GNYHA COVID-19 Resources and Supports, Critical Wave II Preparedness Efforts

With the continued increase in COVID-19 cases and hospitalizations, GNYHA is reissuing this bulletin from October, which covers available resources, staff contact information for when support is needed, and current progress on critical efforts. New information includes updates to the Sit Stat 2.0 and Surge Staffing Resources sections.

COVID-19 Information on the GNYHA Website

Our website features a robust COVID-19 section where you can find the latest on legal and regulatory matters, guidance on best practices, lessons learned on surge capacity, staffing, and other crucial topics.

• Financial Resources: GNYHA tracks all Federal financial resources for hospitals during the public health emergency, and all billing and payment information as it become available.
• Legal and Regulatory: GNYHA has regularly tracked statutory and regulatory waivers at the New York State and Federal levels.
• Infection Prevention and Control: Get the latest information on how your facility can best protect your patients, work force, and environment from COVID-19 transmission.
• Health Education: Our community is our essential partner in containing a second surge. GNYHA has compiled tools to educate the public on testing, best practices, and other COVID-19-related topics.
• Emotional and Mental Health Support: Facing unprecedented stress, anxiety, and grief, frontline health care workers need significant support to continue shouldering the prolonged burden of COVID-19. GNYHA’s offerings include HERO-NY, a “train the trainer” series that adapts combat stress techniques to civilian life, and a list of reading materials.
• NYC Fatality Management Portal: GNYHA, in collaboration with the New York City Office of Chief Medical Examiner, has created this resource hub to house all documents and guidance related to fatality management operations in New York City. Initially created during the first surge, this page is frequently updated, with changes highlighted.
• Operational Guidance: GNYHA shares City, State, and Federal guidance on a variety of topics, such as implementing visitor guidance and managing airborne transmission of COVD-19. Members can also receive a weekly email with links to COVID-19 bulletins sent out that week.

Emergency Preparedness Bulletins

Emergency Preparedness Bulletins provide valuable, time-critical information on public health guidance, upcoming webinars, City, State, and Federal resources, and more. During the height of COVID-19’s first wave, we also offered a weekly roundup every Friday that included links to recently released bulletins and resources. Sign up for these valuable bulletins on our website.

Critical Data Available in Sit Stat 2.0

GNYHA continues to post key data points from daily HERDS surveys on its Sit Stat 2.0 platform. These data points include the number of COVID-19 inpatients, COVID-19 inpatients in the ICU, COVID-19 inpatients intubated, and available staffed beds and available ICU beds. These data for all participating hospitals can be found in the NYS COVID-19 HERDS Data view and the NYC COVID-19 HERDS Data view. Beginning November 20, members are asked to answer a new Hospital Surge Indicator (HSI) twice per day and a small number of surge behavior questions once per day. GNYHA has provided detailed information about these new questions. This new data collection supports Patient Load Balancing strategies. Please see further information below.

GNYHA has also developed a NYS System Transfer Centers view, which contains key contact information for health system transfer centers across the State. This view facilitates patient transfers to support regional load balancing efforts. As events unfold, GNYHA also may activate a COVID-19 Discharge Operations view to display operational data and facilitate patient discharges primarily in the New York City region.

Supply/PPE Questions and Resource Request Process

While GNYHA members are in a much better position with PPE and supplies than in early 2020, supply constraints continue to exist. Members should contact GNYHA’s supply chain leads Glenn Wexler and Courtney Zyla with any questions.

For facilities outside of New York City, the resource request process remains the same. Once members exhaust all usual supply chain options including their hospital system, mutual aid agreements, and assistance from their group purchasing organization (GPO), requests should be made to the county Emergency Management Office. If the county cannot fulfill the request, it will be elevated to New York State for fulfillment.

