Alaska activates crisis care decision-making guidelines for 20 health care facilities

ANCHORAGE, Alaska (KTUU) - As Alaska’s current surge of COVID-19 continues and resources start to run short in hospitals, the state has activated a crisis standards of care document to help guide decision making for 20 hospitals and health care facilities.

The Alaska Department of Health and Social Services announced on Saturday that it had activated a document called Patient Care Strategies for Scarce Resource Situations. The document contains the state’s decision-making framework, which “includes a progression of conventional, contingency and crisis standards of care identifying strategies to be used depending on the situation and types of resource shortfalls being experienced” according to Saturday’s press release.

The state’s Crisis Care Committee, which is made up of 15 health care professionals from across Alaska, requested that the document be activated for the 20 facilities, the release states.

The facilities this applies to are:

Alaska Native Medical Center
Alaska Regional Hospital
Bartlett Regional Hospital
Bristol Bay Area Health Corp./Kanakanak Hospital
Central Peninsula Hospital
Cordova Community Medical Center
Fairbanks Memorial Hospital
Maniilaq Health Center
Mat-Su Regional Medical Center
Norton Sound Health Corporation
Petersburg Medical Center
Providence Alaska Medical Center
Providence Kodiak Island Medical Center
Providence Seward Medical Center
Providence Valdez Medical Center
SEARHC/Mt. Edgecumbe
South Peninsula Hospital
Elias Specialty Hospital
Wrangell Medical Center
Yukon Kuskokwim Health Corp.

A handful of these hospitals, including Alaska Native Medical Center, the Yukon Kuskokwim Health Corp. and Fairbanks Memorial Hospital had already activated their own crisis standards of care this week. However, according to the release, the crisis care decision-making framework was activated in recognition that the state’s health care system is interconnected and interdependent.

“This State document supports facilities, their credentialed providers and staff as they make decisions regarding patient care and also provides liability protection as authorized under House Bill 76 and the department’s Public Health Emergency Order,” the release states.

According to the announcement, the framework was activated for these 20 health care facilities due to medical resources being scarce, limited health care staff and “the difficulty of transferring patients to other medical facilities due to limited bed availability.”

Specifically, the release stated some facilities are struggling with limited oxygen supplies and mechanical ventilation, limited staff and limited renal replacement therapy, which is a type of dialysis used during kidney failure. Facilities also have limited staff trained to use that equipment.

Providence Alaska Medical Center, the state’s largest hospital, was the first to begin operating under crisis care standards. The standards are a way to prioritize care, treatment and resources when hospitals are overwhelmed with limited resources. Also called care rationing, the crisis standards of care allow for treatment to be prioritized for patients who stand the best chances of benefitting from them.

“Crisis standards of care are peer-reviewed guidelines that may be used during a disaster or public health emergency when there are not enough health care resources to provide the usual standard of care to people who need it,” the release states.

State hospitals and health care facilities have been under prolonged stress as Alaska experiences its largest surge in COVID-19 since the pandemic began. The state’s rate of new cases per capita continues to be the highest in the nation, and the number of COVID-19 hospitalizations in the state has remained above 200 for weeks.

The crisis care standards will remain in effect, the state health department said, “until there are sufficient resources to provide the usual standard of care to all patients.”