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CVH, SMH implement Crisis Standards of Care as COVID-19 cases soar

The Idaho Department of Health and Welfare activated Crisis Standards of Care early Tuesday in north Idaho which includes Clearwater Valley Health and St. Mary's Health because of a severe shortage of staffing and an overwhelming increase in patients with COVID-19 who require hospitalization.

Additional hospitals affected by this in this region include Gritman Medical Center, St. Joseph Regional Medical Center, and Syringa General Hospital in Grangeville.

Kootenai Health made the request on Monday, Sept. 6, to the state to activate the Crisis Standards of Care (CSC). CSC guidelines help health care providers and systems decide how to deliver the best care possible under extraordinary circumstances when it is no longer possible to provide all patients the level of care they would receive under normal circumstances. The goal of crisis standards of care is to extend care to as many patients as possible and save as many lives as possible.

Prior to requesting implementation of Crisis Standards of Care, a health care organization must exhaust all other possible resources. Throughout the pandemic, St. Mary's Health and Clearwater Valley Health have stretched our existing staff, which, due to national nursing shortages, was already thin, received additional staffing from the National Guard, canceled elective surgeries and adjusted contingency levels of care to accommodate the COVID-19 patient surges and volume demands. They have again made the request to the National Guard for additional staffing, but the current surge will still require Crisis Standards of Care.

Crisis Standards of Care follow a continuum. Initially, they can mean patients are receiving care in a place they would not be receiving care otherwise, such as a hospital room that was not intended for that specific need, or a classroom that has been converted to a patient care area.

They could also mean that St. Mary's Health and Clearwater Valley Health have to keep patients they would normally transfer to a higher acuity hospital due to the inability to find a hospital who can accept transfers. Additionally, they can mean that hospital staff members such as nurses are providing care to more patients than they would normally care for and monitoring vital signs less frequently than normal.

Only in extreme instances will hospital care teams need to make decisions about who will or will not receive needed resources. St. Mary's Health and Clearwater Valley Health both have multi-disciplinary ethics committees that have established protocols to guide decision-making when extreme circumstances require decisions about the provision of care.

With vaccination rates in all surrounding counties under 40%, very few area businesses requiring masking, children - including those not yet old enough to be vaccinated - returning to school with no masking requirements, local COVID-19 case counts will continue to climb.

St. Marys' Health and Clearwater Valley Health and its medical staff members continue to implore community leaders and citizens to add their efforts to the cause. They are asking every individual and family to do their part to prevent and slow the spread of COVID-19. Please get vaccinated for COVID-19, wear a mask when out in public, avoid optional large gatherings, practice social distancing and wash or sanitize hands frequently.

Learn more about crisis standards of care and see an FAQ at https://coronavirus.idaho.gov/idaho-resources/.

Window on the Clearwater
P.O. Box 2444
Orofino, ID 83544
Phone: (208) 476-0733
Fax: (208) 476-4140