On September 2nd, 2009 the Workshop on Guidance for Establishing Standards of Care for Use in Disaster Situations was held in Washington D.C.:

for the workshop AGENDA and addtional information about this past workshop, please click here

for the letter report resulting from this workshop please see the bottom of this page or click here

____________________________________________________________________

In response to a request from the HHS Office of the Assistant Secretary of Preparedness and Response, the Institute of Medicine has convened an ad hoc committee to conduct a 2-phase activity on standards of care for use in disaster situations. The committee is focusing attention on developing guidance to establish standards of care that should apply to disaster situations--both naturally-occurring and man-made--where there are scarce resources. Ethical principles will be incorporated into the standards.

Phase 1:

An ad hoc committee of the Institute of Medicine (IOM) is conducting a study and will issue a letter report to the Assistant Secretary of Preparedness and Response by October 1, 2009. The letter report will provide guidance on standards of care for use in disaster situations. Specifically the committee will: 

• Develop preliminary framework guidance that identifies and describes the key elements that should be included in disaster standards of care protocols.
• Identify potential triggers that can be used by state and local public health officials to develop standards of care protocols that will assist healthcare providers.
• Develop a template matrix that can be used by state and local public health officials as a framework for developing specific guidance for healthcare providers to develop disaster standards of care.
• Consider roles and responsibilities of various stakeholders in the implementation of the guidance.
• Consider mechanisms for integrating the views of the general public and healthcare providers in the development and implementation of the guidance.

The report letter will identify triggers that indicate a need to change from normal standards to disaster standards. Disaster standards will consider approaches to conserving, substituting, adapting and doing without resources. The committee will not be responsible for establishing, creating, or defining standards of care.

The committee is also commissioning a paper to be delivered by September 1, 2009. This commissioned paper will provide background to the committee deliberations and will examine the key elements in existing state and local standards of care protocols and the impact of allocation schemes on disaster standards, and propose framework guidance for national disaster standards that can be applied to H1N1 response for the coming fall flu season. In addition, the commissioned paper will explore issues related to the implementation of standards of care protocols including legal considerations. The committee will base its recommendations on currently available policies, protocols, published literature, and other available guidance documents and evidence, as well as its expert judgment.

Phase 2:

Phase 2 of the project will prepare a report that will update the preliminary guidance developed in phase 1. The expanded guidance will be based on a series of stakeholder input activities. During this phase the committee will seek input and comment from individuals who used the guidance developed in phase I. In addition the committee will organize and host a series of data gathering activities focused on the provider community and the public (e.g., local civic organizations, leaders from faith-based groups, educators) that would allow an opportunity to provide comment on the guidance developed in phase 1. The expanded report will include considerations about triggers that apply to changes in the standards of care and approaches to conserving, substituting, adapting and doing without resources. In addition, the committee will develop guidance that will include information for healthcare providers from primary care, home health, community health centers, and other provider communities not traditionally engaged.