TY - BOOK AU - Institute of Medicine A2 - Bruce M. Altevogt A2 - Clare Stroud A2 - Lori Nadig A2 - Matthew Hougan TI - Medical Surge Capacity: Workshop Summary SN - DO - 10.17226/12798 PY - 2010 UR - https://nap.nationalacademies.org/catalog/12798/medical-surge-capacity-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system's resources are exhausted and there are more patients than the system can accommodate. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop. ER - TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine A2 - Theresa Wizemann A2 - Megan Reeve Snair A2 - Jack Herrmann TI - Rapid Medical Countermeasure Response to Infectious Diseases: Enabling Sustainable Capabilities Through Ongoing Public- and Private-Sector Partnerships: Workshop Summary SN - DO - 10.17226/21809 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21809/rapid-medical-countermeasure-response-to-infectious-diseases-enabling-sustainable-capabilities PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Emerging infectious disease threats that may not have available treatments or vaccines can directly affect the security of the world's health since these diseases also know no boundaries and will easily cross borders. Sustaining public and private investment in the development of medical countermeasures (MCMs) before an emerging infectious disease becomes a public health emergency in the United States has been extremely challenging. Interest and momentum peak during a crisis and wane between events, and there is little interest in disease threats outside the United States until they impact people stateside. On March 26 and 27, 2015, the Institute of Medicine convened a workshop in Washington, DC to discuss how to achieve rapid and nimble MCM capability for new and emerging threats. Public- and private-sector stakeholders examined recent efforts to prepare for and respond to outbreaks of Ebola Virus Disease, pandemic influenza, and coronaviruses from policy, budget, and operational standpoints. Participants discussed the need for rapid access to MCM to ensure national security and considered strategies and business models that could enhance stakeholder interest and investment in sustainable response capabilities. This report summarizes the presentations and discussions from this workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Kristin Viswanathan A2 - Theresa Wizemann A2 - Bruce M. Altevogt TI - Preparedness and Response to a Rural Mass Casualty Incident: Workshop Summary SN - DO - 10.17226/13070 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13070/preparedness-and-response-to-a-rural-mass-casualty-incident-workshop PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Problems contacting emergency services and delayed assistance are not unusual when incidents occur in rural areas, and the consequences can be devastating, particularly with mass casualty incidents. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop to examine the current capabilities of emergency response systems and the future opportunities to improve mass casualty response in rural communities. ER - TY - BOOK AU - Institute of Medicine A2 - Dan Hanfling A2 - Bruce M. Altevogt A2 - Kristin Viswanathan A2 - Lawrence O. Gostin TI - Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response: Volume 1: Introduction and CSC Framework SN - DO - 10.17226/13351 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13351/crisis-standards-of-care-a-systems-framework-for-catastrophic-disaster PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - Catastrophic disasters occurring in 2011 in the United States and worldwide—from the tornado in Joplin, Missouri, to the earthquake and tsunami in Japan, to the earthquake in New Zealand—have demonstrated that even prepared communities can be overwhelmed. In 2009, at the height of the influenza A (H1N1) pandemic, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, along with the Department of Veterans Affairs and the National Highway Traffic Safety Administration, asked the Institute of Medicine (IOM) to convene a committee of experts to develop national guidance for use by state and local public health officials and health-sector agencies and institutions in establishing and implementing standards of care that should apply in disaster situations-both naturally occurring and man-made-under conditions of scarce resources. Building on the work of phase one (which is described in IOM's 2009 letter report, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations), the committee developed detailed templates enumerating the functions and tasks of the key stakeholder groups involved in crisis standards of care (CSC) planning, implementation, and public engagement-state and local governments, emergency medical services (EMS), hospitals and acute care facilities, and out-of-hospital and alternate care systems. Crisis Standards of Care provides a framework for a systems approach to the development and implementation of CSC plans, and addresses the legal issues and the ethical, palliative care, and mental health issues that agencies and organizations at each level of a disaster response should address. Please note: this report is not intended to be a