Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19

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.Table of ContentsFront Matter1 Introduction2 Reflections, Inflections, and the Future3 Considerations for Staffing, Effects on the Workforce, and FutureTrends4 Crisis Standards of Care: From Plans to Reality5 Legal, Ethical, and Equity Considerations for Crisis Standards ofCare6 Looking ForwardReferencesAppendix A: Workshop AgendasAppendix B: Speaker Biosketches