Recover, Restore and Re-open: A Stanford Medicine framework for bouncing back from pandemic

Stanford Medicine experts have created a framework to guide public officials, school administrators and business leaders on re-establishing normal operations during and after the COVID-19 pandemic.

The R3 framework was conceived to help communities and organizations deal with the pandemic and recover from it.
Stanford Medicine

Last spring, as office buildings emptied and local governments ordered residents to shelter in place, Stanford Medicine faculty members and executives sprang into action to understand more about the mysterious new coronavirus.

Even in the early months of the pandemic, it was clear that a return to normal — bringing students back to classrooms, workers back to offices and travelers back to airlines — would take complex and scientifically grounded policies and guidance.

Now, Stanford Medicine has launched a website to advise various segments of society on getting back to healthy functioning. The effort is called Recover, Restore and Re-open, or R3.

“Our experts’ immediate and steadfast response to the pandemic has built a valuable resource that we feel is imperative to share with the broader community,” said Priya Singh, chief strategy officer and senior associate dean for strategy and communications at Stanford Medicine. “We see the R3 framework as a collection of resources that community members — whether you’re from academia, industry or government, or you’re an individual — can use to inform and guide how they adapt to the uncertainties wrought by COVID-19.”

At the onset of the pandemic, experts from the School of MedicineStanford Health CareStanford Children’s HealthUniversity HealthCare Alliance and Stanford University began building a framework for broad-based recovery. The group considered the needs of the community, such as developing a strategy for expanded coronavirus testing and building a public health surveillance system to track new cases, and used lessons learned from Stanford’s hospitals to inform preparedness for future inevitabilities, such as a surge in cases and a lack of personal protective equipment.

The R3 framework, which was commissioned by Lloyd Minor, MD, dean of the School of Medicine; David Entwistle, president and CEO of Stanford Health Care; and Paul King, president and CEO of Stanford Children’s Health, is powered by more than a dozen Stanford Medicine faculty and leaders. Along with Singh, Bob Harrington, MD, professor and chair of medicine; Mary Leonard, MD, MSCE, professor and chair of pediatrics; and Catherine Krna, MBA, president and CEO of the University HealthCare Alliance, led the R3 committee. Based on the committee’s expertise, the framework is a culmination of the lessons learned while delivering patient care, conducting research and forming policy recommendations as the pandemic evolved.

“Our success in responding so quickly at the beginning of the pandemic was, in part, due to the alignment between the School of Medicine and the clinical enterprises, Stanford Health Care and Stanford Children’s Health,” Krna said. “We would not have been as successful if it weren’t for the joint accountability of our faculty and clinicians and the staff who work with them to care for our patients.”

Guiding current and future response

The R3 framework is a guide to making policy, conducting research and developing treatments, among other things. It’s both a resource for helping communities deal with the pandemic and recover from it. For example, it offers recommendations for protecting vulnerable populations from the virus and safely reopening schools.

R3 is divided into three categories: 

• Contain and control COVID-19.

• Safeguard and support the community.

• Adapt and thrive in the “new normal.” 

The categories cover protocols for responding to new COVID-19 outbreaks and social-distancing regulations, strategies for dealing with the financial and operational repercussions within Stanford Medicine, and recommendations for communications plans that emphasize coordination between local, regional and state authorities. These recommendations and others are detailed on the R3 website.

In the months since the initial outbreak, scientists have continued to learn more about SARS-CoV-2, how it spreads, how to test for it, and what it demands of hospitals and health care workers. R3 committee members hope that many types of entities, including school officials, public health officers and industry leaders, can use the framework to inform the best approach to pandemic response and post-pandemic recovery.



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