detailed guide to emergency preparedness or disaster response. What is described in this report is an extrapolation of existing incident management practices and principles. Crisis Standards of Care is a seven-volume set: Volume 1 provides an overview; Volume 2 pertains to state and local governments; Volume 3 pertains to emergency medical services; Volume 4 pertains to hospitals and acute care facilities; Volume 5 pertains to out-of-hospital care and alternate care systems; Volume 6 contains a public engagement toolkit; and Volume 7 contains appendixes with additional resources. ER - TY - BOOK AU - Institute of Medicine A2 - Dan Hanfling A2 - John L. Hick A2 - Clare Stroud TI - Crisis Standards of Care: A Toolkit for Indicators and Triggers SN - DO - 10.17226/18338 PY - 2013 UR - https://nap.nationalacademies.org/catalog/18338/crisis-standards-of-care-a-toolkit-for-indicators-and-triggers PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care. ER - TY - BOOK AU - Institute of Medicine A2 - Megan Reeve A2 - Bruce Altevogt A2 - Ashley Ottewell TI - Regional Disaster Response Coordination to Support Health Outcomes: Surge Management: Workshop in Brief DO - 10.17226/21696 PY - 2015 UR - https://nap.nationalacademies.org/catalog/21696/regional-disaster-response-coordination-to-support-health-outcomes-surge-management PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - When a disaster strikes, it rarely impacts just one jurisdiction. It is important for jurisdictions to consider how they will respond to a scenario in which the entire region is impacted. To explore these considerations, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events organized three regional workshops in 2014 to explore opportunities to strengthen the regional coordination required to ensure effective medical and public health response to a large-scale multijurisdictional disaster. Each of the three workshops covers different topics that may strengthen regional disaster response. The third and final workshop in this series, which this document summarizes, was held in New Orleans and considered how community engagement and information sharing can impact issues of surge management across the public health and health care spectrum. ER - TY - BOOK AU - Institute of Medicine A2 - Theresa Wizemann A2 - Megan Reeve A2 - Bruce M. Altevogt TI - Preparedness, Response, and Recovery Considerations for Children and Families: Workshop Summary SN - DO - 10.17226/18550 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18550/preparedness-response-and-recovery-considerations-for-children-and-families-workshop PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Preparedness, Response and Recovery Considerations for Children and Families is the summary of a workshop convened in June, 2013 by the Institute of Medicine Forum on Medical and Public Health Preparedness for Catastrophic Events to discuss disaster preparedness, response, and resilience relative to the needs of children and families, including children with special health care needs. Traditional and non-traditional medical and public health stakeholders from across federal, state, and local government health care coalitions, community organizations, school districts, child care providers, hospitals, private health care providers, insurers, academia, and other partners in municipal planning met to review existing tools and frameworks that can be modified to include children's needs; identify child-serving partners and organizations that can be leveraged in planning to improve outcomes for children; highlight best practices in resilience and recovery strategies for children; and raise awareness of the need to integrate children's considerations throughout local and state emergency plans. Communities across the United States face the threat of emergencies and disasters almost every day, natural and man-made, urban and rural, large and small. Although children represent nearly 25 percent of the U.S. population, current state and local disaster preparedness plans often do not include specific considerations for children and families. The preparedness and resilience of communities related to children will require a systems framework for disaster preparedness across traditional and non-traditional medical and public health stakeholders, including community organizations, schools, and other partners in municipal planning. This report examines resilience strategies that lead to successful recovery in children after a disaster and discusses current approaches and interventions to improve recovery in children. ER - TY - BOOK AU - Institute of Medicine A2 - Megan Reeve A2 - Bruce Altevogt A2 - Miriam Davis TI - Regional Disaster Response Coordination to Support Health Outcomes: Summary of a Workshop Series SN - DO - 10.17226/21713 PY - 2015 UR - https://nap.nationalacademies.org/catalog/21713/regional-disaster-response-coordination-to-support-health-outcomes-summary-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - When disaster strikes, it rarely impacts just one jurisdiction. Many catastrophic disaster plans include support from neighboring jurisdictions that likely will not be available in a regional disaster. Bringing multiple