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“Surge Is Coming – Is Your Region Really Ready?” by Adams


The article under analysis was written by Lavonne. E. Adams in December 2009 for the HIS journal of Homeland security. It is entitled “Surge is coming – is your region really ready?”

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The research question has not been stated as such but it has been implied in the article. It can be summarized as “what are the obstacles to providing adequate care during a large scale disaster or incident?” One can deduce that this is the research question because the author has looked at a typical scenario of a large scale disaster; she has also looked at four major concerns that may inhibit the success of an emergency plan and has even offered possible solutions to dealing with this matter. In the end, the author has managed to identify a problem and then centered her research on it so as to prevent occurrence of this problem in the future. This article has also been able to answer the implied research question properly as those obstacles have been fully identified.

The thesis statement can be found in the first paragraph of the article as follows “Surge capacity is not just one component, so to be effective in responding to large-scale incidents, it is critical to consider each of the four S’s when developing an emergency plan. Failure to do so may severely limit your region’s surge capacity.” (Adams, par 1, 2009) One can see that the thesis statement is clearly related to the article headline because the headline mentions readiness with regard to surge capacity while the thesis statement also talks about this readiness by putting forward four major factors that need to be considered in an emergency plan. The entire article is also based on this thesis statement as can be seen by analysis of all the issues that affect emergency responses and even the conclusion ties in with this.

The author does in deed answer the ‘so what’ question because she has shown why the study was worth doing. She did this in the second paragraph when she looks at a plausible disaster. In this scenario, she highlights some of the issues that can possibly hamper successful interventions during emergencies by stating that staff can fall sick, the general population may be affected by both biological and chemical (toxic) infections and the response groups may be facing a scenario where they cannot fully respond to the concerned victims because they may also be injured. By making the reader think of such a scenario, she shows the relevance of her work because readers would actually want to prevent such an incident from occurring. She shows the severity of poor preparedness and therefore makes one want to find out how to solve it.

This study is unique only to a slight extent. This is largely because the author did not go to a specific region to carry out an actual research on the level of unpreparedness during large scale disasters. The effect of this omission is that the study seems to be more of a review than a new study. Also, because many other authors have studied emergency planning, the latter author may seem like she is merely following suit. On the other hand, because Adams (2009) has dwelt on surge capacity specifically i.e. the four S’s then she has brought in a new dimension to disaster preparedness. She has also offered new insights on why systems tend to fail for example because of staff concerns over their family or fear of infections.

The first main point of this article is that most regions may appear to be ready for large scale disasters but they are not. Secondly, once the four S’s have been examined adequately, then one can be well on their way to mitigating the incidence upon occurrence. The four S’s are staff, stuff, systems and structures. The author believes that staff may themselves fall personally ill in the emergency, emergency departments can be overstretched and toxicity may prove difficult for them. Regions may experience problems in having adequate stuff such as oxygen masks, hospital beds or wheelchairs. There may be structural issues such as lack of alternative care sites or systems may be affected through lack of communication. The author suggests that in order to prevent future problems then regions must ensure that support services for staff have been promptly offered and that they are adequately protected from infections such as through vaccination. Also, facilities should create flexible work schedules in disasters. They need to have alternative sites with enough staff. Administrators need to remain as flexible as possible and should frequently drill staff on their concerns and challenges.

The author has offered a literature review of various issues on her research question. First of all, she has a definition of surge capacity from “Exploring the Concept of Surge Capacity,” so as to bring readers up to speed on what surge capacity is. She has looked at the importance of fluidity in emergency planning from “Strengthening the Nonprofit Community’s Response to the National Capital Region’s Next Disaster,” so as to support her suggests. She has also looked at research on common failures in disaster preparedness from “A Comparison of Nurses’ Needs/Concerns and Hospital Disaster Plans Following Florida’s Hurricane Floyd.” So as to provide real life researches on what medial personnel consider important in such large scale incidences.

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The author has not dealt with the aspect of data collection directly. In fact it is implied in the article. One can see that she has utilized secondary research to come up with her assertions. Therefore, the possibility of replicating her study would be difficult since most of her work was not based on primary research methods. The types of sources that she relied on when writing her article were substantially those ones that would further her thesis statement. It is therefore likely to find other books that prioritize issues other than the four s’s with regard to disaster management. Consequently, one may find it rather difficult to come up with the same conclusions and recommendations that the author made since only selective books have been used.

The author does a good job of identifying some of the major variables that must be considered when assessing whether a certain group is actually ready to deal with a disaster. However, one of the major shortcomings of this piece of work is that the author has not considered other points of view. She has mainly focused on her thesis assertion which centered on the four S’s and has not looked into other ways in which she could have answered her research question. In fact, one can assert that Adams (2009) was trapped by the design of her article i.e. it is too structured. If she had no limited herself to this layout, then perhaps her work would have been richer since it would have provided room for other points of view.

The studies’ findings have supported the author’s thesis substantially. As stated earlier, the author has asserted that a region’s failure to consider all four elements of a surge capacity can cause a substantial malfunction in emergency response. Further on in the research, the author finds this to be true. Several researches have been cited showing how poor communication (systemic failure), personnel mismanagement (staff failure), few emergency shelters (structural failure) and lack of logistics (stuff failure) can lead to poor emergency management. The author also gives plausible assertions on why these might be a problem in the future and how they can be dealt with by provision of reasonable points of view.

Adams (2009) has also addressed the implications of her results because she has asserted that the knowledge of the four S’s can go a long way in boosting a region’s capacity to deal with a disaster. She therefore shows how surge capacity is critical in homeland security. However, these implications have not been covered comprehensively as only a small portion of the article is dedicated towards it. Therefore one can assert that it therefore becomes difficult for various industry stakeholders to see the importance of her work.

A major strength of this article is that the author considers implications of the four S’s for different professions i.e. from administrators to nurses to volunteers and others. This means that her work is not just limited to one type of audience. Aside from that, the use of secondary data has enabled her to gain a deep perspective on disaster preparedness which would have been a problem if she focused on one particular group at a time. The author has also dedicated a substantial portion of her work to possible recommendations on these surge challenges. This makes the piece quite practical and handy to emergency response personnel. However, there have also been other shortcomings visible in the study. First of all, the author has relied on some of her earlier books for definitions and literature review and this makes her seem as though she may be more interested in promoting her earlier works than to remain unbiased and objective. Also, the author should have given more examples on her recommendations at the end of the article. For instance, she should have shown what kind of assumptions administrators make and the communication issues that arise in large scale incidences.


The article under review has contributed towards knowledge on disaster preparedness due to its specific focus on surge capacity. However, the overreliance on secondary data may have compromised reader’s abilities to replicate the study.


Adams, L. (2009). “Surge is coming – is your region really ready?” HIS journal of Homeland security. Web.

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StudyCorgi. (2022, January 11). “Surge Is Coming – Is Your Region Really Ready?” by Adams. Retrieved from


StudyCorgi. (2022, January 11). “Surge Is Coming – Is Your Region Really Ready?” by Adams.

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