Greater New York Hospital Association (GNYHA) prepared this toolkit to help member hospitals develop and improve their mass casualty response plans. Mass casualty incident (MCI) response is a critical focus area for GNYHA and its member hospitals. Over the past several years, GNYHA’s collaborative planning efforts for MCI response, in coordination with government response agencies and the health care community, have resulted in new communication protocols and structures, as well as targeted training and programming. This toolkit—designed to assist hospitals throughout the GNYHA membership and beyond—organizes and synthesizes much of the information developed via these collaborative processes, and details emerging best practices from intentional attacks that occurred in the United States and internationally.

In the New York region, MCIs occur frequently, with the majority producing few patients. However, MCIs that result in large numbers of patients, including critical patients with life-threatening injuries, have the potential to quickly overwhelm area hospitals. Hospitals must be prepared to effectively and efficiently respond to such incidents while continuing to meet the needs of other patients.

The toolkit includes suggested preparedness and response actions for the many clinical and non-clinical departments that would be involved in an MCI response. While patient care is the priority, the toolkit emphasizes the importance of planning for and developing protocols and processes for additional activities, including patient registration and tracking, family reunification, and coordination with external entities. If these non-patient care activities are not thought through in advance, the impact can overwhelm a facility and compromise its ability to deliver lifesaving care.

While the toolkit refers to several New York City-specific protocols and resources, GNYHA believes the content will be of value to hospitals throughout the New York metropolitan region. Where possible we have included information about other jurisdiction or state-level resources or processes.