Bureau of Public Health Emergency Preparedness
Crisis Standards of Care (CSC) Project
"Developing a Comprehensive and Compassionate Response"
The Arizona Department of Health Services (ADHS) worked with public health, emergency management, first responders, healthcare, legal, and other partners to create the Arizona Crisis Standards of Care (CSC) Plan. Ethical considerations and principles have played a key role throughout the course of this initiative. Stewardship of resources, duty to care, soundness, fairness, reciprocity, proportionality, transparency, and accountability are the guiding ethical elements of this plan. This foundation has been integrated into public health and emergency response principles to establish this common framework for statewide CSC.
During a public health disaster, the Statewide Disaster Medical Advisory Committee (SDMAC) will convene to develop incident-specific priorities and guidance for the delivery of healthcare and use of scarce medical resources. This guidance may address:
- Triage for emergency medical services (EMS),
- Primary, secondary, and tertiary triage for healthcare facilities,
- Expanded scopes of practice, as approved by regulatory authorities,
- Priorities for medical resources including space, staff, and supplies, and
- Considerations for healthcare access points, including hospitals, out-of-hospital facilities, and alternate care sites.
This collaborative, two-year project included strategic planning sessions, interagency workgroups, and a public engagement campaign. Below is a project timeline highlighting key activities and events undertaken by planning staff and community workgroup participants.
|January 24, 2013||Initial Planning Workshop|
|June 27, 2013||Mid Planning Workshop|
|July 17, 2013|
|October 10, 2013||Emergency Medical Services (EMS) Workgroup|
|October 11, 2013||Clinical Workgroup|
|November, 2013 - January, 2014|
|December 4, 2013||Legal/Ethical Workgroup|
|January-March, 2014||Online Public Comment and Engagement Survey|
|February 26, 2014||Final Planning Workshop|
Legal and Ethical Review
|September 25, 2014||Clinical Proof of Concept Meeting|
|December, 2014||Plan Finalization|
|May 19, 2015||
Arizona CSC Tabletop Exercise Presentation
CSC Situation Manual
- Communities of Interest (COI) for Crisis Standards of Care and the Allocation of Scarce Resources
- Event Poster 1 – Crisis Standards of Care Foundation
- Event Poster 2 – Crisis Standards of Care Support Continuum
Note: Event Poster 2 Acronym Key [EM: Emergency Management, EOC: Emergency Operations Center/s, PH: Public Health, HEOC: Health Emergency Operations Center, SDMAC: Statewide Disaster Medical Advisory Committee]
- Institute of Medicine Report - Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response
- Public Health Emergency Ethics - ASU Sandra Day O'Connor College of Law