Crisis standards of care lay out how the health care system should allocate scarce resources. Activating the staffing portion allows hospitals more flexibility and legal cover to stretch limited staff or bring more in to keep providing emergency care.
With the situation for many Colorado hospitals not improving, the state has activated the portion of the crisis standards of care (CSC) addressing staffing at health care facilities.
According to the state, health care systems must notify the Colorado Department of Public Health and Environment when they activate and deactivate crisis standards of care for staffing. According to the Colorado Hospital Association, close to 40% of facilities expect to experience staffing shortages within a week.
“Crisis standards of care exist to help hospitals or health care organizations make difficult decisions when resources are stretched,” said Cara Welch, Senior director of communications for the CHA.
On Wednesday, the state reported 1,431 people were hospitalized due to COVID-19, marking a new high for the year. The number also surpasses what the Colorado COVID-19 Modeling Group projected as a possibility for late November.
“I think where we’re at right now is where none of us wanted to be,” said Dr. Elizabeth Carlton, an associate professor at the Colorado School of Public Health and part of the modeling team.
“We’re still below the worst of what we saw in December of 2020, but we’re now afraid we could get there and exceed that demand we had in the past.”
The decision to activate CSC for staffing is aimed at maximizing the care hospitals can provide with the staff available. It also allows hospitals to team up staff or move them to units they don’t normally work, as well as minimize paperwork and fast-track training.
“It gives hospitals a bit a more flexibility in what they need to do to provide care with the staff that they have currently,” said Welch.
Last year, the state activated crisis standards of care for personal protective equipment, allowing staff to sterilize and re-use PPE in some cases. It is no longer active.
None of the other crisis standards of care are currently activated by the state. Those include emergency medical services, hospital and acute care facilities, out of hospital care providers, and specialty patient populations.
“What we’re trying to avoid, and the goal that we’re working for, is that we can continue to provide care for every patient that comes to our hospitals, but if we can’t mitigate where we are and make some dramatic changes quickly, we will get to a point where we have to ration care,” Welch said.
The state’s modeling team has projected several scenarios accounting for varying degrees of community spread. In its latest report, the team also laid out mitigation strategies that should be implemented.
“The key to preventing a surge above our hospital’s ability to handle the surge is vaccines, masks, and improved access to treatment,” Carlton said.
While the hospitals are stressed, both Welch and Carlton say it’s crucial people still seek the medical care they need.
