A planning committee of the National Academies of Sciences, Engineering, and Medicine will organize and conduct a series of public workshops on the topic of Crisis Standards of Care (CSC) during public health emergencies, including lessons learned from the COVID-19 pandemic.
The COVID-19 pandemic overwhelmed the U.S. medical care system and supporting supply chains for medications and materials, which led to the widespread consideration of crisis standards of care (CSC) planning and selected implementation of key elements of the CSC framework in communities across the nation. The workshop series will consist of five sessions beginning with an overarching, introductory session that will explore the re-examination of definitions and recommendations first outlined in IOM’s 2009 “Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report”. Subsequent workshops will examine the systems framework articulated in IOM’s 2012 report “Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response”, with a particular attention on:
* Planning and Implementation Considerations:

• Examining the role of key stakeholders groups, such as state governments, state and local health department, hospitals and healthcare systems, and others stakeholders at the federal, state, local, tribal, and territorial levels, in the implementation and communication of CSC.
• Exploring the types of data required to inform CSC triggers, the sources of such data, and the plans for creating the needed infrastructure to allow for better situational awareness, including, for example, disease reporting, surveillance data, hospital transfer data sharing, and how to leverage EHR for the development of more effective clinical processes and operations.
• Understanding how jurisdictions may have changed their attitudes and beliefs about CSC planning as a result of COVID-19.
• Understanding how the public’s attitudes and beliefs about CSC have changed as a result of COVID-19.

*Legal, Regulatory, and Equity Considerations:

• Exploring concerns surrounding emergency declarations, invocation, duties to care, inter-jurisdictional challenges, discrimination, licensure/scope of practice, risks of liability, documentation, and mitigation.
• Discussing ethics, palliative care, mental health and other cross-cutting themes

*Staffing Considerations:

• Exploring the challenges and strategic opportunities for operational considerations and staffing needs during the implementation of CSC : Defining the roles and responsibilities of these stakeholder ; Describing operational considerations associated with their development and implementation of CSC plans ; Examining critical care triage teams, their role, protocols and tools, specifically pertaining to prognostics systems ; Providing brief descriptions of templates that outline the specific functions and tasks for each stakeholder when allocating scarce resources in response to a disaster.
• Reviewing staff responsibilities adjustments, capabilities for Just In Time (JIT) training, provision of “hazard pay”, adequate time off, child care and other benefits to staff, and leveraging health care coalitions to ensure appropriate transfer of patients between hospitals.

The series will conclude with a workshop discussing a path forward to effectively leverage identified opportunities and future CSC improvements.
The planning committee will define the specific topics to be addressed, develop the agendas, and select and invite speakers and other participants. After the workshop series, a single proceedings will be prepared by a designated rapporteur in accordance with institutional guidelines and shall be released to the public.