Researchers to evaluate NDMS bed classification system

Researchers at Virginia Tech University plan to evaluate the reliability of bed classification systems used by the National Disaster Medical Service during national emergencies, according to the university's Carilion School of Medicine.

The NDMS, which is part of the U.S. Department of Defense's Force Health Protection and Readiness division, combines federal and non-federal medical resources to respond to man-made and natural disasters. During such events, the NDMS uses a bed classification system to define the type and number of beds available at institutions on a 12-hour basis.

The research team, led by medical student Erin Straight, seeks to evaluate the reliability of the bed classification systems given the purportedly vague definitions set forth in the classifications.

"As a medical student, this also provides a unique opportunity to coordinate research efforts with emergency management experts, physicians, and nurses to parse out the nuances of hospital evacuation management," Straight said.

The six bed classifications used by the NDMS include psychiatric, burn, pediatric intensive care unit, pediatric medical/surgical, adult intensive care unit and adult medical/surgical. After the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality used the six classifications to develop a national prototype for hospitals to use in emergency and evacuation scenarios, the agency added two more classifications to the list, including operating rooms and negative pressure/isolation.

Straight and her team seek to compile quantitative data evaluating the reliability between professionals in applying the classifications and how reliable the classifications are across hospital systems.

The researchers will evaluate the classifications using a survey of patient case vignettes that healthcare workers will use to apply the four broadest NDMS classifications: pediatric ICU, pediatric medical/surgical, adult ICU and adult medical/surgical. The team will provide the surveys to three institutions in the Virginia Tech area, including Carilion Stonewall Jackson Hospital, Carilion New River Valley Hospital and Roanoke Memorial Hospital. The team will then provide the completed surveys to the statistical team at the university's Laboratory for Interdisciplinary Statistical Analysis to determine the inter-rater reliability of the survey results.

The team expects it will discover statistically significant variation in how NDMS bed classifications are used in patient case vignettes. The findings could be used to improve classification systems, streamline evacuations, improve patient outcomes and decrease hospital and public costs.

According to the U.S. Department of Health and Human Services, hospitals recruited by NDMS Federal Coordinating Centers are encouraged to enter into a voluntary agreement with the NDMS. The hospitals agree to commit a certain number of their acute care beds, subject to availability, for NDMS patients. Hospitals that admit NDMS patients are guaranteed reimbursement at 110 percent of Medicare rates by the federal government.