TABLE 3.

Examples of Indicators and Triggers Used for Implementation of CSC Plan

Standard of Care Level	Conventional Standards of Care Usual Care, Normal Operating Conditions	Contingency Standards of Care Functionally Equivalent Care	CSC Extreme Operating Conditions
Space triggers	Usual patient care space fully utilized	Patient care areas re-purposed (PACU, monitored units for ICU-level care). Doubling of patient rooms; abnormally high percentage of hospitals on divert for EMS	Facility damaged/unsafe or non-patient care areas (classrooms, etc.) used for patient care (alternate care sites)
Staff triggers	Usual staff called in and utilized	Staff extension (brief deferrals of nonemergent service, supervision of broader group of patients, change in responsibilities, documentation, etc.)	Trained staff unavailable or unable to adequately care for volume of patients even with extension techniques; marked increase in staff or school absenteeism (2 specifying 20-30% or >30% thresholds)
Supply triggers	Cached and usual supplies used	Conservation, adaptation, and substitution of supplies with occasional re-use of select supplies	Critical supplies lacking, possible reallocation of life-sustaining resources (ventilators, beds, blood products, antivirals, PPE, etc.)
Indicators	Full utilization of space, staff, and supplies is a potential indicator for contingency standards of care	Maximization of contingency standards of care is a potential indicator for CSC

Abbreviations: CSC, crisis standards of care; EMS, emergency medica; services; ICU, intensive care unit; PACU, post-anesthesia care unit; PPE, personal protective equipment.