Crisis Standards of Care (CSC) inform decisions on medical care during a large-scale crisis such as a pandemic or natural disaster, eliminating the need to make these decisions at the bedside without protections or guidance. Numerous points throughout the COVID-19 pandemic have demonstrated the necessity of this type of crisis planning. The National Academies of Sciences, Engineering, and Medicine Forum on Medical and Public Health Preparedness for Disasters and Emergencies convened a series of public workshops to examine the experiences of healthcare providers during the COVID-19 pandemic and identify lessons that can inform current and future CSC planning and implementation. The workshops examined staffing and workforce needs, planning and implementation of CSC plans, and legal, ethical, and equity considerations of CSC planning. Topics of discussion included improving coordination between the bedside and boardroom, increasing buy-in from elected officials, expanding provider engagement, and addressing health equity issues. This publication summarizes the presentation and discussion of the workshops.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• PLANNING COMMITTEE ON EVOLVING CRISIS STANDARDS OF CARE AND LESSONS LEARNED
• Reviewers
• Abbreviations and Acronyms
• 1. Introduction
  • ORGANIZATION OF THE WORKSHOP
  • ORGANIZATION OF THE PROCEEDINGS
• 2. Reflections, Inflections, and the Future
  • THE FIRST 10 YEARS OF CRISIS STANDARDS OF CARE
  • THREE SCENARIOS OF CRISIS STANDARDS OF CARE
  • LOOKING BACK AT FIRSTHAND EXPERIENCES AND LESSONS LEARNED
• 3. Considerations for Staffing, Effects on the Workforce, and Future Trends
  • EFFECTS OF COVID-19 ON THE WORKFORCE
  • PROMISING STAFFING STRATEGIES AND FUTURE DIRECTIONS
  • REFLECTIONS ON THE NURSING CRISIS AND FUTURE DIRECTIONS
• 4. Crisis Standards of Care: From Plans to Reality
  • SETTING THE STAGE
  • IMPLEMENTATION CASE STORIES
  • EXPLORING CHALLENGES IN CRISIS STANDARDS OF CARE
  • REFLECTIONS
• 5. Legal, Ethical, and Equity Considerations for Crisis Standards of Care
  • LIABILITY PROTECTIONS: ISSUES AROUND MAKING TRIAGE DECISIONS
  • EQUITY AND THE ALLOCATION OF SCARCE RESOURCES
  • REFLECTIONS
• 6. Looking Forward
  • KEYNOTE PRESENTATIONS
  • REFLECTIONS ON CHALLENGES AND OPPORTUNITIES
  • LOOKING TO THE FUTURE
• REFERENCES
• Appendix A. Workshop Agendas
• Appendix B. Speaker Biosketches

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2022. Evolving crisis standards of care and ongoing lessons from COVID-19: Proceedings of a workshop series. Washington, DC: The National Academies Press. https://doi.org/10.17226/26573.

Digital Object Identifier: https://doi.org/10.17226/26573

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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