Skip to main content

Currently Skimming:

6 Looking Forward
Pages 57-72

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 57...
... In this chapter, speakers highlight the experiences of CSC at the federal level and the potential roles for the federal government going forward. A subsequent panel discussion synthesizes the challenges and opportunities across key areas of CSC, as previously discussed throughout this workshop series: staffing; planning and implementation; and legal, ethical, and equity considerations.
From page 58...
... Richard Hunt, senior medical advisor, National Health Care Preparedness Programs, ASPR, shared some observations after listening to many clinicians throughout the pandemic. "We really didn't have a lot of experience implementing CSC before," he said, "but now we have learned quite a bit." While listening to frontline workers and the general public about their thoughts related to CSC is important, Hunt said, it needs to be paired with the years of work spent on planning and learn from those who have clinical bedside experience with CSC.
From page 59...
... REFLECTIONS ON CHALLENGES AND OPPORTUNITIES This section brings together the topics discussed throughout the workshop series. Speakers summarized the targeted discussions and offered either future questions to consider or key lessons to inform planning across the areas of staffing; planning and implementation; and legal, ethical, and equity issues.
From page 60...
... She mentioned the confusion over the difference between moving from contingency mode to crisis mode, and the allocation of scarce resources decisions left to providers at the bedside. She also highlighted the travel nursing industry, which has contributed to many staffing challenges for hospitals and health care centers.
From page 61...
... This body could also provide a pulse check, he said, and be able to assess staffing numbers nationally and provide situational awareness on what is happening around the country. Finally, Meyers said being able to provide virtual care and harness technology in the e-ICU has been such a jump forward.
From page 62...
... The workshop on planning and implementation highlighted that situational awareness should drive decision making relating to CSC development and planning, as well as activation, implementation, evaluation, and monitoring. Health care is not the best at real-time assessment, he noted, as has been discussed previously, but many things emerged across speakers and conversations that can and should inform future work.
From page 63...
... Coordination and Collaboration • There are challenges associated with staffing and tracking equipment and supplies across hospitals and health care systems. • Maintaining situational awareness, resource sharing, and load balancing have been challenging.
From page 64...
... • How likely is a patient to survive even if they do receive the resource being considered? • Does the patient have realistic access to an alternate care pathway if they are triaged to it (e.g., outpatient care including follow-up, equipment, supplies, and medications)
From page 65...
... Legal, Ethical, and Equity Considerations Jennifer Piatt, deputy director, Network for Public Health Law– Western Region Office, reviewed the webinar discussion dedicated to legal challenges and opportunities pertaining to liability protections in CSC, as well as the incorporation of ethical and equity considerations in the allocation of scarce resources. Piatt said there are two approaches
From page 66...
... For example, she reviewed two legal sources for liability protection at the federal level. The CARES Act provides express liability protections for interstate volunteer health care workers, in contrast with the PREP Act, which applies to all covered health care workers against claims of loss in response to a public health emergency.
From page 67...
... Solely looking at some of the mechanisms through which structural racism occurs, she said, will make it difficult to develop ways to mitigate health disparities most effectively. When thinking about scarce resource allocation in the ICU, the resources that come to mind most often are things like ventilators, but as others have mentioned, leaders should be expanding their own mindsets to also think about people, monoclonal antibodies, and other critical resources that may become scarce.
From page 68...
... That is completely inexcusable at this point in the pandemic, he argued. Wynia also commented on the reticence health care institutions had about entering CSC and no longer being able to offer standard services to their population, saying he and his colleagues did expect some of that hesitation.
From page 69...
... Certainly, COVID-19 took us by surprise, McKinney continued, but there were moments throughout the response, especially early on, when we could have anticipated much sooner some of those things that were going to affect our health care systems and ability to implement public health strategies. She amplified Veenema's previous comments on nurses being a scarce resource and taking that into account more seriously in planning efforts.
From page 70...
... Situational awareness became a critical element early in the process. Load balancing became the operative phrase to get the patients to the right place at the right time with the right resources, but without a national data infrastructure, this was a very difficult task.
From page 71...
... 4. Effectively address health equity issues.


This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.