Related Experiment Video
Updated: Jul 28, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Using Two Statewide Medical Operations Coordination Centers to Load Balance in Pediatric Hospitals During a Severe
Steven H Mitchell1, Matthias J Merkel2, Carl O Eriksson3
1Department of Emergency Medicine, University of Washington, Seattle, WA.
Insights
Statewide Medical Operations Coordination Centers (MOCCs) effectively managed a pediatric patient surge by load balancing and coordinating resources. These centers adapted to overwhelming demand, ensuring critical care access for children during a respiratory illness outbreak.
Area of Science:
- Healthcare Management
- Pediatric Critical Care
- Public Health Preparedness
Background:
- A significant surge in pediatric acute and critical care needs overwhelmed hospital capacity in Washington and Oregon during November-December 2022.
- Existing pediatric care infrastructure faced unprecedented demand due to a widespread respiratory illness outbreak.
Purpose of the Study:
- To report on the utilization of two statewide Medical Operations Coordination Centers (MOCCs) to manage a rapid surge in pediatric acute and critical care patient needs.
- To evaluate the effectiveness of adapted MOCC strategies in load balancing pediatric patient care during a crisis.
Main Methods:
- Two existing statewide MOCCs were adapted to manage pediatric patient surge.
- Interventions included enhanced surveillance, modified referral agreements, coordinated resource expansion, and activation of crisis standards of care.
- Integration of pediatric critical care physicians as subject matter experts (SMEs) was implemented.
Main Results:
- The MOCCs managed 183 pediatric transfer requests between November 1 and December 14, 2022.
- Most requests were for infants and young children with acute viral respiratory disease; older children presented with intentional drug ingestions.
- Fifty-eight percent of patients were critically ill, and SMEs influenced disposition in 38% of cases where they were consulted.
Conclusions:
- Statewide MOCCs effectively load-balanced a surge in pediatric patients, mitigating overwhelmed hospital resources.
- Centralized coordination and surveillance provided critical information for capacity expansion and referral process modifications.
- The adaptable nature of MOCCs makes them a valuable resource for managing healthcare surges and ensuring pediatric critical care access.
Objectives:
Report on the use of two statewide Medical Operations Coordination Centers (MOCCs) to manage a rapid surge in pediatric acute and critical care patient needs.
Design:
Brief report.
Setting:
The states of Washington and Oregon during the pediatric respiratory surge in November 2022/December 2022 which overwhelmed existing pediatric acute and critical care hospital capacity.
Patients:
Pediatric patients requiring hospitalization in Washington and Oregon.
Interventions:
Adaptations to the use of two existing statewide MOCCs to provide pediatric patient load balancing through surveillance, modifications of existing referral agreements, coordinated expansion of resources, activation of regional crisis standards of care, and integration of pediatric critical care physicians from Harborview Medical Center as subject matter experts (SMEs).
Measurements And Main Results:
The Washington and Oregon MOCCs managed 183 pediatric requests from hospitals unable to transfer pediatric patients between November 1, 2022, and December 14, 2022. Sixteen percent of requests were for children younger than 3 months and 37% were for children between 3 months and 1 year; most had acute viral respiratory disease. Requests for children older than 13 years old were primarily intentional drug ingestions. Fifty-eight percent were for critically ill children and 17% originated from critical access hospitals. Washington's SMEs were utilized in nearly a quarter of cases with the disposition changing in 38% of these.
Conclusions:
Washington and Oregon statewide MOCCs have leveraged centralized coordination to effectively load balance a surge in pediatric patients which has overwhelmed existing pediatric hospital resources. Centralized coordination and surveillance informed pediatric hospitals and policy makers of unmet clinical needs and facilitated rapid expansion of clinical capacity and modifications to referral processes. Integration of pediatric SMEs enabled efficient triage of these resources. MOCCs provide an adaptable centralized resource for addressing surge and have been effective in managing overwhelmed pediatric hospital resources in Washington and Oregon.
Related Concept Videos
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:30Acute Respiratory Failure-III
01:23Acute Respiratory Failure-IV
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:21Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...