Too Many Patients, Too Few Resources – A Public Engagement Research Project

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Imagine, it is February 2019: At the beginning of the month a new strain of influenza (flu) appears in several U.S. states. People begin streaming into hospital emergency rooms complaining of high fever, confusion, and shortness of breath. Many patients develop severe pneumonia within three days of first becoming ill. Patients with severe pneumonia need a breathing machine called a mechanical ventilator. Without a ventilator, these patients will die.

By the last week of the month the deadly new strain of influenza is hitting San Antonio hard. All hospitals have initiated plans for making the best use of their existing ventilators and intensive care beds. Hospitals change empty operating rooms into makeshift intensive care units, and they cancel non-emergency operations that require the use of ventilators and intensive care beds. In the middle of the week, the state of Texas reports that its entire stockpile of emergency ventilators has been given to hospitals.

Background:  In a widespread public health care emergency, there will be more people who need healthcare than there are resources available to help them.  Making decisions about how to use these limited resources will be difficult.  Hospital personnel and public health officials need to know how to make decisions in these difficult moments in a way that reflects the values of the communities in which those decisions will be made.

Purpose: The purpose of this research study is to engage participants in Texas in a dialogue about which values they feel ought to guide decisions about allocating scarce medical resources during a disaster like a pandemic flu.

Approach: Two approximately five-hour meetings were held at locations in the state to explore how to allocate scarce medical resources during disasters.  

The meetings were held:

  • March 10, 2018 – Columbus, TX
    10 am to 3 pm
  • March 11, 2018 – San Antonio, TX
    10 am to 3 pm

At each meeting, participants broke into small groups in which facilitators and note takers will be present to help them learn about and discuss:

  • The possible ways that decisions could be made to allocate scarce medical resources during a public health disaster; and
  • The extent to which these various decision–making frameworks reflect their personal and community values.

Unlike typical public engagement processes where the public merely reacts to an issue, here participants will engage in small-groups that encourage sharing opinions after a period of informed deliberation and discussion about allocation-related issues.

Every effort will be made to accommodate all those who are interested in participating.  If, for space reasons, we are not able to do so, you will be notified as promptly as possible.

Outcome: One or more documents will summarize what the organizers learn from participants during the course of the project to help state policymakers and healthcare providers make decisions about the allocation of scarce medical resources during a disaster in a way that is consistent with the values of the communities in which those decisions would be made.

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