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Project Information

Project Information


Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: A Workshop Series


Project Scope:

A planning committee of the National Academies of Sciences, Engineering, and Medicine will organize and conduct a series of public workshops on the topic of Crisis Standards of Care (CSC) during public health emergencies, including lessons learned from the COVID-19 pandemic. 

The COVID-19 pandemic overwhelmed the U.S. medical care system and supporting supply chains for medications and materials, which led to the widespread consideration of crisis standards of care (CSC) planning and selected implementation of key elements of the CSC framework in communities across the nation. The workshop series will consist of five sessions beginning with an overarching, introductory session that will explore  the re-examination of definitions and recommendations first outlined in IOM’s 2009 “Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report”. Subsequent workshops will examine the systems framework articulated in IOM’s 2012 report “Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response”, with a particular attention on: 

* Planning and Implementation Considerations:

  • Examining the role of key stakeholders groups, such as state governments, state and local health department, hospitals and healthcare systems, and others stakeholders at the federal, state, local, tribal, and territorial levels, in the implementation and communication of CSC.
  • Exploring the types of data required to inform CSC triggers, the sources of such data, and the plans for creating the needed infrastructure to allow for better situational awareness, including, for example, disease reporting, surveillance data, hospital transfer data sharing, and how to leverage EHR for the development of more effective clinical processes and operations.   
  • Understanding how jurisdictions may have changed their attitudes and beliefs about CSC planning as a result of COVID-19.
  • Understanding how the public’s attitudes and beliefs about CSC have changed as a result of COVID-19.
*Legal, Regulatory, and Equity Considerations:
  • Exploring concerns surrounding emergency declarations, invocation, duties to care, inter-jurisdictional challenges, discrimination, licensure/scope of practice, risks of liability, documentation, and mitigation.
  • Discussing ethics, palliative care, mental health and other cross-cutting themes

*Staffing Considerations:
  • Exploring the challenges and strategic opportunities for operational considerations and staffing needs during the implementation of CSC : Defining the roles and responsibilities of these stakeholder ; Describing operational considerations associated with their development and implementation of CSC plans ; Examining critical care triage teams, their role, protocols and tools, specifically pertaining to prognostics systems ; Providing brief descriptions of templates that outline the specific functions and tasks for each stakeholder when allocating scarce resources in response to a disaster. 
  • Reviewing staff responsibilities adjustments, capabilities for Just In Time (JIT) training, provision of “hazard pay”, adequate time off, child care and other benefits to staff, and leveraging health care coalitions to ensure appropriate transfer of patients between hospitals. 
The series will conclude with a workshop discussing a path forward to effectively leverage identified opportunities and future CSC improvements. 

The planning committee will define the specific topics to be addressed, develop the agendas, and select and invite speakers and other participants. After the workshop series, a single proceedings will be prepared by a designated rapporteur in accordance with institutional guidelines and shall be released to the public. 



Status: Current

PIN: HMD-HSP-21-05

RSO: Wollek, Scott

Board(s)/Committee(s):

Board on Health Sciences Policy

Topic(s):

Health and Medicine


Parent Project(s): N/A


Child Project(s): N/A



Geographic Focus:

Committee Membership



Committee Membership

No data present.


Events


Event Type :  
-

Description :   

Webinar 5: Evolving CSC – Looking Forward

COVID-19 has fundamentally challenged the delivery of health care services worldwide, forcing difficult choices on health professionals and laying bare many preexisting health, medical, and public health sector frailties. This National Academies workshop series will re-explore previous IOM Crisis Standards of Care recommendations in light of ongoing lessons from the COVID-19 pandemic, with a particular focus on disaster planning, legal and equity considerations, and staffing considerations.

In this fifth and final virtual workshop of the series, expert panelists will specifically:

  • Reflect on the challenges and opportunities presented in webinars 2-4
  • Articulate potential opportunities to enhance the CSC framework and improve guidance for planning, activation, implementation, and evaluation/monitoring
  • Suggest focus areas for a potential research agenda related to CSC planning, activation, implementation, and evaluation/monitoring

