Crisis Standards of Care: Lessons from New York City Hospitals' COVID-19 Experience. A Meeting Report [open pdf - 0B]
From the Introduction: "In the spring of 2020, hospitals in New York City suffered an unprecedented surge of novel coronavirus disease 2019 (COVID-19) patients. This surge was associated with extraordinary use of critical care resources and high case fatality ratios (the number deaths divided by the number of recognized cases). During this epidemic, there were many reports of hospitals being overwhelmed. There were also reports about how conventional standards of care were unable to be maintained, forcing hospitals and healthcare workers to adjust the way in which care was provided in order to do the most good for the greatest number. 'Standard of care' is a legal concept related to 'the level at which the average, prudent provider in a given community would practice. It is how similarly qualified practitioners would have managed the patient's care under the same or similar circumstances.' The term 'crisis standards of care' (CSC) refers to 'a substantial change in usual healthcare operations and the level of care it is possible to deliver, which is made necessary by a pervasive (eg, pandemic influenza) or catastrophic (eg, earthquake, hurricane) disaster.' [...] For over a decade, there has been considerable discussion within the healthcare preparedness professional community about CSC. [...] The purpose of this project was to convene a trusted space in which critical care physicians from hospitals across New York City could discuss their experiences with CSC implementation with each other and with national experts on CSC."
2020 Johns Hopkins University
Johns Hopkins Center for Health Security: https://www.centerforhealthsecurity.org/