The same processes used in developing observation units for hospitals are also useful for pandemic management. Initially, hospital leadership must preplan for anticipated volume, anticipate increased surge capacity during the upswing of the disease state, staff the steady state process, and contract during the wind down process as the incidence of the disease decreases. Observation center design for pandemics is similar to standard observation design and is illustrated in three phases: preplanning stage, execution stage, and feedback/ongoing quality assurance phase (ongoing operations).