Weekly tip: Implementing crisis standards of care during a community disaster

Hospital Safety Insider, June 28, 2012

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In 2009, in the midst of the H1N1 pandemic, the Institute of Medicine (IOM) convened a panel of experts to define and outline crisis standards of care, which would become a resource for healthcare facilities and local governments in times of dire need, when resources were at a bare minimum. Experts worried a second wave of H1N1 would overload the healthcare system countrywide.

This didn't happen, but five months later an earthquake struck Haiti, demonstrating the truly devastating effects of a large-scale disaster.

The disaster reinforced the importance of communities establishing preplanned crisis standards of care. In March, IOM issued a follow-up report, Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response, which built upon the same issues set forth in the 2009 report but with more focus on implementation and planning, says Dan Hanfling, MD, special advisor for emergency preparedness and response and clinical professor in the Department of Emergency Medicine at the Inova Health System in Fairfax, Va., and a member of the IOM committee.

"This current report essentially picked up where the first report left off," Hanfling says. "As a committee, we revisited and re-endorsed our initial recommendations, but in this report we had the time to get into many more specifics related to the implementation of crisis standards of care-with new attention focused specifically on EMS efforts."

The new report includes templates for implementing crisis standards of care within your hospital, as well as with partners at the state and local level. It also provides specific guidelines and recommendations for healthcare facilities in terms of planning for extreme situations with limited resources, and how to make the best decisions based on ethical, legal, and community factors.

This tip was excerpted from the July issue of Briefings on Hospital Safety.


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