For facilities in New York City, access to PPE and ventilators will be managed via the New York City stockpile process, a new initiative co-managed by Medline and Agiliti Health. Information about these processes can be found here. For items not in the stockpiles such as refrigerated trailers, facilities should complete a Supply Request Form, which is then routed via GNYHA to NYC Emergency Management (NYCEM) for fulfilment.

Surge Staffing Resources

Staffing is a key surge planning concern for members. Below are updates related to several staffing resources.

• New York State Staffing Volunteer Portal: Over the past several months, GNYHA has had discussions with State officials about the operational effectiveness of the Staffing Volunteer Portal during the peak of the surge and improvement plans for the system. Recent discussions have focused on ensuring that the system can be improved so that GNYHA members can avail themselves of additional staff who may be available to assist in the event of a second surge. As part of that process, we are working to identify hospital human resource staff who can provide direct feedback to State officials about improvements. GNYHA’s goal is to improve the portal’s effectiveness in the short term to address COVID-19 staffing needs, and work with State officials to identify and implement a permanent institutional structure that will benefit hospitals and other providers in the long term should a cadre of volunteers be needed to assist on short notice.
• New York City Medical Reserve Corp (MRC): During the height of the surge, GNYHA worked with City officials to identify a workflow that would allow easier access to the MRC. GNYHA is working with City officials to ensure that improved workflows can also be put in place for the MRC.
• NYCEM GPO: NYC Emergency Management established a Medical Staff GPO to enable health care facilities (HCFs) to hire more staff during a second surge. Each HCF must have its own GPO contract with staffing vendors.
• US Department of Defense (DOD): Members are invited to review the memorandum of agreement with DOD, which will enable military health care providers, if available, to serve as surge staff during a future COVID-19 patient surge

GNYHA members are also encouraged to review GNYHA’s lessons learned document on surge staffing.

Progress on Patient Load Balancing Strategies

In July, GNYHA shared a bulletin on Patient Load Balancing Strategies designed to decrease the possibility of a single facility becoming overwhelmed with patients. We continue to pursue these strategies, with our progress noted below.

• Strategy 1 – EMS: In the near future, the New York City Fire Department (FDNY) Bureau of Emergency Medical Services (EMS) will incorporate information from the daily HSI into internal ambulance destination algorithms. GNYHA and FDNY are discussing this now. Members will be fully briefed before any changes are made.
• Strategy 2 – Enhancing Transfers: To support transfers among hospitals and health systems, GNYHA has collected transfer partner information from independent hospitals. We also routinely convene health system transfer center leaders to share best practices and explore increased collaboration.
• Strategy 3 – Safe Discharges: GNYHA is working to advance the concept of Nursing Facilities with Infectious Disease Specialty Units that could safely care for recovering COVID-19 patients. We are also working with government partners to understand and enhance planning for Alternate Care Sites. Finally, GNYHA recently shared an opportunity with Comunilife that can provide COVID-19 Respite Beds to hospitals through a contractual arrangement.

Lessons Learned Document

Following the spring patient surge, GNYHA developed a series of lessons learned documents that focus on key response areas, including:

• Lessons Learned: In and Out of Hospital surge Space and Alternative Care Sites
• Lessons Learned: Fatality Management in New York City Hospitals
• Lessons Learned: Transportation (NYC only)
• Lessons Learned: PPE and Scarce Patient Care Equipment and Supplies
• Lessons Learned: Hospital and Health System Data Collection & Data Use
• Lessons Learned: Hoteling Programs (NYC only)
• Lessons Learned: Surge Staffing

GNYHA members are encouraged to review these documents to inform their planning efforts.

How to Reach Us and Who to Contact

You can always contact GNYHA at (212) 246-7100. After hours callers will hear a recorded message with instructions for reaching GNYHA staff. You can also send COVID-19-related questions to cvresponse@gnyha.org. This email inbox will be monitored, with messages directed to the appropriate staff person.

To effectively serve our members, GNYHA has assigned specific staff members for common areas of concern. Their names and email addresses are listed below.