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Enhancing Non-ICU Clinician Capability and ICU Bed Capacity to Manage Pandemic Patient Surge

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Annual Update in Intensive Care and Emergency Medicine 2021

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

Abstract

Regardless of location around the world, intensivists and critical care team members were in short supply prior to the current pandemic. Therefore, the surge of critically ill patients with coronavirus disease 19 (COVID-19) stressed healthcare systems’ supplies of intensivists, critical care teams, and resources including beds. Individual facilities and integrated health systems needed to adapt to the realities of the COVID-19 patient surge while continuing to care for patients not infected with severe acute respiratory coronavirus 2 (SARS-CoV-2) in need of acute or critical care. Adaptive approaches included establishing novel intensive care unit (ICU) spaces and training non-ICU clinicians to work with seasoned ICU professionals using a tiered staffing model. Importantly, medical professional organizations played a key role in providing training materials in a free open access medical education (FOAMed) fashion. Early cessation of elective procedures initially provided staff to help care for the surge of acute or critically ill patients. The resumption of usual care while providing COVID-19 patient care has uncovered a need to enhance critical care education and skill competency in a broad range of clinicians to better prepare for the next infectious disease challenge.

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References

  1. Halpern NA, Tan KS, DeWitt M, Pastores SM. Intensivists in acute care hospitals. Crit Care Med. 2019;47:517–25.

    Article  Google Scholar 

  2. Sen-Crowe B, Sutherland M, McKenney M, Elkbuli A. A closer look into hospital bed capacity and resource shortages during the Covid-19 pandemic. J Surg Res. 2021;260:56–63.

    Article  CAS  Google Scholar 

  3. SCCM COVID 19 Rapid Resource Center. Configuring ICUs in the COVID 19 era. Available at https://www.sccm.org/getattachment/03130f42-5350-4456-be9f-b9407194938d/Configuring-ICUs-in-the-COVID-19-Era-A-Collection. Accessed 9 Feb 2021.

  4. National Academy of Medicine. Crisis standards of care for the COVID-19 pandemic. Available at https://nam.edu/112920-crisis-standards-of-care-resources/. Accessed 11 Feb 2021.

  5. Harris GH, Baldisseri MR, Reynolds BR, Orsino AS, Sackrowitz R, Bishop JM. Design for implementation of a system-level pandemic surge staffing plan. Crit Care Explor. 2020;2:e0136.

    Article  Google Scholar 

  6. Maves RC, Downar J, Dichter HR, Hick JL, Devereaux A, Geiling JA, et al. Triage of scarce critical care resources in COVID-19 an implementation guide for regional allocation. Chest. 2020;158:212–5.

    Article  CAS  Google Scholar 

  7. Jayaprakash N, Pflaum-Carlson J, Gardner-Grey J, Hurst G, Coba V, Kinni H, et al. Critical care delivery solutions in the emergency department: evolving models in caring for ICU boarders. Ann Emerg Med. 2020;76:709–16.

    Article  Google Scholar 

  8. Tabah A, Ramanan M, Laupland KB, Buetti N, Cortegiani A, Mellinghoff J, et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey. J Crit Care. 2020;59:70–5.

    Article  CAS  Google Scholar 

  9. Brubaker L. Women physicians and the COVID-19 pandemic. JAMA. 2020;324:835–6.

    Article  CAS  Google Scholar 

  10. Prezant DJ, Zeig-Owens R, Schwartz T, et al. Medical leave associated with COVID-19 among emergency medical system responders and firefighters in New York City. JAMA Netw Open. 2020;3:e2016094.

    Article  Google Scholar 

  11. Goh KJ, Wong J, Tien JCC, Ng SY, Duu Wen S, Phua GC, et al. Preparing your intensive care unit for the COVID-19 pandemic: Practical considerations and strategies. Crit Care. 2020;24:215.

    Article  Google Scholar 

  12. Emanual EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. Fair allocation of scarce medical resources in the time of COVID-19. N Engl J Med. 2020;382:2049–55.

    Article  Google Scholar 

  13. Lacasa L, Challen R, Brooks-Pollock E, Danon L. A flexible method for optimising sharing of healthcare resources and demand in the context of the COVID-19 pandemic. PLoS One. 2020;15:e0241027.

