Resource allocation |
• Recognize that pandemic crisis standards of care can interrupt access to care that is suspended temporarily in outpatient settings. |
• Use a clinical decision support system in triage decision-making with validated criteria for limits (eg, SOFA scores, Multi-Organ Dysfunction Prediction Score (MODS), age).11,15 |
• Account for prognosis, comorbidities, and functional status in admission criteria to the ICU. |
• Form triage teams that are distinct from bedside care team and are specific to allocation decision-making, to reduce moral distress during pandemic settings for the treating team. |
Ethical responsibility to families |
• Palliative care for discussions on advanced care planning or decision to withhold or withdraw life-sustaining treatments are done on an individual basis. |
• Patients appropriately triaged to palliative care are notified of their right to discuss concerns or appeal decisions. In these situations, palliative care and ethics consultation services are readily accessible. |
Ethical responsibility to healthcare workers |
• Conservation and reallocation of resources make utilization more efficient and allow appropriate PPE to be made available to healthcare workers across settings such as the hospital, outpatient, long-term acute care facilities, and hospice. |