Education event

Webinar Participant Information

Health Care Surge Crisis Care Guidelines Webinar

Originally recorded June 23, 2020.



“Extraordinary times call for extraordinary measures…” - Benet Wilson

COVID-19 is challenging America’s health care providers in ways we never imagined. To support them in making difficult decisions during times of scarce medical supplies, California’s health care leadership has been developing guidance that will help frontline health care workers make some of the hardest decisions of their lives.

The California Department of Public Health has released the California SARS-CoV-2 Pandemic: Health Care Surge Crisis Care Guidelines. In this members’ only webinar, senior leadership from the CDPH will present a review of the new guidance, insights into its development, and explain how it can inform real-time clinical decisions.

    These are indeed extraordinary times. 

    Audience includes: 
    Health Care Executives, Legal, Risk Managers and Compliance Officers


    Topics will include:    

    • Overview of the Care Continuum and Key Points about Crisis Care
      • The ethical, moral, and emotional quandaries of crisis care
    • Operational Strategies for Health Care Facilities During Crisis
      • Indicators and Triggers
      • Supply Management
      • The Six Core Strategies:  prepare, substitute, adapt, conserve, re-use, reallocate.
      • Health Care Staff Engagement
      • Integration with Health System Partners
      • Public Engagement and Transparency
    • Response
      • Triage
      • Ethical Considerations and Challenges
        • Basic biomedical and ethical principles
        • Guiding ethical principles in defining allocations of scarce resources, including distributive justice, nondiscrimination (including avoiding risk of implicit bias), protecting and providing for vulnerable populations, disability and return to previous state of health
    • Ventilator Management (Appendix A)
      • Triage System
        • Triage Team/Triage Officer
        • Process
          • Use of allocation framework
          • Communication of triage decisions
          • Appeals process
        • Reassessment of crisis conditions, thresholds, and results of allocation policies
      • Allocation Process
        • Calculating each patient’s SOFA or mSOFA score and assign priority group
          • Absence of categorical exclusion criteria
        • Daily determinations of how many priority groups can receive the scarce resource
        • Resolving “ties” between patients
      • Reassessment for ongoing provision of critical care/ventilation
      • Appropriate care of patients who cannot receive critical care
      • Other Pandemic Patient Care Strategies for Scarce Resource Situations (Appendix B)


    Download Presentation

    Additional Resources

    California SARS-CoV-2 Pandemic Crisis Care Guidelines


    Sonia Angell, MD, MPH
    State Public Health Officer and Director

    Sonia Angell, MD, MPH is the State Public Health Officer and CDPH Director. She is the former deputy commissioner for prevention and primary care at the New York City Department of Health and Mental Hygiene. Prior to that, she was a senior advisor for global noncommunicable diseases, and chief and founder of the Global Noncommunicable Disease Unit at the Centers for Disease Control and Prevention.

    She is board certified in internal medicine and received her medical degree from the University of California San Francisco, and completed Internal Medicine residency at Brigham and Women’s Hospital.

    Jackie Garman 
    Vice President, Legal Counsel
    California Hospital Association

    Jackie Garman oversees and coordinates the association’s legal representation on litigation critical to the hospital industry and assists with evaluating the legal impact of legislation and regulations on hospitals. She also assists in developing legislative and regulatory language, coordinates external counsel on litigation involving CHA and interacts with member hospitals on a variety of issues.

    Hernando Garzon, MD
    Emergency Medicine Physician
    Kaiser Permanente

    Hernando Garzon is an Emergency Medicine physician. In addition to his clinical practice Dr. Garzon has extensive experience in disaster response and Global Health. Dr. Garzon has also held multiple leadership roles in health care, including Director of Emergency Management for Northern California Kaiser Permanente, and he still serves as the Medical Director for Sacramento County’s Emergency Medical Services (EMS).

    In his health care leadership roles Dr. Garzon has participated in standardizing Emergency Department flow and operations, as well as emergency preparedness, trauma and infectious disease surge response, and operational planning for a 21-hospital health system.

    Mary Massey
    Vice President, Emergency Management
    California Hospital Association

    Mary Massey has over 25 years in hospital emergency services and county health disaster management.  She participates in multi-agency, state and federal coalitions and deploys with the CA-1 Disaster Medical Assistance (DMAT) Team.
    A Department of Justice (DOJ) Weapons of Mass Destruction (WMD), Homeland Security Exercise and Evaluation Program (HSEEP) Instructor, and Master Exercise Practitioner, she graduated from Naval Postgraduate School with a Master’s in Homeland Security and Defense and currently is the Vice President, Emergency Management at the California Hospital Association.