Fatality Management Webinar for NYC Hospitals Presentation · 2021. 2. 11. · Access the NYC...

Fatality Management

Webinar for NYC HospitalsDecember 9, 2020

□ Introductory Remarks

□Organization/Agency Updates

□ NYC Office of Chief Medical Examiner

□ Greater New York Hospital Association

□ NYC Emergency Management

□Review of Fatality Management Resources

□Q&A

Agenda2

Introductory Remarks

Organization/Agency

Updates

NYC Office of Chief Medical

Examiner (OCME)Emily Carroll Deputy Director, Emergency

Management / Forensic Operations

Helen Alesbury Assistant Director of Emergency

Management / Forensic Operations

CITY OF NEW YORKOFFICE OF CHIEF MEDICAL EXAMINER HOSPITAL MASS FATALITY PLANNING CHECK IN

8 December 2020

Agenda Wave 2 Situational Awareness & Current Trends

Current Hospital Morgue Operations

Hospital MFM Plans

Next Steps for Wave 2

WAVE 2 SITUATIONAL AWARENESS & CURRENT TRENDS

Current Trends• OCME constantly monitors several

data sources:

– HERDS Data

– DOHMH Data

– Hospital Morgue Survey

– Cases Reported to OCME

• Current trends indicate an increase in positivity

– Not as pronounced or steep of a curve as Wave 1

– Will likely not experience same levels of fatalities in Wave 2

Current Trends: Non-Healthcare Facility Deaths

- 50

100 150 200 250

Non-HCF Cases Reported to and Recovered by OCME

Total # Non-HCF Cases Reported # of Recoveries by field recovery teams*

% non-HCF Tran by FH

Current Trends: Morgue Census Survey

0

1000

2000

3000

4000

5000Hospital Morgue Census

Total Cases Currently at HCFs # Unclaimed # Claimed

CURRENT HOSPITAL MORGUE OPERATIONS

Daily Hospital Morgue Census Survey

• Submission requested every weekday

• Hospitals must designate someone to respond *

• Normal levels are 20-25% citywide usage

– Slight increase to 30% has normalized in recent weeks

*Email ocme_emergencymanagementteam@ocme.nyc.gov to have additional staff added to daily reminder

Daily Survey – Added Question

• Question added regarding the number of cases being held by your hospital pending the results

of a postmortem flu test

• Data will inform the impact of this requirement on morgue census and capacity issues

How To: Decompress Your Hospital Morgue

MonitorClosely monitor your

hospital morgue capacity

Submit daily hospital morgue survey to OCME

Submit

Hospital should submit paperwork to OCME for claim case pick up as soon as possible

• Death Certificate

• Clinical Summary Worksheet

• Facility Facesheet

Do not waitDo not wait to submit

several cases at once (this may result in a delay in

pick up)

Reminders

The 7 – day waiting period for Hospital Claim Only case pick-up remains suspended

Upon receipt of complete and competent paperwork, OCME can

pick up decedents from hospitals as soon as operationally possible (24-48

hours).

HOSPITAL MFM PLAN REVIEW

THANK YOUNearly all hospitals

submitted their updated

Mass Fatality Plans for

review and comments

Plan Review Takeaways

Surge Staffing

Paperwork

BCP Placement and Logistics

Equipment and Supplies

Family Management

Hospital Surge Staffing

Recommendations

Lessons learned from Wave 1 was hospital staffing

shortages in:

Body Handling

Administrative Support

Crosstrain current hospital staff

Identify and establish contracts/agreements

with vendors, temp agencies, and other

mechanisms for support.

Develop just-in-time training including reference sheets, checklists, etc. for

incoming personnel

Hospital Paperwork Protocols

Hospitals should create protocols for submitting required paperwork

to OCME

Update Hospital Plans to Include eVital

Hospital BCP Logistical Considerations

City will make efforts to accommodate the requests of hospitals for specific BCP characteristics, however, during times of resource competition and scarcity, hospitals will be expected to manage various types of BCPs.

