Health Care Facility Characterization for Combat Casualty Care Simulation

Introduction: As part of the congressionally mandated NDMS Pilot Project, researchers sought to simulate the capabilities and patient care surge capacities of NDMS-enrolled facilities in the National Capital Region (NCR). This element of the simulation project focuses on accurately characterizing HCF resources, specialty capacities, and surge potential to support simulation-based patient throughput modeling in high-casualty scenarios. Methods: The project team selected 16 acute care facilities enrolled in the NDMS Bethesda-FCC Region for simulation, excluding psychiatric and rehabilitation-only centers. Using NDMS provided data and publicly available sources, the team developed a detailed HCF characterization framework that includes specialty center designations (e.g., trauma and burn centers), bed type capacity, and geospatial data. Unlike traditional models, this characterization also captured specific medical specialties required for combat casualty care, including niche trauma services. To approximate real-world conditions, the simulation used “licensed beds” as a baseline, with an assumed percentage available as surge capacity, representing the portion of beds theoretically available for NDMS cases. Results: The characterization process resulted in a comprehensive HCF dataset that reflects the nuanced capacity of each facility, including relevant specialties and trauma-related capabilities. This structured HCF data supported realistic patient-to-facility assignments in the simulation, accurately modeling the limits and constraints of each HCF’s ability to manage complex trauma and medical cases from large-scale combat operations. Conclusion: This in-depth characterization of HCFs provides a foundational tool for understanding and optimizing surge capacity in high-casualty scenarios. By capturing detailed specialty and surge capacity data, the model offers a more precise framework for assessing regional healthcare readiness. Future work can confirm or revise current HCF capabilities and capacities through direct contact with the specific HCFs.