The National Academies of Sciences, Engineering, and Medicine will produce a rapid expert consultation on gaps in crisis standards of care (CSC) frameworks and options for addressing them. This consultation will explore the current state and real-world application of CSC frameworks and identify opportunities and needs to strengthen and update these frameworks based on lessons learned and evolving conditions. The consultation will address urgent and strategic questions, such as:

• What gaps exist in current CSC frameworks, based on lessons learned from the COVID-19 pandemic and other recent responses?
• How have prior CSC frameworks, including previous National Academies work, been used in practice, and what is known about their adoption and implementation across health systems?
• What types and formats of CSC guidance are most useful to health systems, and what additional guidance is needed to support decision-making during crises?
• What emerging challenges, including evolving threat scenarios (e.g., Large-Scale Combat Operations), supply chain disruptions, workforce shortages, and concerns related to medical mandates, should be addressed in updated CSC frameworks?
• What needs to be considered when updating CSC frameworks, including implications for authorities, laws, regulations, and other policy levers?
• How were roles and responsibilities of key stakeholders including federal agencies, state, local, tribal, and territorial (SLTT) partners, and other public and private sector stakeholders characterized in prior CSC frameworks, and what insights from experience to date may inform how these roles are considered in updated CSC frameworks?
• How do options for addressing gaps differ in terms of potential impact and what could be advanced prior to a crisis versus during a crisis?

This effort will build upon prior National Academies work on CSC and will be informed by expert input, published literature, and lessons learned from recent public health emergencies. This rapid expert consultation is intended to inform near-term decision-making, including the scoping of potential projects and programmatic activities, but will not include formal findings, conclusions, recommendations, or policy advice.