New report details strategies for COVID-19 critical care surge

As the COVID-19 pandemic expands across the United States, many hospitals and health care systems are challenged with meeting the critical care needs of the sickest COVID-19 patients.

A new report from the RAND Corporation outlines the results of a rapid turn-around project led by Mahshid Abir, M.D., an associate professor of emergency medicine and director of the University of Michigan Acute Care Research Unit. The report, co-authored by Christina Cutter, M.D., an emergency physician and University of Michigan Institute for Healthcare Policy and Innovation National Clinician Scholar, highlights evidence-based strategies for critical care surge in response to the pandemic.

“The recommended strategies were informed by an environmental scan of literature on past public health emergencies and disasters and the current outbreak, a survey of front line emergency providers conducted in March 2020 in partnership with the American College of Emergency Physicians and two expert roundtables conducted through video-teleconference,” says Abir, a senior policy researcher at RAND.

Strategies highlighted in the report include converting post-anesthesia care units and operating rooms into intensive care unit (ICU) beds, re-opening shuttered hospitals, use of ICU tele-consults to expand critical care capabilities in community hospitals, regionalizing sharing of ventilator resources and implementing crisis staff, among other strategies.

“The report also includes an online tool where health care decision leaders can estimate how much critical care capacity can be gained using their own data and various critical care capacity strategies outlined in the report,” Abir says. The study team used this tool to estimate how much critical care capacity can be created in the nation’s ten Federal Emergency Management Agency (FEMA) regions.

The report, funded by the RAND Corporation, is available on its website and the authors hope fellow health care providers find the strategies and calculation tool useful when analyzing their own critical care capacity.

Report cited: “Critical Care Surge Response Strategies for the 2020 COVID-19 Outbreak in the United States,” RAND Corporation. DOI: 10.7249/RRA164-1