Crisis Standards of Care
Crisis standards of care (CSC) are when a health care system is so overwhelmed by an event it is impossible for them to provide the normal, or standard, level of care to patients. For example, during a pandemic or influenza, there may not be sufficient resources—such as Intensive Care Unit (ICU) beds or other equipment—available in the United States to care for all patients requiring critical care.
In situations like this, a formal declaration by state government would occur to recognize health care systems are in crisis operations that may last for some time. MDH supports CSC planning as it is impossible to predict the timing and severity of a future outbreak and waiting for the disaster to strike would be too late.
Minnesota Framework
- CSC Framework (PDF)
The goal of the CSC Framework is to provide planning guidance to health care and public health organizations to successfully manage the transition from conventional to contingency to crisis care in Minnesota, if the need arises. It addresses specific challenges of a pervasive or catastrophic emergency when demand exceeds available resources warranting a shift from individual patients to the good of the community.
Science Advisory Team
The Science Advisory Team (SAT) was established by MDH in 2005 for the purpose of developing guidance for resources that may be scarce in hospitals, health systems, health care coalitions or the community during a public health emergency. The SAT advises MDH Commissioner and clinicians on strategies for optimal allocation of these resources during crisis standards of care situations including ethical and policy considerations.
- Patient Care Strategies for Scarce Resource Situations (PDF) Updated May 2019, now includes ECMO!
A standardized framework to assist Minnesota hospitals, clinics or primary care settings in determining the best use of specialized equipment and supplies during a public health emergency.
- Pharmaceutical Shortages for Minnesota Hospitals (PDF)
Frequently Asked Questions. Updated June, 2019.
- Pandemic Incident Command Considerations for Health Care Facilities by Event Stage
Recommendations for health care facilities to prepare for and respond to a pandemic by event stage.
Community Engagement
- Community Engagement - Crisis Standards of Care
The Center for Emergency Preparedness and Response is conducting community engagement sessions to gather feedback on Minnesota’s Crisis Standards of Care Framework. Public participation in shaping the Framework helps to ensure that the guidance created reflects community values and priorities.
Ethical Considerations
- Minnesota Pandemic Ethics Project
Part of the state of Minnesota's efforts to plan for the possibility of an influenza pandemic.
- Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review
This systematic review identified the most oft-used and –discussed ethical concepts and principles used in disaster planning around CSC.
Additional Resources
- Ambulatory Care Clinic Tool Kit
Toolkit containing material for the clinic management team to use in planning for and responding to infection control aspects of an influenza pandemic.
