The Minnesota Critical Care Working Group 1: Monitoring and Coordinating Statewide Critical Care Surge Response in the COVID-19 Pandemic, March 2020 Through July 1, 2021.

Abstract

Background: In response to the COVID-19 pandemic and as part of the statewide health care coalition response, the Minnesota Critical Care Working Group (CCWG), composed of interprofessional leaders from the state's 9 largest health systems, was established and entrusted to plan and coordinate critical care support for Minnesota from March 2020 through July 1, 2021.

Research question: Can a statewide CCWG develop contingency and crisis-level surge strategies and indicators in response to the COVID-19 pandemic while evolving into a highly collaborative team?

Study design and methods: CCWG members (intensivists, ethicists, nurses, Minnesota Department of Health and Minnesota Hospital Association leaders) met by audio video conferencing as often as daily assessing COVID-19 and non-COVID-19 hospitalization data, developed surge evidence reflecting contingency vs crisis conditions, and planned responses collaboratively. A foundation of collaboration and teamwork developed which facilitated an effective statewide response.

Results: Pandemic surge health care system strategies included use of surge ICU beds, adapted staffing models, restriction of nonemergency procedures, augmentation of tele-ICU care, ability to recognize increasing staff shortages, use of PICU beds for younger adults, and use of noninvasive ventilation in non-ICU settings. CCWG supported development of the Minnesota Medical Operations Coordination Center, which was instrumental in load balancing and mitigating crisis conditions. Minnesota surge strategies are compared with published prepandemic and pandemic experiences regarding staff, space, supplies and medications/equipment, and system strategies. Adopted severe surge best practices included use of adapted staffing models and noninvasive ventilation in non-ICU settings. CCWG effectively developed shared strategies and facilitated ICU load balancing, which supported a regionally consistent standard of care.

Interpretation: The CCWG developed statewide critical care surge strategies assisting health care organization response to COVID-19 surges, providing a platform for clinical and operational activities. Collaboration, trust, and teamwork between CCWG leaders and health care organizations was essential to success and serves as a model for future events.