Confirmed speakers

  • Eric Toner, MD, Senior Scholar, Senior Scientist, Center for Health Security, Johns Hopkins University
  • Asha Devereaux, MD, MPH, Pulmonary Physician, ACCP Task Force for Mass Critical Care, CAL-MAT, Sr. Medical Officer, Sharp Coronado Hospital
  • Tener Goodwin Veenema, PhD, MPH, MS, RN, FAAN, Contributing Scholar and Professor of Nursing Johns Hopkins Center for Health Security Johns Hopkins Bloomberg School of Public Health
  • Mike Wargo, RN, BSN, MBA, PHRN, CMTE, VP & Chief, Enterprise Preparedness & Emergency Operations, HCA Healthcare
  • Anuj Mehta, MD Assistant Professor of Medicine, Denver Health and Hospital Authority, University of Colorado, National Jewish Health
  • Erin Serino, JD, Deputy Chief of Staff, Boston Emergency Medical Services
  • Shandiin Wood, MPH, Health Systems Epidemiologist & Tribal Liaison, New Mexico Department of Health
  • Monica Peek, MD,  Professor of Medicine, University of Chicago
  • Matt Wynia, MD, MPH,  FACP, Director, Center for Bioethics and Humanities, University of Colorado
  • Jennifer Piatt, JD, Deputy Director , Network for Public Health Law’s Western Region Office
  • Gregg S. Meyer, MD, MSc, President of the Community Division & Executive Vice President of Value Based Care, Mass General Brigham
  • Suzet McKinney, DrPH, MPH, Principle & Director, Life Sciences
  • Dan Hanfling, MD, Vice President, Technical Staff, In-Q-Tel
  • David Christian Hassell, PhD, Senior Science Advisor, Deputy Assistant Secretary for Preparedness and Response, Office of the Assistant Secretary for Preparedness and Response, US/HHS
  • Richard Hunt, MD, Senior Medical Advisor, National Health Care Preparedness Programs, Office of the Assistant Secretary for Preparedness and Response, US/HHS


Registration for in Person Attendance :   
N/A


If you would like to attend the sessions of this event that are open to the public or need more information please contact

Contact Name:  Michael Berrios
Contact Email:  mberrios@nas.edu
Contact Phone:  (202) 334-3088

Agenda
-
Supporting File(s)
-
Is it a Closed Session Event?
No

Publication(s) resulting from the event:

-

Event Type :  
Webinar

Description :   

Webinar 4: Evolving CSC: Legal, Ethical & Equity Considerations

COVID-19 has fundamentally challenged the delivery of health care services worldwide, forcing difficult choices on health professionals and laying bare many preexisting health, medical, and public health sector frailties. This National Academies workshop series will re-explore previous IOM Crisis Standards of Care (CSC) recommendations in light of ongoing lessons from the COVID-19 pandemic, with a particular focus on disaster planning, legal and equity considerations, and staffing considerations.

In the fourth virtual workshop of the series, expert panelists will specifically:

  • Explore the legal, ethical and equity challenges and concerns related to planning, activation,  implementation, and evaluation & monitoring of CSC
  • Discuss the current and potential strategies used by key stakeholders to address these challenges and concerns

Focused discussion panels may include:

  • Legal challenges and opportunities pertaining to liability protections
  • Incorporation of ethical and equity considerations in the allocations of scarce resources

Confirmed speakers

  • Eric Toner, MD, Senior Scholar, Senior Scientist, Center for Health Security, Johns Hopkins University
  • Monica Peek, MD, MPH, MS, Associate Professor of Medicine, Director of Research, MacLean Center of Clinical Medical Ethics, the University of Chicago
  • Jennifer Piatt, JD, Deputy Director  Network for Public Health Law’s Western Region Office
  • James Hodge, JD, LLM, Peter Kiewit Foundation Professor of Law, Sandra Day O'Connor College of Law; and Director, Center for Public Health Law and Policy, Arizona State University
  • Robert Onders, MD, JD, Alaska Native Medical Center Administrator, Alaska Native Tribal Health Consortium
  • Valerie Gutmann Koch, JD, co-director of the Health Law & Policy Institute, Houston Law Center; and Director of Law & Ethics at the University of Chicago MacLean Center for Clinical Medical Ethics
  • Doug White, MD, MAS, Vice Chair and Professor of Critical Care Medicine, UPMC Endowed Chair for Ethics in Critical Care Medicine, Director, Program on Ethics and Decision Making in Critical Illness, University of Pittsburgh School of Medicine
  • Nneka Sederstrom PhD, MPH, MA, FCCP, FCCM, Chief Health Equity Officer, Hennepin Healthcare
  • Virginia A. Brown PhD, MA, Assistant Professor, Department of Population Health, Dell Medical School, The University of Texas at Austin
  • Thomas Sequist, MD, MPH, Chief Patient Experience and Equity Officer at Mass General Brigham
  • Govind Persad, JD, PhD, Assistant Professor, Sturm College of Law
  • Cynda Rushton, PhD, MSN, RN, FAAN, professor and chair, Johns Hopkins School of Nursing

Additional speaker confirmations coming soon.



