Regional pandemic command center feasibly provides care for patients with COVID-19

A regional command center in Catalonia helped patients with severe COVID-19 by coordinating transfers between hospitals in the area during the pandemic, according to a research letter published in CHEST.

The purpose of a regional command center is to facilitate transfers across regions so that when a surge occurs, hospital staff are not overwhelmed by an increase in patients, according to researchers.

Youcef Azeli

“All clinicians in the health care system involved in the treatment of critically ill patients have the possibility, in case of overload, to ask for help and transfer their patients to other hospitals in less-burdened regions,” Youcef Azeli, MD, PhD, of the Emergency Medical Systems (EMS) of Catalonia and Pere Virgili Biomedical Research Institute (IISPV), told Healio.

In a prospective observational study, Azeli and colleagues evaluated data of hospitalized patients with severe COVID-19 in Catalonia who were transferred to an EMS-run ICU from a regional command center during the first four waves of the pandemic to gain a better understanding of the characteristics of the patients and the flow of transfers within the area.

From March 15, 2020, to July 1, 2021, researchers found that the regional command center received 3,051 interhospital transfer requests, representing one-third of the ICU admissions in Catalonia. They carried out 2,697 of these transfers.

According to researchers, the monthly percentage of ICU admissions transferred from other hospitals ranged from 15.5% to 40%, for a monthly average of 30.6%. Most transfers took place during March and April of 2020.

Researchers found that growth in transfer requests was not uniform in each province, and this meant that transfers had to be performed across different subregions of the hospital network when there was a surge.

Of 1,468 patients (mean age, 60.6 years; 70.1% male) transferred during the first four waves of the pandemic, only 28% came from a hospital with an ICU, with patients spending a mean 18.6 days in the ICU after the transfer.

Despite a 29.2% hospital mortality rate, there was no transport-related adverse or critical events, and researchers found that the mortality rate of patients transferred was comparable to other studies.

Overall, this regional command center effectively enabled real-time monitoring of demand and available ICU resources to prevent overcrowding while improving communication, the researchers wrote.

“We are now working on our next publication which we expect to be available very soon that will present an improved prioritization and triage scale,” Azeli told Healio. “This scale can be helpful in ordering the flow of patients between different regions in case of need.”

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Youcef Azeli, MD, PhD, can be reached at youcefazeli@gencat.cat.