Today’s HRO Tip: Taking Action after Near Miss Events A patient in the emergency department was undergoing a work up for abdominal pain. A medication commonly used to treat chest pain in cardiac patients was prescribed. The nurse brought her concern to the physician who reviewed the chart and recognized the order was placed in the wrong chart. The patient didn’t get the incorrect medication. Human error must be anticipated because it cannot be prevented. Systems are analyzed since they contribute to human error. Near miss events may uncover a process that needs attention or contributing factors that can be eliminated or mitigated. Thank you for bringing these events forward so we can improve.

The following is an update on Hackensack Meridian Health’s COVID-19 status, recovery and readiness efforts as of August 26, 2020. COVID-19 updates are released Mondays, Wednesdays and Fridays. Status

The following is a breakdown of the number of COVID-19 inpatient positive and those waiting for test results across our network as of August 26, 2020.

Hospital & Long Term Care Current Inpatient Total Inpatients Positive Awaiting Test Results Hackensack University Medical Center 9 0 Jersey Shore University Medical Center 6 3 JFK Medical Center 10 7 2 0 0 4 1 0 Raritan Bay Medical Center – Perth Amboy 1 0 Raritan Bay Medical Center – Old Bridge 1 1 Southern Ocean Medical Center 4 3 Bayshore Medical Center 1 3 Mountainside Medical Center 0 3 Pascack Valley Medical Center 1 2 Carrier Clinic 0 0 HMH Long-term Care Facilities 0 0 Total Hospital & Long Term Care 36 26 Ambulatory Practices Current Positive Total Patients Tested HMH Medical Group Practices 662 7,705 HMH Urgent Care Centers 2,469 31,341

Total Ambulatory Practices 3,131 39,046 Homecare Current Positive Total Patients Awaiting Test Results HMH Homecare 59 0

Tuesday’s Situational Analysis: On Tuesday, COVID-19 volumes at our hospitals decreased by 5 patients or 6.8%, leaving us with 68 patients. When long-term care facilities are included, our COVID-19 patient volume also decreased by 5 patients or 6.8%, leaving us with 68 patients.

Today’s Situational Analysis (8/26): Since yesterday, COVID-19 volumes at our hospitals by decreased 6 patients or 9%, leaving us with 62 COVID-19 patients in our hospitals. When long-term care facilities are included, our COVID- 19 patient volume also decreased by 6 patients or 9%, leaving us with 62 patients.

Update: Travel Advisory There are now 31 states and U.S. jurisdictions on ’s travel advisory list, where out of state travelers should quarantine for 14 days upon arriving to New Jersey. Since last week, Alaska, Arizona, Delaware, Maryland and Montana were removed. Guam was added to the list. See below for the complete list:

Alabama Kentucky South Carolina Arkansas Louisiana South Dakota California Minnesota Tennessee Florida Mississippi Texas Georgia Missouri Utah Guam Nebraska Virginia Hawaii Nevada Virgin Islands Iowa North Carolina Wisconsin Illinois North Dakota Idaho Oklahoma Indiana Puerto Rico Kansas

Graphic Source: Connecticut’s Official State Website

Reminder: HMH Blood Drives Kick-Off This Week Blood donation events begin this week at HMH, and there is currently a critical need. A reminder that it is safe to donate blood. COVID-19 is not transmitted through blood, and donation centers take special measures to ensure social distancing, pre- screening and safety protocols. Those who are healthy, feeling well and eligible to give blood or platelets are urged to make an appointment.

Blood donation events are scheduled at the following HMH locations. Please click the links below to schedule an appointment. Appointments are required. Please note that some drives are open to the public, and some are for team members only.

