Healthcare Management
Crisis Standards of Care
The United States faces the real possibility of a catastrophic public health event that involves tens of thousands or hundreds of thousands of victims. Public health emergencies—such as the 2009 H1N1 pandemic, an intentional anthrax release, infectious disease threats such as severe acute respiratory syndrome (SARS), fires, floods, earthquakes, and hurri- canes—highlight the ever-changing threats posed by acts of terrorism and other public health emergencies, while also underscoring the press- ing reality of these events. A tremendous effort has been made over the past decade to prepare for public health emergencies. Many states and healthcare organizations have developed preparedness plans that include enhancing surge capacity to increase and maximize available resources and to manage demand for healthcare services in response to a mass casualty event. During a wide-reaching catastrophic public health emergency or dis- aster, however, these surge capacity plans may not be sufficient to enable healthcare providers to continue to adhere to normal treatment proce- dures and follow usual standards of care. This is a particular concern for emergencies that may severely strain resources across a large geographic area, such as a pandemic influenza or the detonation of a nuclear device. Healthcare organizations and providers may face overwhelming demand for services, severe scarcity of material resources, insufficient numbers of qualified providers, and too little patient care space.
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