NYC Health + Hospitals 'Continuing Care After Death'

The initiative harnesses data, strengthens community partnerships, and provides key information to grieving families.

In a trend across the country, many hospital morgues have been overrun since the first surge of the coronavirus pandemic. Increased decedent release time not only creates a burden for families but also poses an operational challenge for hospitals, which are forced to supplement their morgues with refrigerated trucks.

Average decedent release times have increased from about three days before the pandemic to as long as two weeks since the pandemic, according to Komal Bajaj, MD, chief quality officer at NYC Health + Hospitals/Jacobi | North Central Bronx, which is a two-campus hospital.

To combat this issue, Jacobi | North Central Bronx hospital has launched a program to improve decedent release time.

Jacobi | North Central Bronx hospital's Compassion for the Community: Continuing Care After Death program has reduced average decedent holding time from 13 days to five days.

"First and foremost, there are implications for the loved ones of the individual who was lost; it impacts their grieving process and their journey," Bajaj says. "It also has significant operational consequences. Being able to release decedents in a timely fashion means that our community partners such as funeral homes can do the work that they need to do."

The Compassion for the Community: Continuing Care after Death program has three primary elements.

• Data infrastructure: The hospitals built the capacity to track data in real-time to have a clear understanding of decedent hold time.
   
• Strengthening community partnerships: The hospitals worked more closely with community partners such as funeral homes and places of worship to co-design processes that were more efficient.
   
• Information resource: The hospitals created an informational packet that includes information on funeral homes in the area, resources for supporting funeral costs, and phone numbers that families can call at Jacobi | North Central Bronx hospital for help.

Through a multipronged effort, there has been a substantial reduction in decedent release time.

"There are certain things that healthcare delivery organizations require. There are certain things that funeral homes require," Bajaj says. "We have put this information in one place, and we have served as a guide for people on how to navigate the process."

The program is reducing delays in the decedent release time process, according to Bajaj. First, the program has reduced delays by giving families a clear understanding of the paperwork and other steps required with the passing of a loved one.

"With that understanding, the paperwork and steps are more likely to be completed in an efficient way," Bajaj says. "A process that previously took three or four days can be shortened to a day-and-a-half."

Improving coordination with community partners has also reduced delays, Bajaj explains.

"For example, if a funeral home is sending out a truck to pick up a decedent, and we know another family has decided to have a decedent go to the same funeral home, we can ensure that the truck can take both decedents at the same time," Bajaj says.

Komal Bajaj, MD, is chief quality officer for NYC Health + Hospitals/Jacobi | North Central Bronx hospital. Photo courtesy of NYC Health + Hospitals.

Taking a team approach

The Compassion for the Community: Continuing Care after Death program is operated by an interdisciplinary team, which includes staff from pathology, care experience, admitting, and finance.

"The department of pathology oversees the morgue, so they are the subject matter experts in operational processes and challenges in decedent release time," Bajaj says. "They are also experts in potential solutions."

Care experience teams and social workers have expertise in thinking about partnering with patients and their families.

"They support families through their grieving process," Bajaj says.

Admitting and finance staff have a good handle on how patients are flowing through the hospital.

"Working with them to understand the data parameters that were available was hugely important," Bajaj says.