• Jeffrey R Dichter, Daniel Brown, Clara Zamorano, Joshua Cohen, Elizabeth A Miller, David E Niccum, Michele LeClaire, Christina Bastin De Jong, Deanna Diebold, Jacob Lyons, Ronald Reilkoff, Heidi L Erickson, Joseph Martinelli, Jennifer A Fischer, Kyle Mairose, Jason Kallestad, Christine Chell, Adam Shadiow, Shawn Stoen, John L Hick, Cheryl Petersen-Kroeber, Judy Seaberg, Erin McLachlan, Alexandra T Waterman, Walter Y James, Sean MacDonell, James Risser, Tom Klemond, Erin S DeMartino, Joel Wu, Debra DeBruin, Susan M Wolf, Nneka O Sederstrom, Karyn D Baum, Kay Greenlee, Helen Strike, Paul A Kettler, Andrea Boehland, Kimberly A Goodman, Ken K Maslonka, Jack M Wolf, Jennifer Schoenecker, Sarah Kesler, and Minnesota Critical Care Working Group.
• University of Minnesota. Electronic address: jrdichter1@gmail.com.
• Chest. 2024 Nov 30.

BackgroundIn 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 nine largest health systems, was established and entrusted to plan and coordinate critical care support for Minnesota from March 2020 through July 1, 2021.Research QuestionCan 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 MethodsCCWG 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 indicators reflecting contingency vs crisis conditions, and planned responses collaboratively. A foundation of collaboration and teamwork developed which facilitated an effective statewide response.ResultsPandemic 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, 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.InterpretationCCWG 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.Copyright © 2024 American College of Chest Physicians. All rights reserved.

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