Optimizing Scarce Resource Allocation During COVID-19: Rapid Creation of a Regional Health-Care Coalition and Triage Teams in San Diego County, California

Asha Devereaux*, Holly Yang, Gilbert Seda, Viji Sankar, Ryan C. Maves, Navaz Karanjia, John Scott Parrish, Christy Rosenberg, Paula Goodman-Crews, Lynette Cederquist, Frederick M. Burkle, Jennifer Tuteur, Chiara Leroy, Kristi L. Koenig

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Successful management of an event where health-care needs exceed regional health-care capacity requires coordinated strategies for scarce resource allocation. Publications for rapid development, training, and coordination of regional hospital triage teams to manage the allocation of scarce resources during coronavirus disease 2019 (COVID-19) are lacking. Over a period of 3 weeks, over 100 clinicians, ethicists, leaders, and public health authorities convened virtually to achieve consensus on how best to save the most lives possible and share resources. This is referred to as population-based crisis management. The rapid regionalization of 22 acute care hospitals across 4500 square miles in the midst of a pandemic with a shifting regulatory landscape was challenging, but overcome by mutual trust, transparency, and confidence in the public health authority. Because many cities are facing COVID-19 surges, we share a process for successful rapid formation of health-care care coalitions, Crisis Standard of Care, and training of Triage Teams. Incorporation of continuous process improvement and methods for communication is essential for successful implementation. Use of our regional health-care coalition communications, incident command system, and the crisis care committee helped mitigate crisis care in the San Diego and Imperial County region as COVID-19 cases surged and scarce resource collaborative decisions were required.

Original languageEnglish
Pages (from-to)321-327
Number of pages7
JournalDisaster Medicine and Public Health Preparedness
Volume16
Issue number1
DOIs
StatePublished - 10 Feb 2022
Externally publishedYes

Keywords

  • capacity building
  • disaster medicine
  • health-care rationing
  • mass casualty incidents
  • triage

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