number of pages14
JournalInternational Journal of Healthcare Management
Early online date5 Feb 2024
Publication statusE-pub ahead of print - 5 Feb 2024

Bibliographical note

© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis GroupThis is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, orbuilt upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.


This work was supported by Universitas Airlangga, Indonesia


  • Flu pandemic
  • patient safety
  • quality of care
  • surge capability
  • hospital surge capacity


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