    Article  CAS  Google Scholar 

  14. Khot UN, Reimer AP, Brown A, Hustey FM, Hussain MS, Kapadia SR, Svensson LG. Impact of COVID-19 pandemic on critical care transfers for ST-segment-elevation myocardial infarction, stroke and aortic emergencies. Circ Cardiovasc Qual Outcomes. 2020;13:e006938.

    PubMed  Google Scholar 

  15. Schaye VE, Reich JA, Bosworth BP, Stern DT, Volpicelli F, Shapiro NM, et al. Collaborating across private, public, community, and federal hospital systems: Lessons learned from the Covid-19 pandemic response in NYC. NEJM Catal 2020;1. https://doi.org/10.1056/CAT.20.0343

  16. Tolentino VR, Derevlany L, De-LaMothe C, Vick S, Chalyavski L. The effects of the COVID-19 pandemic on risk management practice: a report from the epicenter in New York City. J Healthc Risk Manag. 2021;40:46–57.

    Article  Google Scholar 

  17. Gbadamosi A-Q, Oyedele L, Olawale O, Abioye S. Offsite construction for emergencies: a focus on isolation space creation (ISC) for the COVID-19 pandemic. Progr Disaster Med. 2020;8:100130.

    Article  Google Scholar 

  18. American Society for Health Care Engineering. Innovative IV pump placement. Last updated March 20, 2020. Available at https://www.ashe.org/innovative-iv-pump-placement. Accessed 9 Feb 2021.

  19. Leung S, Gregg SR, Coopersmith CM, Layon AJ, Oropello J, Brown DR, et al. Critical care organizations: business of critical care and value/performance building. Crit Care Med. 2018;46:1–11.

    Article  Google Scholar 

  20. Kok N, van Gurp J, Teerenstra S, van der Hoeven H, Fuchs M, Hoedemaekers C, et al. Coronavirus disease 2019 immediately increases burnout symptoms in ICU professionals: a longitudinal cohort study. Crit Care Med. 2021;49:419–27.

    Article  CAS  Google Scholar 

  21. Kleinpell R, Moss M, Good VS, Gozal D, Sessler CN. The critical nature of addressing burnout prevention: results from the Critical Care Societies Collaborative’s national summit and survey on prevention and management of burnout in the ICU. Crit Care Med. 2020;48:249–53.

    Article  Google Scholar 

  22. Yager PH, Whalen KA, Cummings BM. Repurposing of pediatric ICU’s for adults. N Engl J Med. 2020;382:e80.

    Article  Google Scholar 

  23. Aziz S, Arabi YM, Alhazzani W, Evans L, Citerio G, Fischkoff K, et al. Managing ICU surge during the COVID-19 crisis: rapid guidelines. Intensive Care Med. 2020;46:1303–25.

    Article  CAS  Google Scholar 

  24. Nepolitano L, Venkatakrishna R, Gunnerson KJ, Maile MD, Quasney M, Hyzy RC. Physician training in critical care in the United States: Update 2018. J Trauma Acute Care Surg. 2018;84:963–71.

    Article  Google Scholar 

  25. Chan AKM, Nickson CP, Rudolph JW, Lee A, Joynt GM. Social media for rapid knowledge dissemination: early experience from the COVID-19 pandemic. Anaesth Crit Care Pain Med. 2020;75:1579–82.

    CAS  Google Scholar 

  26. SCCM Critical care for the non-ICU clinician. Available at https://www.sccm.org/COVID19RapidResources/Search-COVID19RL?searchtext=critical+care+for+the+non-icu+clinician&searchmode=anyword. Accessed 9 Feb 2021.

  27. Vincent JL, Wendon J, Martin GS, Juffermans NP, Creteur J, Cecconi M. COVID-19: What we’ve done well and what we could or should have done better – the 4 Ps. Crit Care. 2021;25:40.

    Article  Google Scholar 

  28. ESICM European Commission C19_SPACE (COVID-19 skills preparation course). Available at https://www.esicm.org/european-commission-c19-space-information-webinar/. Accessed 9 Feb 2021.

  29. American Heart Association Advanced Life Support Course (ACLS) Available at https://cpr.heart.org/en/cpr-courses-and-kits/healthcare-professional/acls. Accessed 10 Feb 2021.

