US State Crisis Standards of Care Documents
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.
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