Developing alternative systems to deliver emergency health services during a pandemic or public health emergency is essential to preserving the operation of acute care hospitals and the overall health care infrastructure. Alternate care sites which can serve as areas for primary screening and triage or short-term medical treatment, can assist in diverting non-acute patients from hospital emergency departments and manage non-life threatening illnesses in a systematic and efficient manner. Maintaining consistent standards of care in these settings is essential to a uniform approach to the medical management of a public health emergency.

Subject matter experts in emergency and disaster medicine, public health, pediatrics, and various other medical specialties were convened at regular intervals over an 18-month period. Through a consensus-based process this working group created a universal standard of care along with model clinical protocols to manage patients in an out-of-hospital setting using medical and non-medical personnel.

These protocols were designed to allow the mild to moderately ill patient to be managed in a non-acute care hospital or community-based care setting for a limited period of time and then return to their homes for convalescence. Of particular importance are that these protocols applicable to all public health emergencies and do not rely on the active presence of physicians at the alternate care site to render care.

The development of consistent standards of care and the ability to care for patients in an out-of-hospital setting during a pandemic or public health emergency is essential to preserve the sustained operation of acute care hospitals and the entire healthcare system. Diverting patients to a community- based alternate care site or encouraging the early discharge of patients to these locations can assist in managing the large numbers of casualties anticipated during a pandemic or public health crisis.