The Covid-19 Response in New York City : Crisis Management in the Epicenter of the Epicenter / edited by Syra S. Madad, Laura G. Iavicoli, and Eric K. Wei.

Format:

Book

Contributor:

Madad, Syra S., editor.

Iavicoli, Laura G., editor.

Wei, Eric K., editor.

Language:

English

Subjects (All):

Public health--New York (State)--New York.

Public health.

Physical Description:

1 online resource (408 pages)

Edition:

First edition.

Place of Publication:

London : Academic Press, an imprint of Elsevier, [2024]

Summary:

The COVID-19 Response in New York City: Crisis Management in the Largest Public Health System provides an historical accounting of the response to the COVID-19 pandemic through the eyes of the largest public health system in the United States.

Contents:

Front Cover

The Covid-19 Response in New York City

Copyright

Contents

Contributors

Preface

Acknowledgments

I - In the beginning

1 - Standing up the emergency response in the epicenter of the epicenter

Vignette1

The beginning of a virus taking a foothold in New York City

And so it began ...

Problem areas and the unwavering effort to solve them

Communication

Clinical challenges

Clinical solutions

Organizational challenges

Organizational solutions

Public challenges

Public solutions

Supplies

PPE challenges

PPE solutions

Ventilator challenges

Ventilator solutions

Oxygen challenges

Oxygen solutions

Physical space

Space challenges

Space solutions

Redesigning the ED

Streamlining documentation

Clearing the waiting room

Medical screening exam at the ED entrance

The testing tent

Staff

Staffing concerns

Staffing solutions

Onboarding solutions

Specialty teams to care for the masses

Internal staffing support

Clinical guidelines

Clinical guideline challenges

Clinical guideline solutions

Create new guidelines

Disseminate guidelines

Community support

Vignette continued

Conclusion

References

2 - The history of NYC Health+Hospitals

NYC Health + Hospitals/Bellevue

NYC Health + Hospitals/South Brooklyn Health

NYC Health + Hospitals/Elmhurst

NYC Health + Hospitals/Harlem

NYC Health + Hospitals/Jacobi

NYC Health + Hospitals/Kings County

NYC Health + Hospitals/Lincoln

NYC Health + Hospitals/Metropolitan

NYC Health + Hospitals/North Central Bronx

NYC Health + Hospitals/Queens

NYC Health + Hospitals/Woodhull

NYC Health + Hospitals/Gotham Health

Further reading

II - The pivotal moment

3 - Emergency Departments spring into action.

Vignette1

Background

Statement of overarching problem

Organization and purpose of an ED Action Team

Initial and then expanded goals of the ED Action Team

COVID clinical guidelines depending on ED status "disaster care pathways"

Rapid medical screening protocols: Forward treatment areas

Electronic medical record solutions-Rapid notes and rapid discharge templates

After care and follow-up solutions-Pulse oximetry distribution

texting program

Novel use of ED space for admitted patients, observation, and monitoring of COVID patients

Emergency Department dashboards

Level loading between EDs

4 - The crisis shifted to the intensive care units

Timeline of critical care council activities

Problem areas and solutions implemented

Strain level

Resource availability

Communication among temporary staff

Communication to families

Testing

Personal protective equipment

Mechanical ventilators

Tracking mechanical ventilation usage and needs

Maximize supply of ICU ventilators from internal sources

Obtain ICU ventilators from external sources

Use a single ventilator for multiple patients

Renal replacement therapy

Infusion pumps and medications

Oxygen

Space

Existing ICU spaces

Identifying potential ICU spaces

Non-ICU spaces

Double occupancy ICU beds

External spaces

Construction of new ICU spaces

Staffing

Native ICU staff

Liberated hospital staff

Military personnel

Agency staff

Volunteers

Clinical guidelines and protocols

Threshold for intubation

Ventilator strategy

Anticoagulation

Disease-targeted treatment

Resource prioritization

III - A system surge plan put into place.