Registration for in Person Attendance :   
N/A


If you would like to attend the sessions of this event that are open to the public or need more information please contact

Contact Name:  Michael Berrios
Contact Email:  mberrios@nas.edu
Contact Phone:  (202) 334-3088

Agenda
-
Supporting File(s)
-
Is it a Closed Session Event?
No

Publication(s) resulting from the event:

-

Event Type :  
-

Description :   

COVID-19 has fundamentally challenged the delivery of health care services worldwide, forcing difficult choices on health professionals and laying bare many preexisting health, medical, and public health sector frailties. This National Academies workshop series will re-explore previous IOM Crisis Standards of Care (CSC) recommendations in light of ongoing lessons from the COVID-19 pandemic, with a particular focus on disaster planning, legal and equity considerations, and staffing considerations.

In the third virtual workshop of the series, focused on planning and implementation considerations, expert panelists will specifically:

  • Describe the roles of key stakeholders (e.g., STLT governments, hospitals and healthcare systems, and other stakeholders at the FSTLT levels) in the development/planning, declaration/activation, implementation, and evaluation/monitoring of  CSC
  • Explore the impact of COVID-19 on (1) healthcare and public health stakeholder and (2) the general public’s attitudes and beliefs on CSC development/planning, declaration/activation, implementation, and evaluation/monitoring
  • Discuss and analyze the challenges to and current/potential strategies for developing the data, infrastructure, and protocol needed to maintain situational awareness and drive decision-making related to CSC  development/planning, declaration/activation, implementation, and evaluation/monitoring

Speakers include:

  • Eric Toner, MD, Senior Scholar, Senior Scientist, Center for Health Security, Johns Hopkins University
  • Anuj Mehta, MD Assistant Professor of Medicine, Denver Health and Hospital Authority, University of Colorado, National Jewish Health
  • Erin Serino, JD, Deputy Chief of Staff, Boston Emergency Medical Services
  • Shandiin Wood, MPH, Health Systems Epidemiologist & Tribal Liaison, New Mexico Department of Health
  • Megan Jehn, PhD, MHS, Associate Professor, Arizona State University
  • Gina Febbraro, MPH, Principle Consultant for the Colorado Department of Public Health and Environment, Community Engagement Lead for Colorado’s Crisis Standards of Care
  • Erin Talati Paquette, MD, JD, MBe, Assistant Professor, Pediatrics (critical care), and School of Law, Northwestern University
  • Brian Garibaldi, MD, Associate Professor of Medicine, Johns Hopkins Biocontainment Unit
  • Elizabeth Lee Daugherty, MD, MPH, Chief Wellness Officer, Associate Professor of Medicine, Johns Hopkins Medicine
  • Will Stone, Science reporter, NPR
  • More speakers to be announced soon.


Registration for in Person Attendance :   
N/A


If you would like to attend the sessions of this event that are open to the public or need more information please contact

Contact Name:  Michael Berrios
Contact Email:  mberrios@nas.edu
Contact Phone:  (202) 334-3088

Agenda
-
Supporting File(s)
-
Is it a Closed Session Event?
No

Publication(s) resulting from the event:

-

Event Type :  
Webinar

Description :   

COVID-19 has fundamentally challenged the delivery of health care services worldwide, forcing difficult choices on health professionals and laying bare many preexisting health, medical, and public health sector frailties. In the second virtual workshop, “Evolving CSC: Staffing Considerations, Workforce Impacts, and Future Trends”, expert panelists will specifically aim to:

  • Define key stakeholders’ staffing needs during planning, activation, implementation, and evaluation/monitoring of CSC
  • Discuss the operational/staffing/moral considerations and challenges faced by key stakeholders during the activation and implementation of CSC and their overall impact of the workforce
  • Explore the current and/or potential strategies used by key stakeholders to address these operational & staffing challenges

Confirmed speakers include:

