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Pages 1-10

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From page 1...
... Planning to provide care in these types of overwhelming situations can help health care organizations and providers, supported by the entire emergency response system, take proactive steps that enable them to provide patients with the level of care they would usually receive, or care that is functionally equivalent, for as long as possible. In catastrophic disasters, however, these proactive steps may become insufficient: health care resources may become so scarce that reallocation decisions are needed, staff may have to practice outside of their normal scope of practice, and the focus of patient care may need to switch to promoting benefits to the population over benefits to individuals.
From page 2...
... For example, a tornado that touches down in a small, rural community may automatically warrant activation of the health care organization disaster plan, whereas additional information about the size and location of the tornado may be required before making this decision in a larger community with a higher ability to absorb a surge in demand. At the request of the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, the National Highway Traffic Safety Administration in the Department of Transportation, and the Veterans Health Administration, in the fall of 2012 the IOM convened the Committee on Crisis Standards of Care: A Toolkit for Indicators and Triggers.
From page 3...
... A Systems Approach to Catastrophic Disaster Response Successfully responding to a catastrophic disaster will require integrated planning, coordination, cooperation, consultation, and follow-through among many response disciplines and agencies, including state and local governments, EMS, health care coalitions, health care organizations, and health care providers in the community. The 2012 report developed a systems framework for catastrophic disaster response, which includes, but is not limited to, the development and implementation of CSC plans.
From page 4...
... Integrated planning within and across a tiered system of relationships among individual health care organizations, health care coalitions, and local, state, and federal governments is critical for a coordinated response and to avoid prematurely moving to a different level of response along the continuum of care that may adversely impact patient care. The Medical Surge Capacity and Capability framework outlines such a tiered system, and the 2012 IOM report integrates CSC planning and implementation into this framework (Barbera and Macintyre, 2007, 2009; IOM, 2012)
From page 5...
... Developing Useful Indicators and Triggers It is attractive to look at many of the metrics available in health care today and consider their use as indicators. However, multiple factors may make data monitoring less useful than it originally appears, and it can be complex to detect actionable information or an evolving event amid usual variability in large sets of data.
From page 6...
... When developing plans for indicators and triggers, stakeholders should keep in mind the following types of limitations and issues associated with indicators: the accuracy of the data being used as an indicator; naming conventions and "rules of reporting," particularly when indicators are being shared among multiple entities (e.g., to determine how many intensive care unit beds are available in a city, it will be important to know whether hospitals are counting and reporting only staffed beds or currently unstaffed beds as well) ; the dynamic environment in which data are reported; and the challenge of detecting evolving changes amid usual data variability.
From page 7...
... DISCUSSION TOOLKIT The objective of the toolkit is to facilitate discussions about indicators and triggers within and across health care organizations, health care coalitions, emergency response agencies, and jurisdictions. Specifically, the toolkit focuses on indicators and triggers that guide transitions along the continuum of care, from conventional standards of care to contingency surge response and standards of care to crisis surge response and standards of care, and back to conventional standards of care.
From page 8...
... These chapters provide additional questions intended to help participants drill down on the key issues for their own discipline. These chapters also contain tables that provide example indicators, triggers, and tactics across the continuum of care, followed by a blank table for participants to complete.
From page 9...
... 2012. Crisis standards of care: A systems framework for catastrophic disaster response.


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