US State Crisis Standards of Care Documents

Added June 26, 2020

Citation: Romney D, Fox H, Carlson S, et al. Allocation of Scarce Resources in a Pandemic: A Systematic Review of US State Crisis Standards of Care Documents. Disaster Medicine and Public Health Preparedness. 2020 Apr 16:1-7.

What is this? The COVID-19 pandemic is placing a strain on healthcare resources. Existing research on United States (US) crisis standards of care (CSC) plans may provide useful information for policy makers.

In this systematic review, the authors searched for US state CSC plans. They restricted their searches to publicly accessible state CSC documents and the first search in March 2016 with updates in 2019 and 2020. They included 31 CSC plans, of which 18 were pandemic-influenza-specific and 13 used an “all hazards” approach.

What was found: Guidance informing providers and policy-makers on the most effective strategies for the allocation of scare resources during a crisis is inconsistent between US states with CSC documents and may be inadequate.

Five plans (Arizona, Colorado, Minnesota, Nevada, and Vermont) contained all elements of the 2009 Institute of Medicine report guidelines for establishing CSC for use in disaster situations.

28 CSC plans included evidence-based clinical processes and operations and 16 included clear indicators, triggers, and lines of responsibility.

Most CSC plans included strong ethical grounding, engagement and communication aspects, and legal and environmental considerations.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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