  • Eric Toner, MD, Senior Scholar with the Johns Hopkins Center for Health Security and a Senior Scientist in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health [moderator]
  • Tener Goodwin Veenema, PhD, MPH, MS, RN, FAAN,  Contributing Scholar at the Johns Hopkins Center for Health Security & Professor of Nursing and Public Health in the Department of International Health, Johns Hopkins Bloomberg School of Public Health.
  • Ryan Maves, MD, Professor, Infectious Diseases, Wake Forest School of Medicine
  • Asha Devereaux, MD, MPH, Pulmonary Physician, ACCP Task Force for Mass Critical Care, CAL-MAT, Sr. Medical Officer, Sharp Coronado Hospital
  • Jeanette Ives Erickson, RN, DNP, NEA-BC, FAAN, Chief Nurse Emerita, Massachusetts General Hospital, Instructor at Harvard Medical School, and Professor at MGH Institute of Health Professions
  • Andrew Garrett, MD, MPH, NRP, FAEMS, FAAP, Associate Professor & Program Director/Medical Director for Emergency Health Operations, George Washington University; Senior Advisor, Office of Emergency Management and Medical Operation, Office of the Assistant Secretary of Preparedness and Response, Department of Health & Human Services
  • Gamunu Wijetunge, MPP, NREMT-P, Emergency Medical Services Specialist, Office of EMS, NHTSA
  • Cynda Hylton Rushton, PhD, RN, FAAN, Anne and George L. Bunting Professor of Clinical Ethics, Berman Institute of Bioethics, School of Nursing at Johns Hopkins University
  • Lisa Rowen, DNSc, RN, CENP, FAAN, the Senior Vice President for Patient Care Services & Chief Nursing Officer (CNO) at the University of Maryland Medical Center
  • Howard Backer, MD, MPH, Medical Director, California Medical Assistance Teams, California EMSA
  • Alistair Erksine, MD, MBA, Chief Digital Health Officer, Mass General Brigham
  • Mike Wargo, RN, BSN, MBA, PHRN, CMTE, VP & Chief, Enterprise Preparedness & Emergency Operations, HCA Healthcare
  • Gregg Meyers, MD, MSc, President of the Community Division & Executive Vice President of Value Based Care, Mass General Brigham
  • Other speaker confirmations coming soon

A recording of the webinar will be posted to this site a week after it is aired. For more information on this webinar series, please visit the sereis web page.



Registration for in Person Attendance :   
N/A


If you would like to attend the sessions of this event that are open to the public or need more information please contact

Contact Name:  Michael Berrios
Contact Email:  mberrios@nas.edu
Contact Phone:  (202) 334-3088

Agenda
-
Supporting File(s)
-
Is it a Closed Session Event?
No

Publication(s) resulting from the event:

-

Event Type :  
Webinar

Description :   

COVID-19 has fundamentally challenged the delivery of health care services worldwide, forcing difficult choices on health professionals and laying bare many preexisting health, medical, and public health sector frailties. This National Academies workshop series will re-explore previous IOM Crisis Standards of Care recommendations in light of ongoing lessons from the COVID-19 pandemic, with a particular focus on disaster planning, legal and equity considerations, and staffing considerations.

 

In the first virtual workshop of the series, expert panelists will specifically:

  • Re-examine the definitions and recommendations first outlined in IOM’s 2009 “Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report”
  • Re-explore the framework described in IOM’s 2012 report “Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response”
  • Reflect on pre-COVID-19 “lessons learned”, and discuss which have been confirmed and/or refuted by the ongoing COVID-19 crisis.
  • Reflect on the strengths and weaknesses of the CSC framework and activation/implementation guidance in light of our current experiences and challenges with COVID-19.

Confirmed speakers include:

  • Monica Peek, MD, MPH, Professor of Medicine, University of Chicago Medicine
  • Jennifer Piatt, Deputy Director with the Network for Public Health Law’s Western Region Office
  • Mike Wargo, VP for Preparedness & Emergency Operations, HCA Healthcare’s enterprise
  • Anuj Mehta MD, MD, Assistant Professor, University of Colorado
  • Dan Hanfling, MD, Vice President, Technical Staff, In-Q-Tel
  • Craig Vanderwagen, MD, Rear Admiral USPHS - retired, founding Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services, and Founder and General Manager of East West Protection, LLC


Registration for in Person Attendance :   
N/A


If you would like to attend the sessions of this event that are open to the public or need more information please contact

Contact Name:  Michael Berrios
Contact Email:  mberrios@nas.edu
Contact Phone:  (202) 334-3088

Agenda
-
Supporting File(s)
-
Is it a Closed Session Event?
No

Publication(s) resulting from the event:

-

Publications

Publications

No data present.