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OVERWHELMED: DEVELOPING CRISIS STANDARDS OF CARE FOR CATASTROPHIC EMERGENCIES

When a nation or region prepares for public health emergencies such as a pandemic influenza, an earthquake, or any disaster scenario in which the health system may be stressed to its limits, it is important to describe how standards of care would change due to shortage of critical resources. “Crisis standards of care” is defined as a substantial change in usual health care operations and the level of care it is possible to deliver, which is made necessary by a pervasive (e.g., pandemic influenza) or catastrophic (e.g., earthquake, hurricane) disaster. To ensure that the utmost care possible is provided to patients in a catastrophic event, nations/regions need a robust system to guide the public, health care professionals and institutions, and governmental entities at all levels. Building off a report of the U.S. Institute of Medicine, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations, this session focus on opportunities and challenges to integrate crisis standards of care principles into international disaster response plans.

Learning Objectives:

  • Discuss the challenges of providing fair and equitable care in mass casualty incidents
  • Discuss a potential framework for the equitable delivery of care in situations of scarce resources and strategies for operationalizing crisis standards of care in austere environments


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OCR for page 27
B Agenda OVERWHELMED: DEVELOPING CRISIS STANDARDS OF CARE FOR CATASTROPHIC EMERGENCIES When a nation or region prepares for public health emergencies such as a pandemic influenza, an earthquake, or any disaster scenario in which the health system may be stressed to its limits, it is important to describe how standards of care would change due to shortage of critical resources. “Crisis standards of care” is defined as a substantial change in usual health care operations and the level of care it is possible to deliver, which is made necessary by a pervasive (e.g., pandemic influenza) or catastrophic (e.g., earthquake, hurricane) disaster. To ensure that the utmost care possible is provided to patients in a catastrophic event, nations/regions need a robust system to guide the public, health care professionals and institutions, and governmental entities at all levels. Building off a report of the U.S. Institute of Medicine, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations, this session focus on opportunities and challenges to integrate crisis standards of care principles into international disaster response plans. Learning Objectives:  Discuss the challenges of providing fair and equitable care in mass casualty incidents  Discuss a potential framework for the equitable delivery of care in situations of scarce resources and strategies for operationalizing crisis standards of care in austere environments 27

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28 CRISIS STANDARDS OF CARE: INTERNATIONAL DISASTER PLANS  Examine strategies for integrating crisis standards of care principles into disaster response plans  Highlight the impact of international disaster response on changing the standard of care in the host country 1:45 p.m. Introduction: Session Objectives MARK KEIM, Session Chair Senior Science Advisor Office of the Director National Center for Environmental Health Centers for Disease Control and Prevention (CDC) 1:55 A Model for Equitable Delivery of Care in Situations of Scarce Resources DAN HANFLING Institute of Medicine Committee Vice-Chair Special Advisor Emergency Preparedness and Response Inova Health System 10 min Q&A 2:50 Operationalizing Crisis Standards of Care: The Japanese Experience YOSHIKURA HARAGUCHI Division of Pathophysiology in Disaster (retired) National Hospital Tokyo Disaster Medical Center Tachikawa City, Tokyo, Japan 10 min Q&A 3:15 BREAK

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29 APPENDIX B 4:00 Providing Austere Care in Mass Casualty Incidents: Experiences from Latin America JEAN LUC PONCELET Area Manager in Emergency Preparedness and Disaster Relief for Latin America and the Caribbean Pan American Health Organization/World Health Organization 10 min Q&A 4:25 International Health Regulations Treaty: The Grand Experiment FREDERICK “SKIP” BURKLE Senior Fellow, Harvard Humanitarian Initiative Harvard School of Public Health 10 min Q&A 4:50 Panel Discussion: Integrating Crisis Standards of Care Principles into International Disaster Response Plans  How can principles of crisis standards of care be better integrated into existing health systems?  Examine strategies to facilitate operationalizing crisis standards of care in austere environments.  Explore the roles and responsibilities of various stakeholders in the implementation of crisis standards of care. MARK KEIM, moderator Senior Science Advisor Office of the Director National Center for Environmental Health Centers for Disease Control and Prevention (CDC)

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30 CRISIS STANDARDS OF CARE: INTERNATIONAL DISASTER PLANS DAN HANFLING Institute of Medicine Committee Vice-Chair Special Advisor Emergency Preparedness and Response Inova Health System, USA YOSHIKURA HARAGUCHI Department of Surgery (retired) National Hospital Organization Disaster Medical Center, Tokyo, Japan JEAN LUC PONCELET Area Manager in Emergency Preparedness and Disaster Relief for Latin America and the Caribbean Pan American Health Organization/World Health Organization FREDERICK “SKIP” BURKLE Senior Fellow, Harvard Humanitarian Initiative Harvard School of Public Health 5:30 ADJOURN