GNYHA is leading efforts to improve Mass Casualty Incident (MCI) planning and response by addressing gaps that responders to the October 1, 2017, mass shooting in Las Vegas have identified. GNYHA led a fact-finding delegation visit there in February to learn about the city’s experience. The GNYHA delegation included emergency managers and emergency medicine physicians from nine New York State health systems and representatives from numerous New York City and Federal response agencies. During the two-day visit, the delegation met with staff from the three hospitals that received the most patients from the incident, plus police, fire, emergency medical services (EMS), and public health agency staff.

The GNYHA delegation has since been working to address three regional planning areas that we identified and collectively prioritized: training emergency department clinicians on emerging operational and clinical best practices for mass casualty triage; engaging technology and car-sharing companies likely to play a significant role in patient transport during an MCI; and improving patient identification and family reunification systems. In collaboration with the Center for Disaster Medicine at New York Medical College, GNYHA is piloting a course, Principles and Application of Mass Casualty Triage, at four member sites. Once necessary adjustments are made, the course will be offered broadly to interested GNYHA members. Introductory calls to both Lyft and Uber will take place in the coming weeks.

A particular vulnerability that challenged Las Vegas hospitals was unidentified patients. At the peak of the event, Sunrise Hospital and Medical Center, the hospital that treated the most patients, had 92 unidentified patients in-house, a number that overwhelmed its existing naming convention protocol. GNYHA—in collaboration with member health systems staff and representatives from key City agencies including NYC Emergency Management, the New York City Department of Health and Mental Hygiene, and the New York City Office of the Chief Medical Examiner—is developing guidance for hospitals that addresses patient safety concerns and enables the creation of a regional manifest should unidentified victims be spread across multiple hospitals. GNYHA is also engaging experts from the National Transportation Safety Board and the Federal Bureau of Investigation’s Victims Services Division on the development of the guidance. GNYHA hopes to share finalized guidance with all member hospitals later this year, and also plans to work with sister hospital associations in neighboring states to increase regional adoption.