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Catastrophic disasters occurring in 2011 in the United States and worldwide--from the tornado in Joplin, Missouri, to the earthquake and tsunami in Japan, to the earthquake in New Zealand--have demonstrated that even prepared communities can be overwhelmed. In 2009, at the height of the influenza A (H1N1) pandemic, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, along with the Department of Veterans Affairs and the National Highway Traffic Safety Administration, asked the Institute of Medicine (IOM) to convene a committee of experts to develop national guidance for use by state and local public health officials and health-sector agencies and institutions in establishing and implementing standards of care that should apply in disaster situations-both naturally occurring and man-made-under conditions of scarce resources.
Building on the work of phase one (which is described in IOM's 2009 letter report, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations), the committee developed detailed templates enumerating the functions and tasks of the key stakeholder groups involved in crisis standards of care (CSC) planning, implementation, and public engagement-state and local governments, emergency medical services (EMS), hospitals and acute care facilities, and out-of-hospital and alternate care systems. Crisis Standards of Care provides a framework for a systems approach to the development and implementation of CSC plans, and addresses the legal issues and the ethical, palliative care, and mental health issues that agencies and organizations at each level of a disaster response should address. Please note: this report is not intended to be a detailed guide to emergency preparedness or disaster response. What is described in this report is an extrapolation of existing incident management practices and principles.
Crisis Standards of Care is a seven-volume set: Volume 1 provides an overview; Volume 2 pertains to state and local governments; Volume 3 pertains to emergency medical services; Volume 4 pertains to hospitals and acute care facilities; Volume 5 pertains to out-of-hospital care and alternate care systems; Volume 6 contains a public engagement toolkit; and Volume 7 contains appendixes with additional resources.
Contents
- THE NATIONAL ACADEMIES
- COMMITTEE ON GUIDANCE FOR ESTABLISHING STANDARDS OF CARE FOR USE IN DISASTER SITUATIONS
- Reviewers
- Volume 1
- Summary
- REPORT DESIGN AND ORGANIZATION
- FRAMEWORK FOR A SYSTEMS APPROACH TO CRISIS STANDARDS OF CARE
- LEGAL ISSUES
- CROSS-CUTTING ISSUES: ETHICS, PALLIATIVE CARE, AND MENTAL HEALTH
- GOVERNMENTS
- PREHOSPITAL CARE: EMERGENCY MEDICAL SERVICES
- HOSPITALS AND ACUTE CARE FACILITIES
- OUT-OF-HOSPITAL AND ALTERNATE CARE SYSTEMS
- PUBLIC ENGAGEMENT
- RECOMMENDATION
- REFERENCES
- 1. Introduction
- 2. Catastrophic Disaster Response Creating a Framework for Medical Care Delivery
- CONCEPTUALIZING A SYSTEMS APPROACH TO DISASTER RESPONSE
- FUNDAMENTAL FACTORS THAT INFLUENCE THE IMPLEMENTATION OF CRISIS STANDARDS OF CARE
- GUIDANCE FOR DISASTER RESPONSE STAKEHOLDERS
- MILESTONES FOR CRISIS STANDARDS OF CARE PLANNING AND IMPLEMENTATION
- IMPLEMENTATION OF THE DISASTER RESPONSE FRAMEWORK
- RECOMMENDATION
- REFERENCES
- 3. Legal Issues in Emergencies
- 4. Cross-Cutting Themes
- Acronyms
- Summary
- Volume 2
- Volume 3
- Volume 4
- Volume 5
- Volume 6
- 9. Public Engagement
- GOALS AND BENEFITS OF PUBLIC ENGAGEMENT
- A MODEL FOR PUBLIC ENGAGEMENT: RESOURCES FOR STATE AND LOCAL AUTHORITIES
- ESSENTIAL PRINCIPLES OF PUBLIC ENGAGEMENT
- CHALLENGES AND STRATEGIES
- TOOLKIT DESCRIPTION
- CONCLUSION
- REFERENCES
- SPONSOR GUIDEBOOK
- LEAD FACILITATOR GUIDEBOOK
- GUIDEBOOK FOR TABLE FACILITATORS AND NOTE TAKERS
- Acronyms
- 9. Public Engagement
- Volume 7
Rapporteurs: Dan Hanfling, Bruce M. Altevogt, Kristin Viswanathan, and Lawrence O. Gostin.
This study was supported by Contract No. HHSP23320042509XI between the National Academy of Sciences and the Department of Health and Human Services. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
Suggested citation:
IOM (Institute of Medicine). 2012. Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Washington, DC: The National Academies Press.
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
- NLM CatalogRelated NLM Catalog Entries
- Review Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report[ 2009]Review Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter ReportInstitute of Medicine (US) Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations, Altevogt BM, Stroud C, Hanson SL, Hanfling D, Gostin LO. 2009
- Review Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review.[Am J Public Health. 2017]Review Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review.Leider JP, DeBruin D, Reynolds N, Koch A, Seaberg J. Am J Public Health. 2017 Sep; 107(9):e1-e9. Epub 2017 Jul 20.
- Review Crisis Standards of Care: A Toolkit for Indicators and Triggers[ 2013]Review Crisis Standards of Care: A Toolkit for Indicators and TriggersHanfling D, Hick JL, Stroud C, Committee on Crisis Standards of Care: A Toolkit for Indicators and Triggers, Board on Health Sciences Policy, Institute of Medicine. 2013 Sep 27
- Legal considerations during pediatric emergency mass critical care events.[Pediatr Crit Care Med. 2011]Legal considerations during pediatric emergency mass critical care events.Courtney B, Hodge JG Jr, Task Force for Pediatric Emergency Mass Critical Care. Pediatr Crit Care Med. 2011 Nov; 12(6 Suppl):S152-6.
- Review Barriers to Integrating Crisis Standards of Care Principles into International Disaster Response Plans: Workshop Summary[ 2012]Review Barriers to Integrating Crisis Standards of Care Principles into International Disaster Response Plans: Workshop SummaryInstitute of Medicine (US). 2012
- Crisis Standards of CareCrisis Standards of Care
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