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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
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CRISIS STANDARDS OF CARE

Ten Years of Successes and Challenges

PROCEEDINGS OF A WORKSHOP

Megan Snair, Aurelia Attal-Juncqua, and Scott Wollek, Rapporteurs

Forum on Medical and Public Health Preparedness for Disasters and
Emergencies

Board on Health Sciences Policy

Health and Medicine Division

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
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This activity was supported jointly by contracts between the National Academy of Sciences and the Administration for Children and Families (HHSP233201400020B/HHSP23337065), the Assistant Secretary for Preparedness and Response (HHSO100201850012A), the Centers for Disease Control and Prevention (200-2011-38807/75D30119F00077), the Food and Drug Administration (75F40120P00067), and the National Institutes of Health (HHSN263201800029I/HHSN26300026). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2021. Crisis standards of care: Ten years of successes and challenges: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25767.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

Image

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

PLANNING COMMITTEE ON CRISIS STANDARDS OF CARE: TEN YEARS OF SUCCESSES AND CHALLENGES1

JOHN L. HICK (Co-Chair), Professor of Emergency Medicine and Medical Director of Emergency Preparedness, Hennepin Healthcare, University of Minnesota

SUZET M. McKINNEY (Co-Chair), Executive Director and Chief Executive Officer, Illinois Medical District

BROOKE COURTNEY, Senior Regulatory Counsel, Office of Counterterrorism and Emerging Threats, Food and Drug Administration

JAMES HODGE, JR., Professor of Law, Sandra Day O’Connor College of Law, Arizona State University

NIRANJAN (TEX) KISSOON, Executive Medical Director, Children’s and Women’s Global Health; UBC and BCCH Professor in Acute and Critical Care–Global Child Health, British Columbia Children’s Hospital Research Institute

NICOLETTE LOUISSAINT, Executive Director, Healthcare Ready

ANITA PATEL, Senior Special Advisor, Pandemic Medical Care and Countermeasures Lead, Centers for Disease Control and Prevention

PETER PONS, Associate Director of Emergency Medicine, Denver Health Medical Center

COLLEEN M. RYAN, Staff Surgeon, Sumner M. Redstone Burn Center and Shriners Burn Hospital, Massachusetts General Hospital; Professor of Surgery, Harvard Medical School

UMAIR SHAH, Executive Director, Harris County Public Health

STEVEN WARD, Director, Operational Medicine Readiness, Policy and Oversight, U.S. Air Force

MATTHEW K. WYNIA, Director, Center for Bioethics and Humanities, University of Colorado Denver

Health and Medicine Division Staff

SCOTT WOLLEK, Senior Program Officer

CAROLINE CILIO, Associate Program Officer (until October 2019)

KIMBERLY SUTTON, Senior Program Assistant

ANDREW M. POPE, Senior Director, Board on Health Sciences Policy

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

Consultants

LAURA RUNNELS, LAR Consulting

MEGAN SNAIR, Science Writer

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

FORUM ON MEDICAL AND PUBLIC HEALTH PREPAREDNESS FOR DISASTERS AND EMERGENCIES1

DAN HANFLING (Co-Chair), Vice-President, Technical Staff, In-Q-Tel

SUZET M. McKINNEY (Co-Chair), Chief Executive Officer, Illinois Medical District

STACEY J. ARNESEN, Branch Chief, Disaster Information Management Research Center, National Library of Medicine, National Institutes of Health

JOHN BENITEZ, Medical Director, Emergency Preparedness, Tennessee Department of Health

ERIC BLANK, Senior Director, Public Health Programs and Systems, Association of Public Health Laboratories

DUANCE C. CANEVA, Chief Medical Officer, Department of Homeland Security

MARY CASEY-LOCKYER, Senior Associate, Disaster Health Program Development, American Red Cross

BROOKE COURTNEY, Senior Regulatory Counsel, Office of Counterterrorism and Emerging Threats, Food and Drug Administration

JOHN J. DREYZEHNER, Director, Center for Preparedness and Response, Centers for Disease Control and Prevention

DAVID EISENMAN, Associate Professor, David Geffen School of Medicine and Fielding School of Public Health, University of California, Los Angeles

BRUCE EVANS, Fire Chief, Upper Pine River Fire Protection District

JAMES R. FICKE, Robert A. Robinson Professor and Director, Department of Orthopaedic Surgery, Johns Hopkins Medicine

