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

Research output: Contribution to journalReview articlepeer-review


During severe influenza pandemics, healthcare demand often exceeds clinical capacity for routine care. This systematic study examined secondary and tertiary hospital surge capacity interventions and outcomes during the H1N1 pandemic. We searched seven databases for original research on hospital, acute, secondary, and tertiary patient safety outcomes during the 2009–2020 influenza pandemic. A descriptive narrative synthesis assessed influenza-related data. We used the JBI Critical Appraisal Checklist for Cross-Sectional Studies to evaluate each study's methodology. The study found hospitals use various methods to manage their workforce during an influenza pandemic. All hospitals' surge capacity plans modified staff, resources, structure, and system which contributed to improve patient safety, patient and family satisfaction, fewer adverse events, shorter wait times, and better patient flow. Surge capacity strategies improved patient safety by influencing variables such as adverse events, patient and family satisfaction, wait times, and the number of patients who left without being seen. The findings highlight the significance of incorporating surge capacity strategies into healthcare pandemic planning. However, more research in a variety of settings and countries is required to strengthen the evidence base.

Original languageEnglish
JournalInternational Journal of Healthcare Management
Publication statusAccepted/In press - 2024


  • 118
  • Flu pandemic
  • hospital surge capacity
  • patient safety
  • quality of care
  • surge capability


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