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COVID-19 Pandemic Surge: After-Action Report of a Coalition of Emergency Departments in New York City

Published online by Cambridge University Press:  30 June 2021

Christopher Tedeschi*
Affiliation:
Department of Emergency Medicine, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
Angela M. Mills
Affiliation:
Department of Emergency Medicine, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
Rahul Sharma
Affiliation:
Department of Emergency Medicine, Weill Cornell Medicine, New York, NY, USA
Emme Deland
Affiliation:
New York–Presbyterian Hospital, New York, NY, USA
Benjamin Johnston
Affiliation:
New York–Presbyterian Hospital, New York, NY, USA
Emy Schwimmer
Affiliation:
New York–Presbyterian Hospital, New York, NY, USA
Katherine L. Heilpern
Affiliation:
Department of Emergency Medicine, Weill Cornell Medicine, New York, NY, USA
*
Corresponding author: Christopher Tedeschi, Email: ct2122@cumc.columbia.edu.

Abstract

The coronavirus disease (COVID-19) pandemic has stressed the US health care system in unprecedented ways. In March and April 2020, emergency departments (EDs) throughout New York City experienced high volumes and acuity related to the pandemic. Here, we present a structured after-action report of a coalition of 9 EDs within a hospital system in the New York City metropolitan area, with an emphasis on best practices developed during the prolonged surge as well as specific opportunities for growth. We report our experience in 6 key areas using a framework built around lessons learned. This report represents the most salient concepts related to our institutional after-action report, and those seemingly most relevant to our peer institutions dealing with similar circumstances.

Type
Concepts in Disaster Medicine
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

Keene, AB, Shiloh, AL, Eisen, L, et al. Critical care surge during the COVID-19 pandemic: implementation and feedback from frontline providers. J Intensive Care Med. 2021;36(2):233-240.Google ScholarPubMed
Griffin, KM, Karas, MG, Ivascu, NS, Lief, L. Hospital preparedness for COVID-19: a practical guide from a critical care perspective. Am J Respir Crit Care Med. 2020;201(11):1337-1344.CrossRefGoogle ScholarPubMed
Flores, S, Gavin, N, Romney, M-L, et al. COVID-19: New York City pandemic notes from the first 30 days. Am J Emerg Med. 2020;epub.Google Scholar
New York City Department of Health and Mental Hygiene. COVID-19 data. https://www1.nyc.gov/site/doh/covid/covid-19-data.page. Accessed June 20, 2020.Google Scholar
Seid, M, Lotstein, D, Williams, VL, et al. Quality improvement in public health emergency preparedness. Ann Rev Public Health. 2007;28:19-31.CrossRefGoogle ScholarPubMed
Jiang, LG, LeBaron, J, Bodnar, D, et al. Conscious proning: an introduction of a proning protocol for non-intubated, awake, hypoxic emergency department COVID-19 patients. Acad Emerg Med. 2020;27(7):566-569.CrossRefGoogle Scholar
Greenwald, P, Telehealth Working, G, Olsen, E, et al. 203 Telemedicine response to COVID-19 surge in New York City: how emergency department telemedicine changed with the curve. Ann Emerg Med. 2020;76(4):S78-S79.CrossRefGoogle Scholar
Steel, PAD, Siegal, J, Zhang, Y, et al. Telehealth follow up in emergency department patients discharged with COVID-like illness and exertional hypoxia. Am J Emerg Med. 2021;epub.Google Scholar
Mughal, A, Evans, C. Views and experiences of nurses in providing end-of-life care to patients in an ED context: a qualitative systematic review. Emerg Med J. 2020;37(5):265-272.Google Scholar
Cooper, E, Hutchinson, A, Sheikh, Z, et al. Palliative care in the emergency department: a systematic literature qualitative review and thematic synthesis. Palliat Med. 2018;32(9):1443-1454.Google ScholarPubMed
Bomba, P. eMOLST program manual, version 11. 2015. Updated July 8, 2020. https://molst.org/wp-content/uploads/2018/05/eMOLSTProgramManual.pdf. Accessed July 20, 2020.Google Scholar
Lee, J, Abrukin, L, Flores, S, et al. Early intervention of palliative care in the emergency department during the COVID-19 pandemic. JAMA Intern Med. 2020;180(9):1252-1254.CrossRefGoogle ScholarPubMed
Centers for Medicare & Medicaid Services; Department of Health and Human Services. Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers; Final Rule. Fed Regist. 2016;81(180):63860-64044.Google Scholar
California Emergency Medical Services Authority. Hospital Incident Command System – welcome. 2020. https://emsa.ca.gov/disaster-medical-services-division-hospital-incident-command-system-resources/. Accessed June 18, 2020.Google Scholar
Benedek, DM, Fullerton, C, Ursano, RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Ann Rev Public Health. 2007;28:55-68.Google ScholarPubMed
Brooks, SK, Dunn, R, Amlot, R, et al. Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review. BMC Psychol. 2016;4:Article 18.CrossRefGoogle Scholar
Zaidi, SR, Sharma, VK, Tsai, SL, et al. Emergency department well-being initiatives during the COVID-19 pandemic: an after-action review. AEM Educ Train. 2020;epub.Google Scholar
Stoto, MA, Nelson, C, Piltch-Loeb, R, et al. Getting the most from after action reviews to improve global health security. Glob Health. 2019;15(1):58.Google ScholarPubMed
Parker, GW. Best practices for after-action review: turning lessons observed into lessons learned for preparedness policy. Rev Sci Tech. 2020;39(2):579-590.CrossRefGoogle ScholarPubMed