O3192: Pediatric Medical Operation Coordinating Cells- establishing a Pediatric Critical Care Safety Net During a Pediatric Surge Event

Background: At the peak of the Covid-19 pandemic, Medical Operations Coordinating Cells (MOCC) were established to level-load patients and assure equitable access to medical care. The recent “Tridemic” overwhelmed pediatric critical care capacity in many states, leaving young, critically ill children to be cared for in a less-than-optimum care setting. Pediatric focus MOCCs are one tool to help address this situation.

Project Description: Through focused group discussions, the Pediatric Pandemic Network Deployable Assets Workgroup gathered information from MOCCs that functioned during the COVID-19 pandemic and recent RSV, Influenza, and Covid 19 pediatric surge events. We identified different MOCC models across multiple states. Several themes emerged.

Discussion: 1. Accurate and timely Information sharing was essential to match resources with demand effectively.
2. Broad stakeholder engagement and pediatric institutional participation were essential for success. States used public health mandates and executive orders to require participation. Voluntary involvement in MOCCs should be incentivized.
3. Access to secondary (inter-facility) transports further limited the equitable delivery of PICU-level care.
4. Activation criteria, the scope of practice, and lines of authority need to be defined
5. Financial, liability, and legal issues are unresolved.

Conclusion: : During surging demand, equal access to pediatric critical care services is at risk of being compromised. Stakeholders must use the recent “Tridemic” to address the identified concerns and build a pediatric critical care safety net.