stakeholders together from sectors that do not routinely work with each other can augment a response to a disaster, but can also be extremely difficult because of the multi-disciplinary communication and coordination needed to ensure effective medical and public health response. As many communities within a region will have similar vulnerabilities, a logical step in planning is to establish responsibilities and capacities, and be able to work toward common goals to address all-hazards when the entire region is affected. To explore these considerations, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events organized a series of three regional workshops in 2014 to explore opportunities to strengthen the regional coordination required in response to a large scale multijurisdictional disaster. The purpose of each regional workshop was to discuss ways to strengthen coordination among multiple jurisdictions in various regions to ensure fair and equitable treatment of communities from all impacted areas. Regional Disaster Response Coordination to Support Health Outcomes summarizes the presentation and discussion of these workshops. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Megan Snair A2 - Aurelia Attal-Juncqua A2 - Scott Wollek TI - Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series SN - DO - 10.17226/26573 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26573/evolving-crisis-standards-of-care-and-ongoing-lessons-from-covid-19 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Crisis Standards of Care (CSC) inform decisions on medical care during a large-scale crisis such as a pandemic or natural disaster, eliminating the need to make these decisions at the bedside without protections or guidance. Numerous points throughout the COVID-19 pandemic have demonstrated the necessity of this type of crisis planning. The National Academies of Sciences, Engineering, and Medicine Forum on Medical and Public Health Preparedness for Disasters and Emergencies convened a series of public workshops to examine the experiences of healthcare providers during the COVID-19 pandemic and identify lessons that can inform current and future CSC planning and implementation. The workshops examined staffing and workforce needs, planning and implementation of CSC plans, and legal, ethical, and equity considerations of CSC planning. Topics of discussion included improving coordination between the bedside and boardroom, increasing buy-in from elected officials, expanding provider engagement, and addressing health equity issues. This publication summarizes the presentation and discussion of the workshops. ER - TY - BOOK AU - Institute of Medicine A2 - Bruce M. Altevogt A2 - Clare Stroud A2 - Theresa Wizemann TI - Barriers to Integrating Crisis Standards of Care Principles into International Disaster Response Plans: Workshop Summary SN - DO - 10.17226/13279 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13279/barriers-to-integrating-crisis-standards-of-care-principles-into-international-disaster-response-plans PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - When a nation or region prepares for public health emergencies such as a pandemic influenza, a large-scale earthquake, or any major disaster scenario in which the health system may be destroyed or stressed to its limits, it is important to describe how standards of care would change due to shortages of critical resources. At the 17th World Congress on Disaster and Emergency Medicine, the IOM Forum on Medical and Public Health Preparedness sponsored a session that focused on the promise of and challenges to integrating crisis standards of care principles into international disaster response plans. ER - TY - BOOK AU - Institute of Medicine A2 - Theresa Wizemann A2 - Megan Reeve A2 - Bruce Altevogt TI - Engaging the Public in Critical Disaster Planning and Decision Making: Workshop Summary SN - DO - 10.17226/18396 PY - 2013 UR - https://nap.nationalacademies.org/catalog/18396/engaging-the-public-in-critical-disaster-planning-and-decision-making PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Engaging the Public in Critical Disaster Planning and Decision Making is the summary of a workshop held in March 2013 to discuss the key principles of public engagement during the development of disaster plans, the response phase, and during the dissemination phase when interested community partners and the general public are informed of the policies that have been adopted. Presenters provided specific examples of resources to assist jurisdictions in planning public engagement activities as well as challenges experienced and potential solutions. This report introduces key principles of public engagement, provides practical guidance on how to plan and implement a public engagement activity, and presents tools to facilitate planning. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Megan Snair A2 - Aurelia Attal-Juncqua A2 - Scott Wollek TI - Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop SN - DO - 10.17226/25767 PY - 2021 UR - https://nap.nationalacademies.org/catalog/25767/crisis-standards-of-care-ten-years-of-successes-and-challenges PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER -