Background/Problem: During public health emergencies and influenza pandemics, healthcare personnel (HCP) historically have faced a tremendous demand for respirators. If changing respirators between patient encounters, the U.S.’s use count can reach an estimated requirement of 7.41 billion respirators over a six-month span. This surge in respirator demand was evident during the most recent 2019 Coronavirus SARS-CoV-2 pandemic, the 2009 H1N1 influenza pandemic, and the 2003 severe acute respiratory syndrome (SARS) outbreak. In 2012, U.S. acute care hospitals had only 60 million N95® filtering facepiece respirators in stock, which was vastly inadequate for a pandemic demand. In response to critical shortages of respirators during pandemics, the National Institute for Occupational Safety and Health (NIOSH) initiated projects to assess the feasibility of using reusable elastomeric half-mask respirators (EHMRs) in healthcare settings. Methods/Project or Program Description: Three groups of hospital-based demonstration projects were launched between 2018 and 2023 to evaluate the practicality of training HCP on the use of NIOSH Approved® reusable respirators and then maintaining and implementing these in a hospital setting. The Honeywell North® RU8500 respirator was selected for this group of studies to understand HCPs’ device experiences during routine healthcare delivery and to identify disinfection best practices. The studies involved contract partnerships with universities and their associated hospitals new to using EHMRs, namely Emory University (EU), the University of Texas (UoT), and Wayne State University (WSU). In 2020 the studies expanded to include two hospital systems experienced in the use of EHMRs, with the plan to develop implementation guides and get their HCP’s perceptions of using EHMRs. The contracted studies were with the University of Maryland School of Medicine (UoM), which was using 3MTM 7500 model respirators, and the Allegheny Health Network Singer Research Institute (AHN), which was using MSA 200LS model respirators. Results/Lessons Learned: The 2018 hospital demonstration projects focused on feasibility studies ("JETFIT"), involved rapid fit testing and training of HCP, and demonstrated a successful implementation of EHMRs during simulated public health emergencies. The "REUSE" studies provided insights into the routine integration of EHMRs in patient care, while "RESPONSE" studies assessed disinfection protocols. Subsequent projects in 2020 at UoM and AHN further investigated HCP perspectives and culminated in the development of implementation guides, contributing to a comprehensive understanding of EHMR deployment. Peer-reviewed manuscripts, webinars, and reports documented the positive outcomes of these initiatives, including healthcare systems' perspectives on EHMR strategies. Conclusions: The adoption of EHMRs in healthcare settings is feasible and offers a cost-effective, sustainable alternative to disposable N95 filtering facepiece respirators. Best practice guidelines and positive HCP experiences support broader implementation, with the potential to transform respiratory protection strategies in healthcare. Dissemination of findings through webinars, publications, and conferences continues to inform the scientific community and stakeholders, advocating for a paradigm shift in respiratory protection.