COVID-19 led to unprecedented inpatient capacity challenges particularly in Intensive Care Units (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.
Do Medical Operations Coordination Centers (MOCC) augment patient placement during times of severe capacity challenges?
The Minnesota MOCC was established with focus on transfer of adult ICU and med-surg patients; trauma, cardiac, stroke, burn, and ECMO were excluded. The center operated within one healthcare system’s bed management center, utilizing a dedicated 24/7 phone number. Major healthcare 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.
From August 1, 2020 through March 31, 2022 a total of 5307 requests were made, 2008 beds identified, 1316 requests canceled, and 1981 requests were unable to be fulfilled. 1715 patients had COVID-19 (32.3%), 2473 COVID-19 negative or low risk (46.6%), and 1119 COVID-19 status was unknown (21.1%); 760 were patients on ventilators (49.1% COVID-19 positive). C4 placed most patients during the Fall 2020 surge with the Minnesota Governors stay at home order during the peak. However, during the Fall 2021 surge only 30% of ICU patients and 38% of med-surg patients were placed. Indicators characterizing severe surge include the number of C4 requests, decreasing placements, longer placement times, and time series analysis demonstrating significant request-acceptance differences.
Implementation of large-scale Minnesota MOCC program was effective at placing patients during the first pandemic Fall 2020 surge and well-regarded by hospitals and health systems. However, under worsening duress of limited resources during the Fall 2021 surge placement of ICU and med-surg patients was much decreased.
Copyright © 2023. Published by Elsevier Inc.
