Resources on COVID-19 and Vaccines

Caring for Maryland

Crisis Standards of Care

  Maryland hospitals have been using pandemic plans to address COVID-19 throughout the pandemic. They have paused or delayed surgeries that are not medically necessary and worked with insurers, skilled nursing facilities, behavioral health facilities, and others to quickly find treatment facilities for patients that are ready for discharge. Hospital personnel are stretched to their limits right now, and we cannot demand more from them.

This guide helps explain the difference and how these protocols help hospitals deliver the safest care possible to all Marylanders.

Frequently Asked Questions

(Adapted from materials by Luminis Health)

What does crisis standards of care mean?

Crisis standards of care protocols are put into place when there is a need to extend the availability of key resources, while also minimizing the impact of shortages on clinical care. These protocols have been prepared and approved in advance so that hospitals and health systems can quickly implement them in times of crisis.

What changes for patients?

It’s important to note that patients with serious illness and injury should continue to access needed care at hospitals and health systems. The focus will be on care for the sickest patients who truly require inpatient hospital treatment. Those with less serious conditions should avoid the emergency departments and seek care from their primary care provider or an urgent care center. Patients can expect longer wait times for all services and increased limitations on visitors and communication with loved ones. We plan to increase the use of telemedicine to triage the need for in-person clinic appointments.

What does it mean for staff?

During this period, staff may be redeployed or asked to change regular protocols in order to better care for the sickest patients. These changes may include the frequency of imaging studies, expedited transfer and discharge processing, streamlined documentation, and the use of telemedicine to triage patients before scheduling inpatient clinic appointments. Surgeries will be limited to urgent cases that cannot otherwise be managed with more conservative measures, and the emergency department will be reserved for those with life-threatening illnesses and injuries.

Can someone still go to the hospital when they need care?

Hospitals and health systems are always here for those with serious illnesses and injuries. During this time, those with less serious needs should go to their primary care doctor or an urgent care center. Because hospitals are caring for so many with COVID-19, there are fewer staff and fewer beds available for those with other needs, so surgeries may be postponed. Hospitals and health systems are working diligently to get back to normal care protocols as soon as possible.

How long will the crisis protocols be in place?

It is difficult to know when the need for crisis standards of care will abate. Gov. Hogan has stated that the next four to six weeks could be a very difficult time for the state of Maryland, and the pandemic models we are seeing form the CDC and other trusted sources support this. Hospitals and health systems are closely monitoring the evolving situation and making decisions accordingly.

What can the community do to help?

The most important things the community can do is to take care of themselves. Get vaccinated and boosted. Practice the 3Ws – wear a mask, watch your distance and wash your hands. During this crisis, we ask those with less serious needs to go to their primary care doctor or an urgent care center rather than the emergency departments. Patients within the emergency department should understand that our staff is working at peak capacity, and there may be longer wait times or differences in care experience.


CSOC 1 What are CSOC Q and A 

In an interview on CNN's Erin Burnett OutFront, Bob Atlas, President & CEO of the Maryland Hospital Association, discusses the recent shift to Crisis Standards of Care in some hospitals.

CSOC 2 the 3 Cs of Hospital Care