NYCEM currently maintaining a cache of 53’ trailers

NYCEM Role

• Deployment of BCP unit to fulfill resource requests

• Provide contract to support fuel management and BCP maintenance/servicing

Hospital Responsibilities

• Pre-identify location proximate to hospital for one or two BCP units

• Ensure accessibility for tractor to deliver/retrieve BCP and fuel truck

• Identify safe and respectful mechanism for the loading and unloading of decedents

• Utilize necessary measures to ensure privacy of operations

• Monitor ambient temperature of units to ensure optimal storage conditions

• Ensure strict security and access control measures

• Maintain inventory of supplies/equipment to support Fatality Management operations

• Reminder: Shelving not to be installed in BCPs for second wave

Hospital BCP Retrieval

Ready before scheduled pick up?

Contact BCP Coordinator

Option 2:

Scheduled Retrieval

Option 1:

• Maximize BCP storage capacity within the unit

• Confirm BCP decedent list is current and correct

• Verify that all cases in the BCP are properly packaged and labeled

• Ensure all case paperwork has been submitted to OCME and requested corrections have been made

• Hospital Face Sheet, Registered Death Certificate, and List of Decedents in BCP

• The hospital must prepare the site for removal of the BCP, including preparing to remove privacy tenting or structures fixed to the unit

Hospital Equipment and Supplies

Survey current hospital supply

inventories

1Create list of

necessary items to support BCP

operations and/or a fatality surge

2Identify critical

vendors and outline resource request or

hospital-specific supply replenishment process

3Lesson Learned:

Ruggedized Human Remains Pouches: Plan on having at least 300 on hand

4

Hospital Family ManagementEach hospital should identify internal staff and processes for managing families, answering family inquiries and maintaining communication.

Hospitals are responsible for the following:

• Make a notification of death to the decedent’s family

• Communicate with the family to understand and document the family’s intention for final disposition, if available

• Provide the family with general overview regarding the process for case storage and release to the funeral home or OCME

• If family is unknown, follow protocol to report the case to the Public Administrator

• Coordinate with the family to facilitate release all personal effects

Upon taking custody of decedents from hospitals, OCME will:

• Communicate with the known family and the chosen funeral home to affect case release for final disposition

• If family is not identified, or unavailable, OCME will conduct an outreach investigation to determine appropriate family with whom to coordinate

• OCME maintains a long-term storage operation to ensure appropriate storage of decedents until the family can make arrangements

NEXT STEPS FOR WAVE 2

Hospital Quick-sheets• Will be sent out next week

• Will serve as a centralized location of the most important information

• Are prefilled with data from Sit Stat

– Update Sit Stat as soon as possible

Fill out and return by THURSDAY, DECEMBER 31ST to:Ocme_emergencymanagementteam@ocme.nyc.gov

MFM Plan Template

• Several hospitals requested a template for their MFM

Plans

• Will be sent out following this webinar

• Can be used to help restructure plans

• Not required for plan update

• Updated plans requested by 1/15/2021

Summary

Avoid morgue capacity issues by steadily submitting case paperwork to OCME

Keep submitting the

morgue census

If necessary, may be requested 7-days a week

OCME Emergency Management may follow up to ensure you have the support you need

Update Sit Stat As Soon As Possible

Complete Quick Sheet by 12/31/20

Use Plan Template to update your MFM Plan if desired

Submit updated plans by 1/15/21

Thank You

Emily Carroll, MPHDeputy Director of Emergency Management, Forensic OperationsCity of New York Office of Chief Medical Examineremcarroll@ocme.nyc.gov

Helen Alesbury, MAAssistant Director of Emergency Management, Forensic OperationsCity of New York Office of Chief Medical Examinerhalesbury@ocme.nyc.gov

Elissia ConlonDeputy Director, Forensic OperationsCity of New York Office of Chief Medical Examinereconlon@ocme.nyc.gov

GNYHASamia McEachin Senior Project Manager,

Emergency Preparedness and Employee Wellness

□ Portion of OCME quick sheet data is also in Sit Stat

□ Dedicated Sit Stat Fatality Management Views□ NYC Fatality Mgmt Contacts (key roles/departments)

□ NYC Fatality Mgmt Operations (morgue capacity and BCP locations)

□ Hospitals will update data directly in Sit Stat□ Data will be shared with the hospital community, as well as response

agencies and GNYHA

□ OCME will pull data from Sit Stat to pre-populate the quick sheets

□ Coordinate with your hospital or health system Sit Stat POC to submit the Sit Stat data □ Contact Samia McEachin if you don’t know your Sit Stat POC.

