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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 [email protected] 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:[email protected]
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 [email protected]
Helen Alesbury, MAAssistant Director of Emergency Management, Forensic OperationsCity of New York Office of Chief Medical [email protected]
Elissia ConlonDeputy Director, Forensic OperationsCity of New York Office of Chief Medical [email protected]
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 ([email protected])
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
Thank You!