  30. Albutt K, Luckhurst CM, Alba GA, Hechi ME, Mokhtari A, Breen K, et al. Design and impact of a COVID-19 multidisciplinary bundled procedure team. Ann Surg. 2020;272:e72–3.

    Article  Google Scholar 

  31. Sajayan A, Arora N, Williamson A, Nair A. COVID intubation team (CIT) – An experience at a UK center. Curr Anesth Crit Care. 2020;33:27–9.

    Google Scholar 

  32. Kumaraiah D, Yip N, Ivascu N, Hill L. Innovative ICU physician care models: Covid-19 pandemic at New York-Presbyterian. NEJM Catal. April 28, 2020. https://doi.org/10.1056/CAT.20.0158.

  33. Guirgis FW, Jones L, Esma R, Weiss A, McCurdy K, Ferreira J, et al. Managing sepsis: electronic recognition, rapid response teams, and standardized care saves lives. J Crit Care Med. 2017;40:296–302.

    Article  Google Scholar 

  34. Heffernan DS, Evans HL, Huston JM, Claridge JA, Blake DP, May AK, et al. Surgical infection society guidance for operative and peri-operative care of adult patients infected by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Surg Infect. 2020;21:301–8.

    Article  CAS  Google Scholar 

  35. Kleinpell R, Ferraro DM, Maves RC, Kane Gill SL, Branson R, Greenberg S, et al. Coronavirus disease 2019 pandemic measures: Reports from a national survey of 9,120 ICU clinicians. Crit Care Med. 2020;48:e846–55.

    Article  CAS  Google Scholar 

  36. Kang Y, Shin KR. COVID-19 Korean nurses’ experiences and ongoing tasks for the pandemic’s second wave. Int Nurs Rev. 2020;67:445–9.

    Article  Google Scholar 

  37. Dyer C. Covid 19: 15,000 deregistered doctors are told “Your NHS needs you”. BMJ. 2020;364:m1152.

    Google Scholar 

  38. Chen LK, Yudan RP, Ji XJ, Lu XY, Xiao J, Tao JB, et al. Modular composite building in urgent emergency engineering projects: a case study in accelerated design and construction of Wuhan Thunder God Mountain/Leishenshan hospital to COVID-19 pandemic. Autom Constr. 2021;24:103555.

    Article  Google Scholar 

  39. Madhaven S, Bastarache L, Brown JS, Butte AJ, Dorr DA, Embi PJ, et al. Use of electronic health records to support a public health response to the Covid-19 pandemic in the United States: a perspective from 15 academic centers. ACI Open. 2021;28:393–401.

    Google Scholar 

  40. Jordan RM, Ullrich LA, Decapua-Guarino A, Klock B. Trends in surgical critical care training among general surgery residents: pursuing and ideal curriculum. Amer Surg. 2020;89:1119–23.

    Article  Google Scholar 

  41. Smith AG, Brainard JC, Campbell KA. Development of an undergraduate medical education critical care content outline utilizing the delphi method. Crit Care Med. 2020;48:98–103.

    Article  Google Scholar 

  42. Mohr NM, Wessman BT, Bassin B, Elie-Turenne MC, Ellender T, Emlet LL, et al. Boarding of critically ill patients in the emergency department. Crit Care Med. 2020;48:1180–7.

    Article  Google Scholar 

  43. SCCM. United States Resource Availability for COVID-19. Available at https://sccm.org/getattachment/Blog/March-2020/United-States-Resource-Availability-for-COVID-19/United-States-Resource-Availability-for-COVID-19.pdf?lang=en-US. Accessed 14 May 2021.

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Authors and Affiliations

  1. Department of Emergency Medicine, Durham VA Medical Center, Durham, NC, USA

    H. Bailey

  2. Division of Trauma, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    L. J. Kaplan

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  1. H. Bailey
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Correspondence to H. Bailey .

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Editors and Affiliations

  1. Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

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Bailey, H., Kaplan, L.J. (2021). Enhancing Non-ICU Clinician Capability and ICU Bed Capacity to Manage Pandemic Patient Surge. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2021. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-73231-8_25

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  • DOI: https://doi.org/10.1007/978-3-030-73231-8_25

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  • Online ISBN: 978-3-030-73231-8

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