Crisis Standard of Care: Refocusing Health Care Goals During Catastrophic Disasters and Emergencies

Koenig, Kristi L.; Lim, Hoon; Tsai, Shin-Han

doi:10.1016/j.jecm.2011.06.003

Cited by 28 publications

(32 citation statements)

References 38 publications

(31 reference statements)

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“…2 Emergency Medical Services (EMS) are at the forefront of the response to MCIs and large-scale events. In recent years, US EMS agencies suffered from recurrent shortages of essential medications.…”

Section: Introductionmentioning

confidence: 99%

Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

Sayed

Tamim

Mann

2016

Prehosp. Disaster med.

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Section: Introductionmentioning

confidence: 99%

Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

Sayed

Tamim

Mann

2016

Prehosp. Disaster med.

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“…Koenig (2012) Response to Schultz & Annas (2011) and IOM (2012)/Crisis standards of care are essential Disagrees with Schultz/Annas that no crisis standards are needed and with IOM that there might be different crisis standards in different situations; argues for a single set of crisis standards. Koenig et al (2011) Primarily US medical and emergency department background and support for crisis standards of care Crisis standard of care are essential for good practice in the face of major disasters and should be based on legal considerations; procedural justice; evidence-based decision-making process; ethics and public engagement and communication.…”

Section: Discussionmentioning

confidence: 99%

“…The key to applying the ANA definition is not that resource gaps negate standards of care, but the precise manner in which the accepted standards of nursing practice are adapted to the changed circumstances. Koenig, Lim, and Tsai (2011) prefer the term 'crisis standard of care' to indicate the degree of change in practice that may be needed under extreme conditions. Other discussions have used 'altered standards of care' (Agency for Healthcare Research and Quality, 2005) or 'adapted standards of care' (Gebbie et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Call for national dialogue: Adapting standards of care in extreme events. We are not ready

Cusack

Gebbie

2017

Collegian

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Clinical practices are based on a common understanding of nursing's professional standards in all aspects of patient care, no matter what the circumstances are. Circumstances can however, change dramatically due to emergencies, disasters, or pandemics and may make it difficult to meet the standard of care in the way nurses are accustomed. The Australian nursing profession has not yet facilitated a broad discussion and debate at the professional and institutional level about adapting standards of care under extreme conditions, a dialogue which goes beyond the content of basic emergency and disaster preparedness. The purpose of this paper is to encourage discussion within the nursing profession on this important ethical and legal issue. A comprehensive review of the literature was undertaken to determine the state of the evidence in relation to adapting standards of care under extreme conditions. Content analysis of the literature identified categories related to adapting standards of care that have been considered by individuals or groups that should be considered in Australia, should a dialogue be undertaken.The categories include ethical expectations of professional practice; legal interpretation of care requirements, resource priority between hospital and public health and informing communities.Literature reviews and commentary may provide the background for a national dialogue on the nursing response in an extreme event. However, it is only with the engagement of a broadly representative segment of the professional nursing community that appropriate guidance on adapting standards of care under extreme conditions can be developed and then integrated into the professional worldview of nursing in Australia.

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“…Many of these skills are unique to health security events and are new skills and knowledge that must be adapted to dynamic situations, particularly infectious disease outbreaks. They also must be performed in resource-constrained environments, requiring adaptation of unfamiliar crisis standards of care by healthcare providers [17]. An additional challenge for healthcare responders is the deterioration of previously learned knowledge and skills.…”

Section: Global Health Security Workforce Competency Challengesmentioning

confidence: 99%

Simulation and Modeling Applications in Global Health Security

French

2020

Advanced Sciences and Technologies for Security Applications

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Global health security (GHS) is dependent upon having an adequate and prepared health security workforce. There are currently numerous challenges in establishing and maintaining a health security workforce. The frequency and magnitude of disasters have increased significantly over the past 30 years. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging GHS threats [1]. Developing and maintaining GHS -specific skills in the healthcare workforce is a tremendous logistical challenge. Innovative education technologies, including simulation and digital learning, can be leveraged to achieve preparedness for GHS threats [2].Ebola Virus Disease (EVD), Middle East Respiratory Syndrome (MERS) and other emerging infectious diseases (EID) are also concerns for GHS. The world faces increasing challenges related to natural and manmade disasters as the frequency and magnitude of disasters have increased significantly over the past 30 years. Healthcare workers protect the well-being of people around the world by preventing, detecting, and responding to public health threats. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging threats [3].There is a global public health workforce shortage. The WHO tracks healthcare workforce data on 186 countries, and 57 were insufficient in healthcare provider availability and accessibility [4]. The 2013-2016 African EVD epidemic revealed WHO organizational deficiencies in coordinating responses to public health emergencies and a shifting of priorities away from global health security threats [5]. It Providing initial and sustainment training to the diverse GHS healthcare workforce is expensive and inefficient utilizing the traditional classroom model. Greater demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate healthcare providers in the ever-expanding body of disaster medicine knowledge [22].Many of these challenges can be met with gaming and simulation technologies new generations of GHS responders have embraced. Simulation-based training (SBT) has been demonstrated to provide effective learning and is increasingly being integrated into healthcare provider education [23]. The advantages of SBT may be summarized as follows: (1) safety-simulated lives and health can be jeopardized to any extent required for training without harming any people; (2) economy-simulated material and equipment can be used, misused, and expended;(3) visibility-simulation can provide visibility in two ways; you can make the invisible visible and control the visibility of details allowing the learner to discern the forest from the trees or the trees from the forest as needed; (4) time control -simulator time can be sped up, slowed down, or stopped. It can also be completely reversed, allowing learners to replicate specific problems, events, or opera...

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Crisis Standard of Care: Refocusing Health Care Goals During Catastrophic Disasters and Emergencies

Cited by 28 publications

References 38 publications

Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

Call for national dialogue: Adapting standards of care in extreme events. We are not ready

Simulation and Modeling Applications in Global Health Security

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