Abstract
Background: A regional understanding of mechanical ventilator utilization to support COVID-19 induced respiratory failure was developed to inform healthcare system decision makers about resource distribution, and potentially redistribution during the coronavirus pandemic. This resource could support the planning, procurement, and staffing needs of respiratory therapists, nurses, and physicians.
Methods: With permission, an E-mail solicitation was sent through the Maryland/District of Columbia (MD/DC) Society for Respiratory Care’s managers listserv with a request to participate in mechanical ventilator utilization data collection. Following coordinating center Institutional Research Board approval, participating sites signed a Letter of Commitment. Three questions were answered by participating sites on a daily basis: 1) How many spontaneously breathing (i.e., non-intubated) COVID(+) patients are in your hospital?; 2) How many intubated COVID(+) patients are in your ICUs?; and 3) What is the total number of ventilators your institution has on hand? Following completion of all daily surveys, data was regionally aggregated automatically to include 3 or more hospitals in any one region. If there was an instance when a region had less than 3 hospitals participating, the data was aggregated with the next closest region. Once data aggregation was complete it was made available through the web-based dashboard. The process eliminated any potential for personally identifiable information.
Results: The Eastern Shore Regional Graphical Information Systems Collaborative (ESRGC) provided a dashboard displaying anonymized data in aggregate as well as calculated variables (e.g., utilization and estimates of reserve per region and as a state). Approximately 20% of hospitals in the state of Maryland and 17% of hospitals in the District of Columbia provided data on a daily basis for this study. The need for mechanical ventilation in Maryland and D.C. did not rise to the same levels as seen in New York City or some countries in Europe.
Conclusions: Hospital and managers were commonly reluctant to participate because of workload and concern for liability for the data. Natural and man-made disasters happen periodically. Countries with the most technological advancements and widely available resources can be severely impacted. Developing data sharing processes during disasters is difficult and should be prioritized in times of relative calm.
Screen shot of the pubically available COVID-19 Ventilator Dashboard
Footnotes
Commercial Relationships: None
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