Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic
Objectives: To assess hospitals’ plans for implementing Minnesota’s statewide guidance for allocating scarce critical care resources during the COVID-19 pandemic. Patients and Methods: Individuals from 23 hospitals across Minnesota were invited to complete a 25-item survey between July 20, 2020, and...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S254245482400064X |
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| author | Kirsten A. Riggan, MS, MA Sarah Kesler, MD Debra DeBruin, PhD Susan M. Wolf, JD Jonathon P. Leider, PhD Nneka Sederstrom, MPH, PhD Jeffrey Dichter, MD Erin S. DeMartino, MD |
| author_facet | Kirsten A. Riggan, MS, MA Sarah Kesler, MD Debra DeBruin, PhD Susan M. Wolf, JD Jonathon P. Leider, PhD Nneka Sederstrom, MPH, PhD Jeffrey Dichter, MD Erin S. DeMartino, MD |
| author_sort | Kirsten A. Riggan, MS, MA |
| collection | DOAJ |
| description | Objectives: To assess hospitals’ plans for implementing Minnesota’s statewide guidance for allocating scarce critical care resources during the COVID-19 pandemic. Patients and Methods: Individuals from 23 hospitals across Minnesota were invited to complete a 25-item survey between July 20, 2020, and September 18, 2020 to understand how hospitals in the state intended to operationalize statewide clinical triage instructions for scarce resources (including mechanical ventilation) and written ethics guidance on the allocation of critical care resources in the event crisis standards of care triggered triage. Results: Of individuals invited from 23 hospitals, 14 hospitals completed the survey (60.9% institutional response rate) and described plans for triage at their respective hospitals. Planned triage team composition and size varied. Hospitals’ plans for which individuals should assign a triage score (reflecting patients’ illness severity) also differed markedly. Most respondents described plans for staff training to address potential bias in triage. Conclusion: Despite explicit state guidance to encourage consistency across hospitals, we found considerable heterogeneity in implementation plans. Plans diverged from Minnesota’s written ethics guidance on whether to consider race during triage to help mitigate health disparities. Inconsistencies between the state’s 2 guidance documents could explain some of these differences. Collaboration between hospitals and committees developing statewide guidance may help identify barriers to effective operationalization. Ongoing review of published guidance and hospital plans can identify issues of clarity and consistency and promote equitable triage. |
| format | Article |
| id | doaj-art-f1888f0ff9f44df79bdfd430ef3ffb28 |
| institution | Kabale University |
| issn | 2542-4548 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj-art-f1888f0ff9f44df79bdfd430ef3ffb282024-12-06T05:14:00ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482024-12-0186537547Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 PandemicKirsten A. Riggan, MS, MA0Sarah Kesler, MD1Debra DeBruin, PhD2Susan M. Wolf, JD3Jonathon P. Leider, PhD4Nneka Sederstrom, MPH, PhD5Jeffrey Dichter, MD6Erin S. DeMartino, MD7Biomedical Ethics Research Program, Mayo Clinic, Rochester, MNDivision of Pulmonary, Allergy, Critical Care, and Sleep Medicine Division, University of Minnesota, Minneapolis, MNCenter for Bioethics, University of Minnesota, Minneapolis, MNUniversity of Minnesota Law School, Minneapolis, MN; University of Minnesota Medical School, Minneapolis, MNDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MNHealth Equity Department, Hennepin Healthcare, Minneapolis, MNDivision of Pulmonary, Allergy, Critical Care, and Sleep Medicine Division, University of Minnesota, Minneapolis, MNBiomedical Ethics Research Program, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN; Correspondence: Address to Erin S. DeMartino, MD, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.Objectives: To assess hospitals’ plans for implementing Minnesota’s statewide guidance for allocating scarce critical care resources during the COVID-19 pandemic. Patients and Methods: Individuals from 23 hospitals across Minnesota were invited to complete a 25-item survey between July 20, 2020, and September 18, 2020 to understand how hospitals in the state intended to operationalize statewide clinical triage instructions for scarce resources (including mechanical ventilation) and written ethics guidance on the allocation of critical care resources in the event crisis standards of care triggered triage. Results: Of individuals invited from 23 hospitals, 14 hospitals completed the survey (60.9% institutional response rate) and described plans for triage at their respective hospitals. Planned triage team composition and size varied. Hospitals’ plans for which individuals should assign a triage score (reflecting patients’ illness severity) also differed markedly. Most respondents described plans for staff training to address potential bias in triage. Conclusion: Despite explicit state guidance to encourage consistency across hospitals, we found considerable heterogeneity in implementation plans. Plans diverged from Minnesota’s written ethics guidance on whether to consider race during triage to help mitigate health disparities. Inconsistencies between the state’s 2 guidance documents could explain some of these differences. Collaboration between hospitals and committees developing statewide guidance may help identify barriers to effective operationalization. Ongoing review of published guidance and hospital plans can identify issues of clarity and consistency and promote equitable triage.http://www.sciencedirect.com/science/article/pii/S254245482400064X |
| spellingShingle | Kirsten A. Riggan, MS, MA Sarah Kesler, MD Debra DeBruin, PhD Susan M. Wolf, JD Jonathon P. Leider, PhD Nneka Sederstrom, MPH, PhD Jeffrey Dichter, MD Erin S. DeMartino, MD Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic |
| title_full | Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic |
| title_fullStr | Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic |
| title_full_unstemmed | Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic |
| title_short | Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic |
| title_sort | minnesota hospitals plans for implementing statewide guidance on allocation of scarce critical care resources during the covid 19 pandemic |
| url | http://www.sciencedirect.com/science/article/pii/S254245482400064X |
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