Ocean Medical Center Hackensack University Jersey Shore Palisades Medical Thursday, 8/27 Medical Center University Medical Center 10:30 a.m. – 5:30 p.m. Wednesday, 9/2 Center Friday, 9/18 OPEN TO PUBLIC Jurist Research Building Friday, 9/11 11 a.m. – 6 p.m. Registration Link 8 a.m. – 4 p.m. 11:30 a.m. – 4:30 p.m. OPEN TO PUBLIC NOT OPEN TO PUBLIC NOT OPEN TO PUBLIC Registration Link Registration Link Registration Link

Recovery

Update: Patient Volume The HMH team continues to rebuild its patient volumes following the height of the pandemic. Here’s a look at how our hospitals are doing:  Our admissions are at 94% across the network, compared to our pre-COVID volume.  Our elective surgeries and invasive procedures are at 93%, compared to our pre-COVID volume.  Our outpatient volume average for MRIs, chemotherapy, CT scans and PET scans is at 84% compared to our pre-COVID average.  Our Emergency Department volume is at 70%, compared to our pre-COVID volume.

Our admissions and elective surgeries and invasive procedures remain flat from last week. Our outpatient volume average for MRIs, chemotherapy, CT scans and Pamela Hileman, RN, and Jane PET scans and emergency department volumes increased Lynn, RN from Jersey Shore 1%. University Medical Center’s Northwest Pavilion 6. New: In the News News 12 New Jersey recently featured a story online and on-air highlighting the effectiveness of convalescent plasma in treating COVID-19, reporting that doctors at Hackensack University Medical Center are playing a key role in fighting the coronavirus. Dr. Karan Omidvari, who recovered from COVID-19 after being treated with convalescent plasma, is profiled in the piece, along with Dr. Michele Donato. View the article and video here. **Please note, this link is best viewed on mobile devices.

Readiness

Reminder: Complete the Keep Getting Better Pulse Survey Today One of the best ways we can live our brand promise to Keep Getting Better is through listening and involving team members in the decisions we make as an organization. This week, we will launch our first Keep Getting Better pulse survey to hear feedback from you and your team members on our response to COVID-19, with a specific focus on garnering your ideas and feedback to shape our response to future crisis and a potential surge in the fall. The survey is now live and you can participate by visiting www.teamhmh.com/pulsesurvey. Click here for more information.

New: Playbook Summary: Infection Prevention and Control The HMH COVID-19 Steering Committee has been developing HMH’s preparedness plan for a potential second wave of COVID-19. The team’s robust COVID 2.0 Playbook is comprised of 31 chapters that outline our strengths, areas for improvement and preparedness plans. Today, we are highlighting the Infection Prevention & Control chapter.

Challenges: By definition, the job of infection prevention and control professionals is to prevent or stop the spread of infections in health care settings. With the rapidly evolving pandemic and limited historical knowledge on how COVID-19 spreads, infection prevention and control had one of the most challenging jobs in the face of the pandemic.

Strengths:  The Infection Prevention team was able to rapidly address the evolving clinical situation, providing around the clock guidance and expertise to sites across the network. Above: Members of the Palisades  Infection Prevention had a tight collaboration with Medical Center Clostridioides materials management and purchasing to track and Difficile Prevention Team, Doreen distribute appropriate PPE while addressing McSharry, CIC,CHSP, and Rose Lee, pending shortages and coming up with contingency Pharm.D, sent a shout out to the plans to conserve supplies. Hackensack Meridian Health Health  Ongoing communication and education across the Care Heroes during the height of the network took place, including education for proper pandemic. They are holding hand donning and doffing of PPE, unit-based observers to sanitizer that was donated by ensure compliance with infection prevention International Flavors and techniques, documentation on PPE conservation Fragrances (IFF). strategies and daily updates, among other important topics.  Infection Prevention was deeply involved in guidance for clinical care, including COVID-19 testing, discontinuation of isolation, cohorting environments and standards for safe transfers.

 Overall, the Infection Prevention team, led by Dr. Jerry Zuckerman, was closely involved in all aspects of the COVID-19 response. The team helped guide the development of many COVID- 19 related actions, policies and procedures.

Preparedness Recommendation: In the event of a second wave, Infection Control and Prevention is implementing the following plans:  Establishing multiple platforms for communications important updates, such as text, intranet, e-mail, etc.;  Expanding ongoing training programs for donning and doffing of PPE with on-site sessions that include nights and weekends;  Development of a real-time monitoring system for team member exposures, including identification of potential outbreaks before they occur;  Assisting with PPE stockpile in partnership with materials management; and  Expanding onboarding and creating a standardized curriculum for traveling nurses or agency staff to include infection prevention.