The Minnesota Critical Care Working Group 1: Monitoring and Coordinating Statewide Critical Care Surge Response in the COVID-19 Pandemic, March 2020 Through July 1, 2021.

Background: In 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 Question: Can 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 Methods: CCWG 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.

The Minnesota Critical Care Working Group 2: Crisis Conditions During the COVID-19 Pandemic, July 2021 through March 2022.

Background: The Minnesota Statewide Healthcare Coordination Center requested that the Minnesota Critical Care Working Group (CCWG) and Ethics Working Group (EWG), comprising interprofessional leaders from Minnesota's 9 largest health systems, plan and coordinate critical care operations during the COVID-19 pandemic, including the fall 2021 surge.

Research Question: Can a statewide working group collaboratively analyze real-time evidence to identify crisis conditions and to engage state leadership to implement care processes?

Study Design And Methods: The CCWG and EWG met via videoconferencing during the severe surge of fall 2021 to analyze evidence and plan for potential crisis care conditions. Five sources of evidence informed their actions: group consensus on operating conditions, federal teletracking data, the Medical Operations Coordination Center (MOCC) patient placement data, and 2 surveys created and distributed to hospitals and health care professionals.

Acquired intercostal lung herniation: conservative management may lead to continuation of symptoms and other adverse consequence.

Background: It is quite rare for lung to herniate between a patient's ribs, most often seen after surgery; it is, however, also rarely seen in other situations, notably during coughing fits situations such as coughing spells. There is minor controversy in the literature regarding management, namely, a question of whether to manage conservatively or with surgical correction, since this is such a rare entity physicians, may face difficulty in knowing how to proceed. Here, we provide evidence supporting acquired lung herniation management to be repaired surgically, and early, while at the same time medically optimizing the patient's risk factors for further herniation events or intercostal muscle tears.

Confidence with and Barriers to Serious Illness Communication: A National Survey of Hospitalists.

Objective: To describe the concerns, confidence, and barriers of practicing hospitalists around serious illness communication.

Background: Hospitalist physicians are optimally positioned to provide primary palliative care, yet their experiences in serious illness communication are not well described.

Methods: Web-based survey, conducted in May 2016.