Health Care Considerations - Crisis Standards of Care

These resources are designed to help health care facilities plan for shortfalls in the health care system during a pervasive or catastrophic public health event, which may cause overwhelming medical surge. Each health care facility or health care system will determine the most appropriate steps and actions for their entity based on their environment, hazards, and resources. Since pre-planned actions are always preferred to impromptu decisions, pre-event familiarity with the contents of this website and development of facility-level crisis standards of care plans is recommended.

Framework

• Minnesota CSC Health Care Facility Framework (PDF) Updated 
  This document provides the guidance for health care facilities to create a crisis standards of care plan or incorporate crisis standards of care strategies into an existing EOP.

COVID-19

• National Academy of Medicine: Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV-2 
  The principles of crisis standards of care (CSC) ensure fair processes are in place to make clinically informed decisions about scarce resource allocation during an epidemic.

Tools

• Template: Facility Crisis Standards of Care Plan (Word)
  Use this template to write a facility level CSC plan. Be sure to use the Ethical Checklist below when you’re done!
• Ethical Checklist (PDF) 
  After writing your plan or incorporating crisis standards of care principles into your existing plan, use this checklist to ensure it meets the ethical objectives outlined in the Minnesota CSC Ethical Framework.
  
   
• Patient Care Strategies for Scarce Resource Situations (PDF)
  A standardized tool to assist Minnesota hospitals, clinics, or primary care settings in determining the best use of specialized equipment and supplies during a pervasive or catastrophic public health event. Be sure to incorporate this tool into your plan.
• Health Care Facility Process Diagram (PDF)
  Health care facilities can use this hospital process diagram during a CSC situation to help guide the process and steps involved in responding to an incident—similar to the “Planning P” used in the Incident Command System.
• Hospital Scarce Resource Decision-Making Tree (PDF)
  Health care facilities could use this more detailed triage plan during a CSC situation.
• Legal Considerations for Crisis Standards of Care
  Be sure to review the Minnesota CSC Legal Framework, which includes an overview on relevant state and federal laws.

Resources

• MDH Ambulatory Care Clinic Tool Kit
  This toolkit contains material for the clinic management team to use in planning for and responding to infection control aspects of an influenza pandemic. Provided are useful policies, fact sheets, templates, and checklists that can be adapted to fit your facility type and size. The information should be integrated with your clinic’s emergency management plan.  
   
• MDH High Consequence Infectious Disease (HCID) Toolbox for Frontline Health Care Facilities
  Provides ready-to-use editable tools for frontline facilities to prepare and respond to patients who might have an HCID. It also incorporates standard infection prevention concepts into training and exercises.
   
• MDH Airborne Infectious Disease Management: Methods for Temporary Negative Pressure Isolation
  This document was created by MDH and the University of Minnesota. Published in 2007, however content remains up to date. Some hyperlinks may be out of date.
   
• Introduction and Executive Summary Care of the Critically Ill and Injured during Pandemics and Disasters: CHEST Consensus Statement
  This supplement provides suggestions for all of those involved in a disaster or pandemic with multiple critically ill patients, including frontline clinicians, hospital administrators, professional societies, and public health or government officials.
   
• The National Academies of Sciences, Engineering, and Medicine—Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response
  Download the 2012 Report.