Call C4 at: 410-706-7797

Critical Care Coordination Center

The Maryland Institute for Emergency Medical Services Systems (MIEMSS), in response to the COVID-19 pandemic, created the Critical Care Coordination Center (C4) to facilitate critical care transfers throughout the State of Maryland. The overarching goal for the C4 is for patients to receive the “Right Care, at the Right Time, at the Right Place.” MIEMSS continues to utilize the C4 to help physicians identify available hospital critical care resources when patient transfers are necessary. C4 is staffed with critical care coordinators, Central Intensivist Physicians (CIP), and Central Advisor Pediatric Physicians (CAPP) 24/7. Any Maryland hospital with a patient needing a critical care transfer, treatment guidance, or in need of a pediatric bed can contact the C4 at 410-706-7797. The C4 coordinators have a near-real-time view of statewide hospital critical care bed capacity. The CIP or CAPP works with referring physicians to identify patients’ anticipated critical care or pediatric patient needs. The C4 coordinator and physicians, working jointly with the sending and receiving facilities, match the patients with available critical care and pediatric resources that can manage the patients’ conditions.


Dwayne Kitis, Manager
Critical Care Coordination Center (C4)
Office: 301-895-5934

Mission Statement

The goal of the Critical Care Coordination Center (C4) is to promote a coordinated process for the delivery of critical and pediatric care that ensures:

  1. A system strongly aligned to improve overall quality of critical and pediatric care through quality improvement initiatives to include standardization of patient care and use of technology and data gathering to provide ICU leaders and practitioners with “medical intelligence”;
  2. “Tiering” of hospitals according to the level of critical and pediatric care required;
  3. Facilitation of medical direction and consultation between differently tiered patient acuity centers for critical care, specialty care, and pediatric care; and
  4. Facilitation of other requested assistance related to resource allocation, bed location, communication between referring and accepting facilities, and transport assistance where feasible.


The COVID-19 pandemic caused an unprecedented demand for critical care services. Centralized management of critical care resource allocation was necessary to ensure the overall quality of patient care. A centralized Critical Care Coordination Center (C4) for the state of Maryland is designed to ensure that critically ill patients receive the “Right Care, at the Right Time, at the Right Place.”

The C4 strives to establish a network of resources that allocate scarce healthcare resources--such as protocols, definite procedures, or care pathways—based on geography with the goal of providing higher-value care. The ultimate goal is to improve the quality of care, optimize and ensure timely critical care transport, reduce the length of stay, and reduce overall costs. Staffed at MIEMSS by a fellowship-trained / board-certified critical care physician and nationally registered paramedic or registered nurse coordinator, the desired end state is to create a nationally renowned critical care network that is strongly aligned with efficiency, sustainability, and improved patient outcomes.

C4 Medical Direction

Dr. Tara Roque,
C4 Medical Director

Dr. Jennifer Anders,
C4 Pediatric Medical Director

Assistant C4 Medical Director

Dr. Siddhartha Dante,
Assistant C4 Pediatric Medical Director

Dr. Samuel Galvagno,
C4 Medical Director Emeritus

C4 Administration

Dwayne Kitis,
C4 Manager

Melissa Kelly,
Administrative Unit Leader

Todd Bowman,
Operations Unit Leader

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