NATALIE GRANT, Director, Office of Human Services Emergency Preparedness and Response, Administration for Children and Families, Department of Health and Human Services

LORI GRUBSTEIN, Program Officer, Health Care Group, Robert Wood Johnson Foundation

JOHN L. HICK, Professor of Emergency Medicine and Medical Director of Emergency Preparedness, Hennepin Healthcare, University of Minnesota

ROBERT KADLEC, Assistant Secretary for Preparedness and Response, Department of Health and Human Services

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

THOMAS KIRSCH, Professor of Military and Emergency Medicine, Director, National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences

NICOLETTE A. LOUISSAINT, Executive Director, Healthcare Ready

FREDA GAIL LYON, Vice President, Emergency Services, WellStar Health System

PHILLIP MAYTUBBY, Director, Public Health Protection, Oklahoma City-County Health Department

BIRGITTE MESSERSCHMIDT, Director of Applied Research, National Fire Protection Association

AUBREY K. MILLER, Senior Medical Advisor, Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health

BARBARA MULACH, Director, Office of Science Coordination and Program Operations, National Institute of Allergy and Infectious Diseases, National Institutes of Health

IRA NEMETH, Chair, Disaster Medicine Section, American College of Emergency Physicians, Associate Medical Director for EMS and LifeFlight at UMass Memorial Hospital

JOHN OSBORN, Operations Manager and Assistant Professor of Health Care Systems Engineering, Department of Surgery, Mayo Clinic College of Medicine and Science

TARA O’TOOLE, Senior Fellow and Executive Vice President, In-Q-Tel

ANDREW T. PAVIA, George and Esther Gross Presidential Professor, Division of Pediatric Infectious Diseases, University of Utah School of Medicine

LEWIS RADONOVICH, Chief of Research, National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health

TERRY RAUCH, Deputy Assistant Secretary of Defense for Health Readiness Policy and Oversight, Office of the Assistant Secretary of Defense for Health Affairs, Department of Defense

SARA ROSZAK, Vice President, Pharmacy Care and Health Strategy, National Association of Chain Drug Stores

COLLEEN M. RYAN, Staff Surgeon, Sumner M. Redstone Burn Center, Massachusetts General Hospital; Professor of Surgery, Harvard Medical School

ROSLYNE SCHULMAN, Director, Policy Development, American Hospital Association

RICHARD SERINO, Distinguished Visiting Fellow, National Preparedness Leadership Initiative, Harvard T.H. Chan School of Public Health

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

ALAN SINISCALCHI, Surveillance Coordinator for Influenza, Bioterrorism, and Public Health Preparedness, Connecticut Department of Public Health

W. CRAIG VANDERWAGEN, Cofounder and Director, East West Protection, LLC

TENER VEENEMA, Professor of Nursing, Johns Hopkins University

JENNIFER WARD, President, Trauma Center Association of America

GAMUNU WIJETUNGE, EMS Specialist, Office of Emergency Medical Services, National Highway Traffic Safety Administration, Department of Transportation

MATTHEW K. WYNIA, Director, Center for Bioethics and Humanities, University of Colorado Denver

Forum Staff

SCOTT WOLLEK, Forum Director

AURELIA ATTAL-JUNCQUA, Associate Program Officer

MICHAEL BERRIOS, Research Associate

KIMBERLY SUTTON, Senior Program Assistant

ANDREW M. POPE, Senior Director, Board on Health Sciences Policy

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by BOBBIE BERKOWITZ, Columbia University School of Nursing and University of Washington. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25767.
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In 2009 the Institute of Medicine (IOM) began to assess the need for better-defined medical and public health crisis standards of care (CSC) for catastrophic disasters and public health emergencies. Over the next 10 years, the IOM defined templates for those stakeholders responsible for integrated CSC planning and implementation; created a tool kit with guidance on indicators and triggers; provided a discussion kit for stakeholders to use with their own communities to establish appropriate indicators and triggers to guide their planning; disseminated the messages and key concepts of CSC; and built on the initial efforts to refine certain elements and address remaining gaps. This current Proceedings of a Workshop captures the discussions from a 2019 workshop reviewing the successes and gaps over the last 10 years of CSC work, in order to inform the next phases of planning and implementation.

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