• Adam B Keene, Arieil L Shiloh, Lewis Eisen, Jay Berger, Manoj Karwa, Daniel Fein, Deborah Orsi, and Michelle Gong.
• Department of Medicine, Division of Critical Care Medicine, Montefiore Medical Center, 2013Yeshiva University's Albert Einstein College of Medicine, New York, NY, USA.
• J Intensive Care Med. 2021 Feb 1; 36 (2): 233-240.

PurposeMontefiore Medical Center (MMC) in the Bronx, New York, was subjected to an unprecedented surge of critically ill patients with COVID-19 disease during the initial outbreak of the pandemic in New York State in the spring of 2020. It is important to describe our experience in order to assist hospitals in other areas of the country that may soon be subjected to similar surges.Materials And MethodsWe retrospectively reviewed the expansion of critical care medicine services at Montefiore during the COVID-19 surge in terms of space, staff, stuff, and systems. In addition, we report on a debriefing session held with a multidisciplinary group of frontline CCM providers at Montefiore.FindingsThe surge of critically ill patients from COVID-19 disease necessitated a tripling of critical care bed capacity at (MMC), with attendant increased needs for staffing, equipment, and systematic innovations to increase efficiency and effectiveness. Feedback from a multidisciplinary group of frontline providers revealed multiple opportunities for improvement for the next potential surge at MMC as well as guidance for other hospitals.ConclusionsGiven increasing cases and burden of critical illness from COVID-19 across the US, engineering safe and effective expansions of critical care capacity will be crucial. We hope that our description of what worked and what did not at MMC will help guide other hospitals in their pandemic preparedness.

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