BACKGROUND At the request of the Statewide Healthcare Coordination Center, the Minnesota Critical Care Working Group (CCWG) and ethics subgroup (EWG), composed of interprofessional leaders from Minnesota's nine largest health systems were asked to plan and coordinate critical care operations during the COVID-19 pandemic, including the 2021 Fall surge. RESEARCH QUESTION Can a statewide Working Group collaboratively analyze real time evidence to identify crisis conditions and engage state leadership to implement care processes? STUDY DESIGN AND METHODS CCWG/EWG met via video conferencing during the Fall 2021 severe surge to analyze evidence and plan for potential crisis care conditions. Five sources of evidence informed their actions including group consensus on operating conditions; Federal Tele-Tracking data; MOCC patient placement data; and two surveys created and distributed to hospitals and healthcare professionals. The group developed and recommended processes to mitigate the conditions and engaged statewide leadership for support. RESULTS Evidence of crisis conditions included rising numbers of inpatient COVID-19 patients, tertiary care centers with difficulty accepting transfers (including emergencies), severe ED crowding, activation of ICU allocation teams, and low patient placement rate at the Minnesota MOCC. A statewide hospital survey demonstrated numerous staffing adaptations, expansion of telemedicine, and delay of non-emergent procedures. A survey of healthcare professionals revealed instances of poor patient outcomes, bedside rationing, implicit triage, and moral distress. Leadership engagement resulted in public messaging, though no change in how ICU care was allocated, or transfers managed. INTERPRETATION CCWG collected and analyzed evidence demonstrating crisis conditions and healthcare professional moral distress during the Fall 2021 COVID-19 surge. However, the group had a limited impact on care processes. This paper analyzes the group's efforts. It includes recommendations for researchers and policy makers.

中文翻译：

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明尼苏达州重症监护工作组 2：COVID-19 大流行期间的危机状况，2021 年 7 月至 2022 年 3 月。


背景 应全州医疗保健协调中心的要求，由明尼苏达州九个最大卫生系统的跨专业领导者组成的明尼苏达州重症监护工作组 （CCWG） 和伦理小组 （EWG） 被要求在 COVID-19 大流行期间规划和协调重症监护操作，包括 2021 年秋季激增。研究问题 全州工作组能否协作分析实时证据以识别危机状况并让州领导层参与实施护理流程？研究设计和方法 CCWG/EWG 在 2021 年秋季严重激增期间通过视频会议会面，以分析证据并规划潜在的危机护理条件。五个证据来源为他们的行动提供了信息，包括对运营条件的小组共识;联邦电报跟踪数据;MOCC 患者安置数据;以及创建并分发给医院和医疗保健专业人员的两项调查。该小组制定并推荐了缓解这种情况的流程，并聘请了全州领导层提供支持。结果危机情况的证据包括住院 COVID-19 患者人数增加、难以接受转诊（包括紧急情况）的三级护理中心、严重的急诊科拥挤、ICU 分配团队的启动以及明尼苏达州 MOCC 的患者安置率低。一项全州范围的医院调查显示，大量人员配备调整、远程医疗的扩大和非紧急程序的延迟。一项针对医疗保健专业人员的调查揭示了患者预后不佳、床边配给、隐性分诊和道德困扰等情况。领导层的参与导致了公共信息传递，尽管 ICU 护理的分配方式或转移管理方式没有变化。 解释 CCWG 收集并分析了 2021 年秋季 COVID-19 激增期间危机状况和医疗保健专业人员道德困扰的证据。然而，该小组对护理过程的影响有限。本文分析了该小组的努力。它包括对研究人员和政策制定者的建议。