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Crisis Standards of Care: Summary of a Workshop Series (2010)

Chapter: Appendix C: Workshop Agendas

« Previous: Appendix B: Summary of *Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report*
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

C
Workshop Agendas1

Irvine Workshop

March 12, 2009

The Beckman Center

Irvine, CA


Orlando Workshop

April 14, 2009

Disney’s Coronado Springs Resort

Lake Buena Vista, FL


New York Workshop

April 27, 2009

Albert Einstein College of Medicine

Bronx, NY


Chicago Workshop

May 8, 2009

American Medical Association

Chicago, IL

1

To save space, the individual agendas from each regional meeting have been compiled into a single document. Under each session speakers have been identified based on each meeting location at which they participated: Irvine, Orlando, New York, and/or Chicago.

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

Workshop Objectives:

  • Illuminate the progress and successes of efforts underway to establish local, state, and regional standards of care protocols.

    • What have been some of the barriers in establishing protocols?

    • What solutions have been developed to operationalize standards of care protocols?

  • Improve regional efforts by facilitating a dialogue and coordination among neighboring jurisdictions.

  • Discuss the roles and responsibilities of each stakeholder community in the development and implementation of standards of care protocols, including officials from state and local health departments and providers.

  • Examine what resources, guidelines, and expertise have been used to establish standards of care protocols, including legal and ethical expertise that has been used to establish standards of care protocols.

  • Identify and discuss resource requirements that will be necessary from federal, state, and regional authorities to advance and accelerate the establishment of standards of care protocols.

Welcoming Remarks

New York

DEAN ALLEN SPIEGEL, Albert Einstein College of Medicine of Yeshiva University

Chicago

JAMES J. JAMES, American Medical Association

Welcome, Introductions, and Workshop Objectives

Irvine, Orlando, New York, Chicago

SALLY PHILLIPS, Agency for Healthcare Research and Quality, Workshop Chair

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

SESSION I:
OVERVIEW AND CURRENT NATIONAL EFFORTS

Session Objective: Provide an overview of current efforts under way nationally to assist state and local leaders in establishing standards of care protocols.

Standards of Care During a Mass Casualty Event—Federal Guidance

Irvine, Orlando, New York, Chicago

SALLY PHILLIPS, Agency for Healthcare Research and Quality, Workshop Chair

Surge Capacity Continuum: Conventional, Contingency, and Crisis

Irvine, Chicago

JOHN HICK, Hennepin County Medical Center, MN


Orlando, New York

DAN HANFLING, Inova Health System

Altered Standards of Care Continuum: Conventional, Contingency, and Crisis

Irvine, Orlando, New York, Chicago

DAN HANFLING, Inova Health System

Framing Legal and Ethical Considerations

Irvine

CHERYL STARLING, California Department of Public Health


Orlando, New York, Chicago

TIA POWELL, Montefiore-Einstein Center for Bioethics

Discussion with Attendees

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

SESSION II:
LOCAL AND STATE STANDARDS OF CARE PROTOCOLS

Session Objective: An interactive discussion with local, state, and regional officials about efforts to establish standards of care. Discuss implementation strategies and how these protocols were advanced to become operational entities in their respective communities. What are the current opportunities and barriers to facilitating improved implementation of protocols?

Session Objectives and Background

Irvine, Chicago

JOHN HICK, Hennepin County Medical Center, MN, Session Chair


Orlando, New York

DAN HANFLING, Inova Health System, Session Chair

Panel Discussion with State and Local Leaders

Irvine

KAY FRUHWIRTH, Los Angeles County Emergency Medical Services Agency

KRISTI KOENIG, University of California–Irvine

PAUL PATRICK, State of Utah Department of Health

SUSAN ALLAN, University of Washington School of Public Health

CHRISTINE DENT, Saint Alphonsus Regional Medical Center, ID


Orlando

JOHN ROBINSON, Baptist Memorial Hospital–North Mississippi

ROY ALSON, North Carolina Office of Emergency Medical Services

ROBERT HOOD, Florida Department of Health

KENN BEEMAN, Mississippi State Department of Health


New York

TIA POWELL, Montefiore-Einstein Center for Bioethics

DONNA LEVIN, Massachusetts Department of Public Health

LISA KAPLOWITZ, Alexandria Health Department, Virginia

RICK HONG, Delaware Division of Public Health

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

Chicago

JANET ARCHER, Indiana State Department of Health

DAVID FLEMING, University of Missouri School of Medicine

KERRY KERNEN, Summit County Health District, OH

KEN BERKOWITZ, Veterans Health Administration National Center for Ethics in Health Care

