PMID- 37597611 OWN - NLM STAT- MEDLINE DCOM- 20240112 LR - 20240202 IS - 1931-3543 (Electronic) IS - 0012-3692 (Linking) VI - 165 IP - 1 DP - 2024 Jan TI - The Minnesota Medical Operations Coordination Center: A COVID-19 Statewide Response to Ensure Access to Critical Care and Medical-Surgical Beds. PG - 95-109 LID - S0012-3692(23)05277-7 [pii] LID - 10.1016/j.chest.2023.08.016 [doi] AB - BACKGROUND: COVID-19 led to unprecedented inpatient capacity challenges, particularly in ICUs, which spurred development of statewide or regional placement centers for coordinating transfer (load-balancing) of adult patients needing intensive care to hospitals with remaining capacity. RESEARCH QUESTION: Do Medical Operations Coordination Centers (MOCC) augment patient placement during times of severe capacity challenges? STUDY DESIGN AND METHODS: The Minnesota MOCC was established with a focus on transfer of adult ICU and medical-surgical patients; trauma, cardiac, stroke, burn, and extracorporeal membrane oxygenation cases were excluded. The center operated within one health care system's bed management center, using a dedicated 24/7 telephone number. Major health care systems statewide and two tertiary centers in a neighboring state participated, sharing information on system status, challenges, and strategies. Patient volumes and transfer data were tracked; client satisfaction was evaluated through an anonymous survey. RESULTS: From August 1, 2020, through March 31, 2022, a total of 5,307 requests were made, 2,008 beds identified, 1,316 requests canceled, and 1,981 requests were unable to be fulfilled. A total of 1,715 patients had COVID-19 (32.3%), and 2,473 were negative or low risk for COVID-19 (46.6%). COVID-19 status was unknown in 1,119 (21.1%). Overall, 760 were patients on ventilators (49.1% COVID-19 positive). The Minnesota Critical Care Coordination Center placed most patients during the fall 2020 surge with the Minnesota Governor's stay-at-home order during the peak. However, during the fall 2021 surge, only 30% of ICU patients and 39% of medical-surgical patients were placed. Indicators characterizing severe surge include the number of Critical Care Coordination Center requests, decreasing placements, longer placement times, and time series analysis showing significant request-acceptance differences. INTERPRETATION: Implementation of a large-scale Minnesota MOCC program was effective at placing patients during the first COVID-19 pandemic fall 2020 surge and was well regarded by hospitals and health systems. However, under worsening duress of limited resources during the fall 2021 surge, placement of ICU and medical-surgical patients was greatly decreased. CI - Copyright (c) 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. FAU - Baum, Karyn D AU - Baum KD AD - Essentia Health, Duluth, MN; University of Minnesota, Minneapolis, MN. FAU - Vlaanderen, Lauren AU - Vlaanderen L AD - M Health Fairview, Minneapolis, MN; Scope Anesthesia of North Carolina PLLC, Charlotte, NC. FAU - James, Walter AU - James W AD - Minnesota Department of Health, St. Paul, MN. FAU - Huppert, Mary Jo AU - Huppert MJ AD - M Health Fairview, Minneapolis, MN. FAU - Kettler, Paul AU - Kettler P AD - M Health Fairview, Minneapolis, MN. FAU - Chell, Christine AU - Chell C AD - Metro Health & Medical Preparedness Coalition, Minneapolis, MN. FAU - Shadiow, Adam AU - Shadiow A AD - Arrowhead EMS Association, Duluth, MN. FAU - Strike, Helen AU - Strike H AD - Allina Health, Minneapolis, MN. FAU - Greenlee, Kay AU - Greenlee K AD - CentraCare, St. Cloud, MN. FAU - Brown, Daniel AU - Brown D AD - Mayo Clinic, Rochester, MN. FAU - Hick, John L AU - Hick JL AD - University of Minnesota, Minneapolis, MN; Hennepin Healthcare, Minneapolis, MN. FAU - Wolf, Jack M AU - Wolf JM AD - University of Minnesota, Minneapolis, MN. FAU - Fiecas, Mark B AU - Fiecas MB AD - University of Minnesota, Minneapolis, MN. FAU - McLachlan, Erin AU - McLachlan E AD - Minnesota Department of Health, St. Paul, MN; Hennepin Healthcare, Minneapolis, MN. FAU - Seaberg, Judy AU - Seaberg J AD - Minnesota Department of Health, St. Paul, MN; Hennepin Healthcare, Minneapolis, MN. FAU - MacDonnell, Sean AU - MacDonnell S AD - Minnesota Department of Health, St. Paul, MN; Hennepin Healthcare, Minneapolis, MN. FAU - Kesler, Sarah AU - Kesler S AD - University of Minnesota, Minneapolis, MN. FAU - Dichter, Jeffrey R AU - Dichter JR AD - University of Minnesota, Minneapolis, MN. Electronic address: jdichter@umn.edu. LA - eng PT - Journal Article DEP - 20230817 PL - United States TA - Chest JT - Chest JID - 0231335 SB - IM CIN - Chest. 2024 Jan;165(1):2-4. PMID: 38199733 MH - Adult MH - Humans MH - *COVID-19/epidemiology/therapy MH - Minnesota/epidemiology MH - Pandemics MH - Critical Care MH - Intensive Care Units MH - Hospitals MH - Surge Capacity OTO - NOTNLM OT - COVID-19 OT - MOCC OT - Medical Operations Coordination Center OT - bed coordination OT - critical care OT - load-balancing OT - patient flow COIS- Financial/Nonfinancial Disclosures None declared. EDAT- 2023/08/20 00:41 MHDA- 2024/01/12 06:42 CRDT- 2023/08/19 19:23 PHST- 2022/12/03 00:00 [received] PHST- 2023/08/03 00:00 [revised] PHST- 2023/08/05 00:00 [accepted] PHST- 2024/01/12 06:42 [medline] PHST- 2023/08/20 00:41 [pubmed] PHST- 2023/08/19 19:23 [entrez] AID - S0012-3692(23)05277-7 [pii] AID - 10.1016/j.chest.2023.08.016 [doi] PST - ppublish SO - Chest. 2024 Jan;165(1):95-109. doi: 10.1016/j.chest.2023.08.016. Epub 2023 Aug 17.