Design for Implementation of a System-Level ICU Pandemic Surge Staffing Plan.

Autor:	Harris GH; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA., Baldisseri MR; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA., Reynolds BR; Department of Surgery, Division of Trauma and Acute Care Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.; UPMC Office for Advanced Practice Providers, Center for Interprofessional Practice and Education, University of Pittsburgh School of Medicine, Pittsburgh, PA., Orsino AS; Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA., Sackrowitz R; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.; UPMC ICU Service Center, Pittsburgh, PA., Bishop JM; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Jazyk:	angličtina
Zdroj:	Critical care explorations [Crit Care Explor] 2020 Jun 15; Vol. 2 (6), pp. e0136. Date of Electronic Publication: 2020 Jun 15 (Print Publication: 2020).
DOI:	10.1097/CCE.0000000000000136
Abstrakt:	Background: The current coronavirus disease 2019 pandemic is causing significant strain on ICUs worldwide. Initial and subsequent regional surges are expected to persist for months and potentially beyond. As a result of this, as well as the fact that ICU provider staffing throughout the United States currently operate at or near capacity, the risk for severe and augmented disruption in delivery of care is very real. Thus, there is a pressing need for proactive planning for ICU staffing augmentation, which can be implemented in response to a local surge in ICU volumes. Methods: We provide a description of the design, dissemination, and implementation of an ICU surge provider staffing algorithm, focusing on physicians, advanced practice providers, and certified registered nurse anesthetists at a system-wide level. Results: The protocol was designed and implemented by the University of Pittsburgh Medical Center's Integrated ICU Service Center and was rolled out to the entire health system, a 40-hospital system spanning Pennsylvania, New York, and Maryland. Surge staffing models were developed using this framework to assure that local needs were balanced with system resource supply, with rapid enhancement and expansion of tele-ICU capabilities. Conclusions: The ICU pandemic surge staffing algorithm, using a tiered-provider strategy, was able to be used by hospitals ranging from rural community to tertiary/quaternary academic medical centers and adapted to meet specific needs rapidly. The concepts and general steps described herein may serve as a framework for hospital and other hospital systems to maintain staffing preparedness in the face of any form of acute patient volume surge. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
Databáze:	MEDLINE
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