Response Panel

Irvine

STEPHEN CANTRILL, Denver Health Medical Center

JEFFREY DUCHIN, Public Health, Seattle and King County

CHERYL STARLING, California Department of Public Health


Orlando

STEPHEN CANTRILL, Denver Health Medical Center

RADM ANN KNEBEL, Office of the Assistant Secretary for

Preparedness and Response, U.S. Department of Health and Human Services

JACK HERRMANN, National Association of County and City Health Officials


New York

STEPHEN CANTRILL, Denver Health Medical Center

CHERYL PETERSON, American Nurses Association


Chicago

STEPHEN CANTRILL, Denver Health Medical Center

CHERYL PETERSON, American Nurses Association

TIA POWELL, Montefiore-Einstein Center for Bioethics

Discussion with Attendees

  • What resources, guidelines, and expertise have been used to establish standards of care protocols?

  • What are the current opportunities and barriers to creating stronger partnerships and how can these issues be addressed?

  • What strategies have been used to help integrate these protocols into practice?

  • What are the current opportunities and barriers to facilitating improved implementation of protocols?

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

SESSION III:
PROVIDER COMMUNITIES

Session Objective: Discuss the roles and responsibilities of the key provider communities in the development and implementation of standards of care protocols. Identify and discuss solutions related to implementing protocols into practice.

Session Objectives and Background

Irvine, Orlando, New York, Chicago

STEPHEN CANTRILL, Denver Health Medical Center, Session Chair

Panel Discussion with Stakeholder Leaders

Irvine

SUE HOYT, St. Mary Medical Center, Long Beach, CA

DEBRA WYNKOOP, Utah Hospitals and Health Systems Association

ASHA DEVEREAUX, Sharp Coronado Hospital, CA

KEVIN MCCULLEY, Association for Utah Community Health


Orlando

J. PATRICK O’NEAL, Georgia Department of Human Resources

KNOX ANDRESS, Louisiana Poison Center

SHAWN ROGERS, Oklahoma State Department of Health

LORI UPTON, Texas Children’s Hospital

MARY FALLAT, University of Louisville, KY


New York

VALERIE SELLERS, New Jersey Hospital Association

BRIAN CURRIE, Montefiore Medical Center

CATHERINE RUHL, Association of Women’s Health, Obstetric and Neonatal Nurses

GEORGE FOLTIN, New York University School of Medicine/Bellevue Hospital


Chicago

MICHAEL ROBBINS, Chicago Department of Public Health

LESLEE STEIN-SPENCER, National Association of State EMS Officials

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

MARIANNE LORINI, Akron Regional Hospital Association

CONNIE J. BOATRIGHT, Managed Emergency Surge for Healthcare (MESH), IN

Response Panel

Irvine

EDWARD GABRIEL, The Walt Disney Company

KATHRYN BRINSFIELD, Office of Health Affairs, Department of Homeland Security

MARGARET MCMAHON, Emergency Nurses Association


Orlando

EDWARD GABRIEL, The Walt Disney Company

KATHRYN BRINSFIELD, Office of Health Affairs, Department of Homeland Security

MARGARET MCMAHON, Emergency Nurses Association

CHERYL PETERSON, American Nurses Association


New York

JACK HERRMANN, National Association of County and City Health Officials

MARGARET MCMAHON, Emergency Nurses Association

CHERYL PETERSON, American Nurses Association


Chicago

JAMES J. JAMES, American Medical Association

MARGARET MCMAHON, Emergency Nurses Association

CHERYL PETERSON, American Nurses Association

Discussion with Attendees

  • What concerns do provider communities have in implementing policies into practice?

  • How do protocols get implemented operationally?

    • Who is responsible for implementing plans during events?

    • What are the triggers?

  • What action steps are required to improve involvement of the provider community in the development of standards of care protocols?

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

SESSION IV:
INTERSTATE AND NEIGHBORING COMMUNITY COOPERATION AND COORDINATION

Session Objective: Discuss what cooperation and coordination will be required between neighboring states and communities in preparation and when implementing standards of care protocols. Discuss the roles of specific stakeholders. Identify what resources will be required and how those may be shared. Explore the current opportunities and barriers to facilitating improved cooperation and coordination and how these may be overcome.

