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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Evolving Crisis Standards
of Care and Ongoing
Lessons from COVID-19

_____

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

Proceedings of a Workshop Series

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts between the National Academy of Sciences and the Administration for Children and Families (contract no. HHS P233201400020B/75P00120F37103), the Assistant Secretary for Preparedness and Response (contract no. 75A50121P00089), the Centers for Disease Control and Prevention (contract no. 200-2011-38807/75D30120F00093), the Department of Homeland Security (contract no. HSHQDC-17-A-B0001/70RHAD18FR0000003), the Food and Drug Administration (contract no. 75F40120P00067), the National Highway Traffic Safety Administration (contract no. 693JJ921P000049), and the National Institutes of Health (contract no. 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.

International Standard Book Number-13: 978-0-309-68879-6
International Standard Book Number-10: 0-309-68879-5
Digital Object Identifier: https://doi.org/10.17226/26573

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Copyright 2022 by the National Academy of Sciences. All rights reserved.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Evolving crisis standards of care and ongoing lessons from COVID-19: Proceedings of a workshop series. Washington, DC: The National Academies Press. https://doi.org/10.17226/26573.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×

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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The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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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. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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PLANNING COMMITTEE ON EVOLVING CRISIS STANDARDS OF CARE AND LESSONS LEARNED1

ERIC TONER (Chair), Senior Scholar, Johns Hopkins University

ASHA DEVEREAUX, Senior Medical Officer, Sharp Coronado Hospital

MEGAN JEHN, Associate Professor, Arizona State University

ANUJ MEHTA, Pulmonary and critical care physician, Denver Health and Hospital Authority

GREGG S. MEYER, President, Community Division, and Executive Vice President, Value-Based Care, Mass General Brigham

MONICA E. PEEK, Associate Professor of Medicine, University of Chicago

JENNIFER PIATT, Deputy Director, Network for Public Health Law–Western Region Office

ERIN SERINO, Deputy Chief of Staff, Boston Emergency Medical Services

TENER GOODWIN VEENEMA, Contributing Scholar, Professor of Nursing, Johns Hopkins Center for Health Security, Johns Hopkins Bloomberg School of Public Health

MICHAEL WARGO, Vice President and Chief, Enterprise Preparedness and Emergency Operations, HCA Healthcare

SHANDIIN WOOD, Health Systems Epidemiologist and Tribal Liaison, New Mexico Department of Health

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

Health and Medicine Division Staff

SCOTT WOLLEK, Forum Director

LISA BROWN, Senior Program Officer

AURELIA ATTAL-JUNCQUA, Program Officer

MICHAEL BERRIOS, Research Associate

KIMBERLY SUTTON, Senior Program Assistant

ANDREW M. POPE, 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. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Consultants

LAURA RUNNELS, LAR Consulting

KELLY SCHENK, LAR Consulting

MEGAN SNAIR, SGNL Solutions

JUSTIN SNAIR, SGNL Solutions

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×

Reviewers

This Proceedings of a Workshop Series 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:

JAMES G. HODGE, Peter Kiewit Foundation Professor of Law, Director of the Center for Public Health Law and Policy, Sandra Day O’Connor College of Law, Arizona State University

JEFFREY UPPERMAN, Professor and Chair, Department of Pediatric Surgery, Vanderbilt University

MATTHEW WATSON, Senior Analyst, Johns Hopkins Center for Health Security; Senior Research Associate Johns Hopkins Bloomberg School of Public Health

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 ROBERTA LAVIN, FAAN Professor and Ph.D. Program Director at the University of New Mexico, College of Nursing. She was responsible for making certain that an independent

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×

examination of this proceedings was carried out in accordance with the 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. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×

Abbreviations and Acronyms

ASPR Office of the Assistant Secretary for Preparedness and Response
CDPHE Colorado Department of Public Health and Environment
CSC crisis standards of care
EMS emergency medical services
HHS U.S. Department of Health and Human Services
ICU intensive care unit
MRC Medical Reserve Corps
OCR Office for Civil Rights
PPE personal protective equipment
SOFA sequential organ failure assessment
SVI Social Vulnerability Index
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/26573.
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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.

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