Breakout Session 10: Miscellaneous Topics

Abstract

This final breakout session provided subject matter experts with an opportunity to discuss additional considerations that were not previously covered during the Alternate Care Facilities (ACF) Symposium. Participants reflected on operational experiences not otherwise captured and discussed barriers, mitigation strategies, and future priorities for ACF implementation. Several recurring themes emerged. Despite significant hospital strain, many ACFs experienced underutilization due to institutional reluctance to transfer patients, financial and political considerations, limited stakeholder engagement, and patient mistrust of nontraditional care settings. Participants described successful approaches to improving operations, including staff wellness initiatives, work-rest cycles, community engagement, and communication strategies to improve patient trust. Persistent challenges included patient refusal of transfer, difficulties coordinating care and patient movement across multiple ACFs within a region, loss of institutional knowledge following staff turnover, and leadership fatigue due to limited redundancy among key operational personnel. Participants emphasized the need for regional coordination mechanisms, centralized repositories of operational lessons learned, earlier integration of non-clinical operational leaders, and deliberate communication strategies to increase trust among referring hospitals and communities. These findings suggest that successful ACF implementation depends on institutional trust, regional coordination, workforce sustainability, and preservation of operational knowledge to support future emergency response efforts.