Improving Crisis Preparedness: Lessons from Acute Care Settings in Minnesota During the COVID-19 Pandemic

Improving Crisis Preparedness is a project led by the Center for Bioethics at the University of
Minnesota. The project will solicit healthcare stakeholder input on the COVID-19 response and
develop recommendations for improving the state’s crisis preparedness and response
frameworks. Under contract with the Minnesota Department of Health (MDH), this project aims
to gather input from diverse healthcare stakeholders throughout the state to assess the
adequacy of those frameworks and make recommendations for improvements. Virtual listening sessions are planned with various healthcare stakeholder groups, including clinicians and hospital/health system leadership. The project team will then draft recommendations for revisions to the state’s crisis preparedness and response framework.

Minnesota joins other groups in leading crisis preparedness planning with this project, particularly through learning from the experiences of healthcare stakeholders. Analysis of listening sessions is a burgeoning method to reflect on and learn from the statewide COVID-19 response. Nationally, health policy work on COVID-19 preparedness and response has revealed several key insights:

Scarce healthcare resources affected the ability to provide care in ways that resulted in widespread psychological burdens
Frontline clinicians often struggled to identify acceptable standards of care amidst rapidly changing healthcare needs and policies
Clinicians sometimes failed to receive sufficient institutional support in allocating scarce resources
In-hospital mortality prediction scores during the pandemic risked producing racial disparities in resource allocation
Pre-existing plans and their inherent assumptions often failed to meet in-the-moment needs of providers

While many of these conclusions may reflect the on-the-ground situation in Minnesota over the last few years, further Minnesota-specific input is required to refine the state’s position as a frontrunner in creating resilient healthcare systems. By spotlighting the experiences of healthcare stakeholders, this project elevates those who have worked tirelessly within contingency and crisis conditions from March 2020 to April 2023 and prioritizes their feedback to promote refinement of the state’s guidance for emergency preparedness and response.

Institutional Review Boards at both the University of Minnesota and MDH have determined that this project does not constitute human research. Nevertheless, the project team will implement safeguards to protect participants' privacy and confidentiality.

Interested in learning more or participating? Please contact Debra DeBruin at [email protected].

Our Team

Debra DeBruin, PhD
[email protected]
Dr. Debra DeBruin primarily works on issues in public health ethics and the ethics of health
policy, with a focus on concerns about social justice and health equity. She has done substantial
work on public health emergency planning, with an emphasis on the importance of equity in this
perilous context. She co-directed the Minnesota Pandemic Ethics Project and led the project to
develop ethics guidance for Crisis Standards of Care in Minnesota; both of these projects were
conducted under contract with the Minnesota Department of Health (MDH). During the COVID-
19 pandemic, she co-led the Minnesota COVID Ethics Collaborative (MCEC), a statewide
advisory group that provided input to MDH on ethical issues in pandemic response. She
continues to assist groups of clinicians statewide in managing drug shortages. Dr. DeBruin
directs the Center for Bioethics at the University of Minnesota.

Joel Wu, JD, MPH, MA, HEC-C
[email protected]
Joel Wu is a Center for Bioethics’ Clinical Ethics Assistant Professor and a senior lecturer in the
Division of Health Policy and Management at the University of Minnesota’s School of Public
Health. He is a co-chair of the University of Minnesota Medical Center's Ethics Committee, co-lead for the clinical ethics consultation service for MHealth Fairview system hospitals, and
member of the MHealth Fairview Ethics Council. Professor Wu, a member of MCEC, helped
draft some of the group’s recommendations to MDH.

Adam Negri, MA
[email protected]
Adam Negri is a historian of medicine and a PhD Candidate in the History of Science,
Technology, and Medicine program at the University of Minnesota. He has conducted several
healthcare-aligned oral history projects, focusing on neurology, COVID-19, HIV/AIDS, and co-
directs the Minnesota Reproductive Health Oral History Project. He is an Interdisciplinary
Doctoral Fellow at the Minnesota Population Center, interested in health equity and healthcare
policy.

JP Leider, PhD
Dr. JP Leider is an associate professor at the University of Minnesota School of Public Health
(SPH) and founding director of the SPH Center for Public Health Systems (CPHS). With Dr.
DeBruin, he worked on the Minnesota Pandemic Ethics Project and the project to develop ethics
guidance for Crisis Standards of Care in Minnesota. He served as an MCEC member and
helped draft the group’s recommendations to MDH. He also led the project to develop and
manage a centralized access platform for monoclonal antibody therapies during the COVID-19
pandemic that linked over 31,000 patients in Minnesota to care during its operation (The
Minnesota Resource Allocation Platform, or MNRAP).

John L. Hick, MD
Dr. John L. Hick is a faculty emergency physician at Hennepin Healthcare and a Professor of
Emergency Medicine at the University of Minnesota Medical School. He serves as the Deputy
Medical Director for Hennepin County Emergency Medical Services and Medical Director for
Emergency Preparedness at Hennepin Healthcare. He served the Minnesota Department of
Health as the Medical Director for the Office of Emergency Preparedness from 2002-2014 and
as the Manager for the COVID-19 Statewide Healthcare Coordination Center. He currently
serves as the Senior Editor for the US Administration for Strategic Preparedness and
Response’s (ASPR’s) Technical Resources, Assistance Center, and Information Exchange
(TRACIE). He is an expert on hospital preparedness and crisis standards of care issues and
has published over one hundred peer-reviewed papers dealing with hospital preparedness for
contaminated casualties, disaster standards of care, and surge capacity. He has co-chaired or
been a member of multiple National Academies of Medicine committees.