Session Objectives and Background

Irvine

CHERYL STARLING, California Department of Public Health, Session Chair


Orlando

EDWARD GABRIEL, The Walt Disney Company, Session Chair


New York

JACK HERRMANN, National Association of County and City Health Officials, Session Chair


Chicago

SALLY PHILLIPS, Agency for Healthcare Research and Quality, Session Chair

Panel Discussion with State and Local Leaders

Irvine

NANCY AUER, Swedish Medical Center, WA

MARK GOLDSTEIN, Memorial Health System, CO

JEFFREY RUBIN, California Emergency Medical Services Authority


Orlando

TERRY SCHENK, Florida Department of Health

ROBERT BALL, South Carolina Department of Health and Environmental Control

RAYMOND PEPE, Uniform Law Commission

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

New York

STEVEN GRAVELY, Troutman Sanders LLP

JAMES HODGE, Johns Hopkins University

FLOYD RUSSELL, West Virginia University

JAMES GEILING, White River Junction Veterans Administration Medical Center

Chicago

TIM WIEDRICH, North Dakota Department of Health

WILLIAM FALES, Michigan State University–Kalamazoo Center for Medical Studies

PAULA NICKELSON, Department of Health and Senior Services, MO

TIMOTHY CONLEY, Western Springs Fire Department and Emergency Medical Services, IL

Response Panel

Irvine

DAN HANFLING, Inova Health System

SHAWN FULTZ, Department of Veterans Affairs

LTC(P) WAYNE HACHEY, Department of Defense

CAPT DEBORAH LEVY, Centers for Disease Control and Prevention


Orlando

DAN HANFLING, Inova Health System

SHAWN FULTZ, Department of Veterans Affairs

LTC(P) WAYNE HACHEY, Department of Defense

CAPT DEBORAH LEVY, Centers for Disease Control and Prevention

JAMES BLUMENSTOCK, Association of State and Territorial Health Officials

New York

DAN HANFLING, Inova Health System

RICHARD CALLIS, Department of Veterans Affairs


Chicago

DAN HANFLING, Inova Health System

DARLENE WEISMAN, Department of Veterans Affairs

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×

Discussion with Attendees

  • What cooperation will be needed between states and neighboring communities?

  • What are the roles of providers and other stakeholders in ensuring cooperation and coordination?

  • How can resources best be shared during an event and what plans and agreements need to be in place?

  • What strategies can be used to improve coordination and cooperation among neighboring jurisdictions?

SESSION V:
GENERAL DISCUSSION WITH WORKSHOP PARTICIPANTS AND ATTENDEES

Session Objective: Discuss what opportunities and constraints exist to implementing standards of care at local, state, and regional jurisdictions. Review opportunities and challenges identified during the workshop. Identify and discuss the most promising near-term opportunities for improving standards of care protocols at local, state, and regional jurisdictions. Discuss common threads that emerged among each of the regional workshops.

Synopsis of Today’s Discussions: Common Threads

SALLY PHILLIPS, Agency for Healthcare Research and Quality, Workshop Chair

Discussion with Attendees

  • What new ideas have surfaced in this meeting today that should be explored further?

  • What specific challenges arise in the development of standards of care protocols?

  • What action steps are required to integrate these strategies into the current public health system?

  • What resources and further infrastructure investments will be necessary in the short- and long-term?

Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 95
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 96
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 97
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 98
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 99
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 100
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 101
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 102
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 103
Suggested Citation:"Appendix C: Workshop Agendas." Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12787.
×
Page 104
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During a wide-reaching catastrophic public health emergency or disaster, existing surge capacity plans may not be sufficient to enable health care providers to continue to adhere to normal treatment procedures and follow usual standards of care. This is a particular concern for emergencies that may severely strain resources across a large geographic area, such as a pandemic influenza or the detonation of a nuclear device. Under these circumstances, it may be impossible to provide care according to the standards of care used in non-disaster situations, and, under the most extreme circumstances, it may not even be possible to provide basic life sustaining interventions to all patients who need them.

Although recent efforts to address these concerns have accomplished a tremendous amount in just a few years, a great deal remains to be done in even the most advanced plan. This workshop summary highlights the extensive work that is already occurring across the nation. Specifically, the book draws attention to existing federal, state, and local policies and protocols for crisis standards of care; discusses current barriers to increased provider and community engagement; relays examples of existing interstate collaborations; and presents workshop participants' ideas, comments, concerns, and potential solutions to some of the most difficult challenges.

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