On February 2, GNYHA and the New York City Department of Health and Mental Hygiene (DOHMH) together hosted a facilitated discussion that explored the health care response to the January 9 apartment fire in the Bronx, which resulted in significant morbidity and mortality. The facilitated discussion, held virtually, involved nearly 70 representatives from hospitals that received patients plus the involved agencies, including the Fire Department of the City of New York (FDNY) – Emergency Medical Services (EMS), NYC Emergency Management, DOHMH, and the New York City Office of the Chief Medical Examiner. Representatives were split into three discussion groups, each of which explored two topics.
Key findings from each discussion group are attached below.
We hope that the discussion itself and the above key findings can lead to improved preparedness at the facility, health system, and regional level. The following regional priorities were identified as a result of this facilitated discussion:
- Improve and drill the Sit Stat Mass Casualty Incident (MCI) Level C Survey
- Improve visibility around the real-time availability of specialty beds (i.e., burn beds) and resources (i.e., hyperbaric chambers)
- Advance bidirectional communications between FDNY-EMS and hospital emergency departments (EDs) to inform FDNY operations and transport decisions. The information flow is currently unidirectional.
- Finalize, formalize, and socialize a statewide unidentified patient naming convention to be used by all hospitals, then integrate the naming convention protocols into jurisdictional systems and plans, including EMS protocols and New York City’s Unified Victim Identification System
Through the facilitated discussion, the following hospital-level best practices were identified and should be considered when planning for future responses to MCIs:
- Hospitals should maintain situational awareness about an incident, in addition to what is provided through formal channels and EMS field staff, by obtaining critical information via various sources, including the Citizen App and other social media sources
- Upon notification, hospitals should quickly activate and bring resources and staff directly to the ED from other areas within the facility to support ED response
- Unidentified patient naming conventions should be integrated into hospital electronic medical records to facilitate the automated tracking of event-related and unknown patients
- Internal mental health and social work resources should be quickly activated to support the response, especially when dealing with unaccompanied minors. Internal hospital staff involved in response should also receive appropriate debriefing and mental health support following tragic events.
GNYHA and DOHMH thank everyone who participated in the February 2 facilitated discussion, as well as the event facilitators and scribes