Australian highlevel public policy preparedness for population-based triage during the pandemic

The COVID-19 pandemic brought attention to scarce clinical resource allocation via secondary population-based triage (S-PBT) throughout the international healthcare community. Experiences overseas highlighted the importance of coordinated and consistent approaches to allocating resources when facing overwhelming demand, particularly for critical care. Noting the importance of consistency and the system of devolved governance deployed in Australia, this study aimed to identify and analyse sources of high-level policy that affect Australia’s health system preparedness for the operationalisation of S-PBT. Of the 39 documents reviewed, 17 contained potential references to S-PBT. There was a lack of clear recommendations and guidance to inform S-PBT operationalisation and, where provided, advice conflicted between documents. Many jurisdictions did not detail how S-PBT would be operationalised and failed to delineate stakeholder responsibilities. These results are important as they reveal a lack of high-level jurisdictional policy preparedness for coordinated and consistent S-PBT operationalisation. These results offer insights and opportunities for enhanced disaster preparedness as clinicians, policymakers and academics critically reflect on pandemic responses. The results show a need for enhanced preparedness around the management of overwhelming demand and clinical resource management in Australia.