Surge Phase Playbook: COVID-19

Preparing for increase in hospital, critical care capacity

As the coronavirus pandemic grows and the number of cases quickly rises in the United States, Kaiser Permanente Northern California expects an influx of COVID-19 patients requiring intensive care management. Medical centers should plan and prepare to rapidly create a twofold increase in hospital capacity and a threefold increase in critical care capacity.

The 63-page Kaiser Permanente Northern California COVID-19 Hospital Surge Playbook includes detailed guidance for ICU expansion and management — with detailed checklists, FAQs, and graphics.

The playbook reviews strategies for the rapid expansion of a medical facility’s existing intensive care capacity using a “Space, Stuff, Staff” strategy.

• Space refers to where critically ill patients are treated in the hospital, including areas outside of the ICU that can be modified to provide care. Be aware of adjacent areas that may have an impact on the flow into and out of the ICU, such as triage areas that will be a frequent source of patient intake or wards for patients who will receive palliative care when critical care is not appropriate.
• Stuff refers to the equipment and supplies required to manage critically ill patients, including cardiac monitors, mechanical ventilators, IV pumps, medications, and medical gases.
• Staff refers to the human resources required to care for patients. In addition to usual ICU staff, the ICU may require supplementary assistance from other health care professionals in the hospital or community. Usual ICU staffing ratios will be difficult to maintain during a surge, and personnel less experienced in critical care may be needed to augment critical care staff, with the necessary training and supervision and training provided.

The information in this playbook is intended for clinicians only. Information for consumers, members, and patients can be found at cdc.gov or kp.org.

Kaiser Permanente Northern California COVID-19 Hospital Surge Playbook