Identify metrics to assess the development of crisis standards of care protocols by state and local governments, that include elements such as dissemination, development, and implementation,
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Review the impact of its 2009 letter report including progress made by state and local governments and health care organizations in establishing crisis standards of care guidance.
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Develop templates for states, emergency medical services (EMS) systems, hospitals and individual clinicians to guide decision making when implementing crisis standards of care that can be easily read, understood and executed during an incident. These templates will:
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Address the inclusion of all critical components of the emergency response and health care system necessary to plan for and respond to crisis standards of care situations.
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Examine the specific process of declaring a shift to crisis standards of care, focusing on roles and responsibilities of decision-makers from the local to the national level, including.
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The roles and responsibilities of public and private health care systems (e.g., the responsibility of a local VA Medical Center Director vs. regional Veterans Integrated Service Network (VISN) Director, authority and the role of military treatment facilities (MTFs), local, regional and national healthcare system clinical and administrative leadership in private health care systems;
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The role of state EMS authorities in providing medical oversight and coordination of a shift to crisis response for a state's EMS system including 9-1-1 dispatch and pre-hospital emergency medical care.
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Identify clinical and administrative indicators that govern the transition from conventional surge response and conventional standards of care to crisis surge response and crisis standards of care, and the return to conventional standards of care. Reference and highlight existing clinical protocols and related governance structures that need to be in place to facilitate decision making under crisis standards.
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These indicators, clinical protocols, and governance structures should be applicable to specific scenarios of both gradual onset as well as no notice incidents, and should pertain to the pre-hospital, community and hospital settings.
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Define terms and provide consistent language (e.g. definitions, situational markers) for communicating across jurisdictions and levels of government the status of healthcare systems related to crisis standards of care
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In addition the committee will develop templates that can be used by state and local governments to guide community engagement. These would be based on a series of focus groups utilizing scenario-based engagement strategies to identify what shifts are tolerable from the community point of view, including the physician, active duty military, and veteran's communities.
Phase 2 of this project will result in a report that is expected to be released in late 2011.