Public health emergencies, natural disasters, and mass casualty events require hospitals to implement triage protocols to prioritize care based on patient severity and treatment likelihood. Hospitals must strive for equitable access, particularly for vulnerable populations, while addressing the ethical implications of resource allocation.
2020 Virtual Disaster Conference
This presentation reviews how hospitals can develop and implement guidelines for continuing care when resources become critically constrained. The session provides information for hospitals on the process of shifting from conventional to contingency and ultimately to crisis care, where the focus transitions from individual patient care to managing care for the broader population. Highlights of the session include the ethical and non-discriminatory decision-making processes that help prepare hospitals for adapting their operations.
2021 Virtual Disaster Conference
Presented by UC Davis Health, this session offers a unique perspective to Crisis Standards of Care, offering strategies for operating with scarce resources in disaster events. Learn how this system convened a group of physicians, bio-ethicists, communications specialists, and disaster planners to work through this incredibly arduous topic.
Adapting Care under Extreme Conditions In 2006 the American Nurses Association (ANA) embarked on a new effort to engage the nursing profession in the policy development process on a timely policy issue impacting their profession. The resulting policy document addresses topics relevant to health professionals who provide care during extreme emergencies and with scarce resources.
When the demand for healthcare services surpasses available resources, hospitals face challenging decisions. Effective resource allocation requires assessing the urgency and necessity of treatments, and hospitals may establish frameworks to prioritize patients based on factors such as the severity of their condition, the likelihood of treatment benefit, and overall public health outcomes.
Earlier this week, the California Department of Public Health (CDPH) announced it would delay adopting emergency regulations for acute psychiatric hospital staffing until June 1, rather than its original deadline of Jan. 31.
2024 Disaster Conference
This presentation shares experiences leading successful teams and averting crisis, and explores techniques that can be used to help even the most novice leader rise to meet the challenge in front of them and bring their teams along with them.
The pandemic has revealed weaknesses in the health care system and how we deliver care. The Emergency Department is often on the front line when making difficult decisions regarding care when resources become scarce. It is important to address this with education on crisis standards of care as well as scrutiny of existing models. This includes challenging how they are best designed to meet our current needs, where there might be crucial gaps in the assessment of need and delivery of care, and when they must be implemented.
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Has the state of California released any guidance for hospitals on crisis standards of care?
In June, the California Department of Public Health (CDPH) issued its California SARS-CoV-2 Pandemic Crisis Care Guidelines: Concept of Operations/Health Care Facility Surge Operations and Crisis Care, providing a framework to help health care facilities plan for an overwhelming medical surge due to the pandemic. The guidelines include an overview of surge capacity and crisis care operational considerations, as well as a decision-making framework for allocating ventilators and pandemic patient care strategies for scarce resource situations.
Importantly, while the Guidelines provide information to support individual health care facilities or health system operations, CDPH makes clear that the Guidelines do not replace the judgment of operational management, medical directors, legal advisors, or clinical staff or consideration of other relevant variables and options. To assist hospitals as the winter surge continues to grow, CHA has prepared several resources that highlight the guidelines’ key concepts and planning considerations for allocating scarce medical resources during surge operations. These include:
CHA recommends that when hospitals implement the crisis care guidelines they notify the local CDPH district office as a way of communicating the change in operations at the hospital.
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The latest report from national health care management consulting firm Kaufman Hall shows that one in five California hospitals — dozens throughout the state — is at risk of closure. That means health care services for millions of Californians are at risk.