Fatality Management Data in Sit Stat33

NYC Fatality Mgmt Contacts View34

Data points include:

□ FM Executive

Sponsor

□ Primary FM POC

□ Backup FM POC

□ Primary EM POC

□ Hospital Morgue

Census Survey

POC

□ Hospital Morgue

□ Facilities Dept.

□ BCP Logistics POC

□ Security Dept.

□ Admitting Dept.

□ Pathology Dept.*

□ Case Mgmt POC

□ Family Mgmt POC

NYC Fatality Mgmt Operations View35

Data points include:

□ Morgue Capacity

□ Internal Morgue Surge Space / Capacity

□ BCP Location / Coordinates

□ BCP Location Site Description

□ Tractor Trailer Access

□ Loading Dock Access

□ Loading / Unloading

□ Public View Concerns, etc.

□ Access Control Measures

□ HVAC / Air Intake

□ Shore Power, etc.

1. Log into GNYHA’s Sit Stat platform.

2. Access the NYC Fatality Mgmt Contacts view.

3. Click on the keys icon next to your facility’s name.

4. Fill in contact information for each of the key Fatality Management roles/departments, updating any incorrect information.

5. Click Save at the bottom.

6. Repeat this process in the NYC Fatality Mgmt Operationsview to submit data related to morgue capacity and BCP locations.

How to Update Information in Sit Stat36

Keys Icon Data Submission Screen

37 How to Update Information in Sit Stat

NYC Office of Emergency

Management (NYCEM)Justin Diehl Director, Ground Support Logistics

James Fingerhut Consultant, Health and Medical

Logistics

□ NYC Emergency Management has staged 100 Body Collection Points (BCPs) for potential re-deployment

• BCPs are staged in New Jersey and can be deployed within a few hours of request

• All BCPs are 53 feet and diesel fueled (same as the first wave)

• As a reminder, do not install shelving in the BCPs

□ To request a BCP (and any other resources), please submit this as a resource request through your healthcare associations

• H+H facilities should contact H+H Central Office Emergency Management

• All other NYC hospitals should contact GNYHA

• Note: For emergency PPE needs, utilize the PPE Services Center (PPESupport@health.nyc.gov)

BCP Resources & Requests39

□ The Facility is responsible for:

□ Providing 24/7 security; including video recording

□ Having appropriate infrastructure and staffing in place to maintain BCP operations

□ Providing concealment of the assets

□ Providing 24 hour access for Contractors and Fuel Service providers

□ Creating a functional check schedule to ensure that as operations continue, the

asset continues to operate as intended

□ Adhering to guidelines for labeling, tracking, and release of decedents (including

transfer of custody) as outlined in OCME’s guidance documents during incidents of

higher than normal fatality rate

□ Notifying NYCEM when the BCP operation has completed

BCP Site Requirements40

Review of Available

Fatality Management

Resources

Hospital

Planning

Resources

42

□ OCME Hospital Toolkit

□ Lessons Learned and Special Considerations Documents

□ Document Portal and Resource Hub

□ DOHMH HPP-funded Fatality Management Plan Update deliverable

□Housed on GNYHA website, in collaboration with OCME

□ Includes all fatality management guidance

□ Resources to update fatality management plans

□ Information about current operations

□ Document repository

□Hospital-facing operational and guidance documents

□ Most current versions easy to find with changes highlighted

□ Older versions archived and available

Document Portal & Resource Hub43

Q&AAdditional Questions/Comments?

Contact Faiza Haq (fhaq@gnyha.org; 212-506-5421)

Thank You!