Good question. Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. For example- hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies, and beds could be in short supply; and alternate care facilities may need to be used.
You can imagine how difficult it would be to set alternative standards of care in the middle of an emergency- which is why we’ve been working with a statewide Crisis Standards of Care planning group since last January. Our Public Health Emergency Preparedness team has been working with healthcare, public health, emergency management, and legal experts to develop a plan and a set of standards to guide the delivery of healthcare during the most catastrophic disasters- providing guidance for managing scarce resources (both people and stuff) in an emergency.
A key resource is a landmark crisis standards of care report developed by the Institute of Medicine- which examines indicators and triggers that guide the implementation of crisis standards of care and provides a toolkit to help stakeholders establish indicators and triggers for their own communities. The IOM report has toolkits for behavioral health, emergency management, emergency medical services, hospital care and public health.