5 - Bringing key players together, standing up incident command, and communicating with everyone

Communicating with compassion and support

Evolving to support the System's readiness and improve incident command

Communicating with everyone

Employee communications

The essential employee communications toolkit

Intranet resource hub (Fig. 5.4)

Dedicated email address

Electronic newsletter

Live town halls and informational webinars

6 - The iterations of patient movement throughout the surge: Load-balancing demand through interfacility transfers

Introduction

Challenges and solutions

Pre-transfer clinical review

Challenge

Solution

Tracking patients through the transfer process

Situational awareness of hospital strain and capacity

Clinical communications

Vignette

7 - Supply chain and PPE, the wave 1 dilemma

A supply chain at the breaking point and reshaping materials management

Conservation and crisis care strategies

The changing landscape of infection prevention and control

8 - Staffing for pandemic surges in the NYC safety-net health system

Wave 1 the ancestor strain

Nursing

Credentialed providers: Doctors, advanced practice providers, certified nurse anesthetists

Wave 2 and beyond

9 - Fatality management during the worst crisis of our lifetime

Vignette 12

COVID's unexpected impact

Fatality management background

The looming crisis

Initial wave challenges

Space limitations

"Stuff" and supply chain impacts

System disruptions

Vignette 2

Omicron variant wave-December 2021 through January 2022

Decedent load balancing as a process

Communication.

Transfer logistics

EMR complications

Protocolizing, reviewing, and improving

Moving forward: A journey of continual improvement

10 - Fine tuning the surge (and flex) plan

Prologue1

Sustaining the surge

Bed surge plan

PPE surge plan

Mass casualty plan

Staffing plan

Staff support and care

Support service

Capital plan

Coordination

Level-loading

Transportation challenges

Epilogue

IV - The technical side of the response

11 - Situational awareness, going from flying blind to eyes on it all: DnA (Data and Analytics)

Building a data and analytics program during a pandemic

Adapting to a changing landscape

Sudden need

System enhancement

Defined and managed

Optimized

Proactive and predictive

Reference

12 - IT-coordinating the technology infrastructure of the system

Vignette1-Defining the patient with COVID-19

The challenge of defining the patient with COVID-19

The solution - A COVID-19 patient registry

External data challenge

Enterprise Information Technology Services (EITS): An overview of COVID-19 response

Vignette: Informatics during a disaster

Clinical vignette conclusion

Chapter conclusion

13 - Donations were a full-time job

Vignette1/musing

Challenges/solutions

Operationalizing donations: A logistics problem

Reinventing roles for the response: Central Office PI team and systemwide H3 teams

Aligning good donor intentions with system need

The system, and the hospitals

Managing the money

Tracking donor wishes

Accountability and "the forward"

Allocating the donated dollars and goods

Vignette/musing continued

V - Nuances of a massive health system.

14 - The correctional health response to COVID-19

NYC health+hospitals/correctional health services

The patients

Responding to COVID-19

Containment: Housing

Containment: Screening/testing

Containment: Vaccination

Decarceration

Healthcare access

15 - Alternate care sites including hoteling, a new path in a massive surge response

Roosevelt Island Medical Center experience

Leveraging Carter Long-Term Acute Care Hospital during initial COVID

Standing up isolation and quarantine hotels

Scouting and selection of hotels

Program operations

Intake and transfer of hotel guests

Guest management

Infection prevention and control

Overview of clinical supports

Integration of clinical and other services

Information technology infrastructure and data management

Employee lodging: Creating a safe space for healthcare workers

16 - Behavioral health and COVID-19

Vignette1 (COVID: Not just on inpatient medicine)

Telebehavioral support implementation: Technological advances in real time paired with regulatory support

Vignette (Early days and the struggle for safety)

Adapting treatment for the new normal: COVID care in the midst of behavioral healthcare

Vignette: Workforce isolation and mutual support

Supporting staff through the pandemic

Vignette: In this together and working together

Intradepartment and interagency collaboration for systemic change in service delivery

Vignette (Adapting together to keep on going)

Acknowledgment

17 - External affairs: Managing communications with regulators and stakeholders

COVID-19 response

Individual champions

Internal processes

Spotlight on emergency funding sources

Additional stakeholders.

Lessons learned: Aligning multiple stakeholders.

Notes:

Description based on publisher supplied metadata and other sources.

Description based on print version record.

ISBN:

9780443187568

0443187568

OCLC:

1431980691