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Colorado reactivating crisis standards of care for staffing of health care systems

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Posted at 6:21 PM, Nov 09, 2021
and last updated 2021-11-10 11:04:43-05

DENVER — Colorado is reactivating crisis standards of care for staffing of health care systems to help manage the influx of patients who need care for COVID-19 or any other illness.

Crisis standards of care are guidelines for how the medical community should allocate scarce resources.

The public health objectives of the crisis standards of care for health care staffing are to:

  • Expand the availability of health care workers and health care resources to combat the COVID-19 pandemic and to serve patients seeking non-COVID-19 related care;
  • Assure that guardrails and supports are in place to optimize workplace safety, health care worker resilience in the face of moral and physical stress, patient safety and health outcomes of COVID-19 and non-COVID-19 patients.

Staff shortages have been reported due to COVID-19 illness, increased workloads from hospitals working at capacity and staff burnout, CDPHE said.

Gov. Jared Polis just last week warned Colorado could be heading to crisis standards of care. He also said the state was preparing to ask the federal government to supply medical surge teams and is considering stopping elective surgeries, though that has not happened yet.

On Sunday, Polis then signed two executive orders to give the state control of hospital admissions and transfers — which authorized the CDPHE to direct facilities to transfer patients to prevent overwhelming the capacity of a facility and its staff — and to lay the groundwork to authorize crisis standards of care. Hospitals are required by federal law to accept a transfer if they are able to provide the level of care needed and if they have capacity.

The Colorado Hospital Association also implemented Tier 3 last week, which is the highest tier, to deal with the strain on the hospital system. Tier 3 allows the Combined Hospital Transfer Center to take charge of moving patients during a shortage of beds. According to the state's COVID-19 dashboard, 101 ICU beds are currently available.

State health officials just last week estimated hospitalizations would peak in early December at around 1,400 people hospitalized. However, the state already surpassed that estimate on Tuesday with 1,426 hospitalizations for COVID-19 across the state.

The Colorado COVID-19 Modeling Team said the state should immediately increase its COVID-19 mitigation strategies, such as mask wearing, testing and physical distancing, to reduce the magnitude of the coming coronavirus peak.

“We want to be sure Coloradans know they can and should continue to access necessary health care. If you’re sick and need care, please go get it,” said Dr. Eric France, Chief Medical Officer. “Activating staffing crisis standards of care allows health care systems to maximize the care they can provide in their communities with the staff they have available.”

At this time, the state is not activating crisis standards of care for emergency medical services, hospital and acute care facilities, out of hospital care providers, specialty patient populations or for personal protective equipment.

A committee updated the crisis standards of care early on in the pandemic in April 2020. The state deactivated Colorado’s crisis standards of care for health care staffing and emergency medical services on Feb. 11, 2021.