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 healthcare 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 July1, 2021.

Research Question: Can a statewide Critical Care Working Group 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, MDH and MHA leaders) met by audio video conferencing as often as daily assessing COVID and non-COVID hospitalization data, developed surge indicators reflecting contingency versus crisis conditions, and planned responses collaboratively. A foundation of collaboration and teamwork developed which facilitated an effective statewide response.

Results: Pandemic surge healthcare system strategies included use of surge intensive care unit (ICU) beds, adapted staffing models, restriction of non-emergency procedures, augmentation of tele-ICU care, ability to recognize increasing staff shortages, use of pediatric ICU beds for younger adults, and use of non-invasive ventilation (NIV) in non-ICU settings. CCWG supported development of the Minnesota Medical Operations Coordination Center, instrumental in load-balancing and mitigating crisis conditions. Minnesota surge strategies are compared to published pre- and pandemic experiences regarding staff; space; supplies, medications/equipment; and system strategies. Adopted severe surge best practices included use of adapted staffing models and NIV in non-ICU settings. CCWG effectively developed shared strategies and facilitated ICU load-balancing, which supported a regionally consistent standard of care.

Interpretation: CCWG developed statewide critical care surge strategies assisting healthcare organization response to COVID-19 surges, providing a platform for clinical and operational activities. Collaboration, trust, and teamwork between CCWG leaders and healthcare organizations was essential to success and serves as a model for future events.