Simulation of "North Carolina Protocol for Allocating Scarce Inpatient Critical Care Resources in a Pandemic" in a Multi-hospital Health Care System.

An integrated nonprofit health care system with 13 North Carolina medical centers conducted a time-pressured quality improvement simulation of its plan to implement the "North Carolina Protocol for Allocating Scarce Inpatient Critical Care Resources in a Pandemic" attendant to pandemic scenario planning. Simulation objectives included assessing the plan in terms of a) efficiency and effectiveness; b) comorbidity scoring validity; c) impact by race/ethnicity, gender, age, and payer status; and d) simulation participant impressions of potential impact on clinicians. The simulation scenario involved scoring 14 patients with the constraint that only 10 could be afforded critical care resources.