Announcements

General Announcements

MAID

Medical Aid in Dying (MAID) became legal in New York State on 8/5/26

NYP has established a dedicated MAID clinical team that will manage all MAID requests and care.

Conversations about MAID must be initiated by the patient.

Provider participation in MAID care is voluntary. If a patient asks about MAID, follow the established referral process and continue providing care and support in accordance with your role.

If a patient presents to the ED after a MAID ingestion, first verify DNR/DNI status and review the MOLST, if available.

If DNR/DNI status is unclear or cannot be verified, proceed with resuscitation.  This is consistent with our approach to any actively dying patient when goals of care are unclear, documentation cannot be verified, and/or there is conflict between patient and family wishes.

For patients who die following MAID, the cause of death (for the purposes of documentation and the death certificate) is the underlying terminal illness, not overdose or medication ingestion.

If questions arise in real time, please contact the hospital AOD, who can help connect you with additional resources.

Additional information is also available through the NYS DOH website.

These ED presentations are expected to be very uncommon.  While documented DNR/DNI status is not mandatory for a patient pursuing MAID, at NYP this will be strongly encouraged as part of advance care planning.  In addition, most patients pursuing MAID are expected to already be enrolled in hospice or otherwise have well-established end-of-life care plans.

If you are interested in joining the NYP MAID working group and becoming a subject matter expert in this area or have any other questions, please reach out to Lily Abrukin.

Hospital at Home (HaH)

HaH Overview

Hospital at Home (HaH) is acute inpatient-level care in the home setting

Currently taking patients in Manhattan, Bronx + Medicare FFS or Healthfirst Medicare or Aetna Managed Medicare (Will expand with time)

Patients can be admitted to HaH directly from the ED (7a-4p) or from inpatient admissions

Patients admitted to HaH open up inpatient admission spots for non-HaH admissions

Who is eligible for HaH

Stable patients that need inpatient floor level care - ie resolving sepsis, CHF, pneumonia, COPD, cellulitis, UTI, etc..

Screened and eligible patients will have a small "house" icon next to their name on the Epic Trackboard

Admitting to HaH

Patients can be admitted to HaH directly from the ED (7a-4p) or from inpatient admissions

On-hours (7a-4p): Epic Chat "CUIMC HaH Consult"

Off-hours: Admit to medicine in typical fashion, consider messaging "CUIMC HaH Consult" for awareness to enroll during on-hours

HaH can be contacted via

- Team Epic Secure Chat to “Hospital at Home"

- Epic Consult to “Hospital at Home“

HaH Services

2 RN visits/day

1 virtual HAH physician/PA + consults

IV medications (ie antibiotics and fluids)

Respiratory Care (<6 L O2)

Durable Medical Equipment

Diagnostics (labs + radiology)

PT, OT + Speech

Social work + Care Coordination

HaH Exclusion Criteria

Unstable VS

Need for live telemetry (ie arrhythmia, ACS concern)

New respiratory distress >6L O2 from pt’s baseline

IV narcotics

Requires urgent procedure/surgery

Hemodialysis

Transfusions

Undomicilied

Significant concern for mental/psychological status (ie SI)

ED Bert at Cornell:

Standardized response for acutely agitated or unsafe patients who may need medication administration (To be sse for any patient in ED even if endorsed). Any staff can activate via ED overhead: “ED BERT + location”. Use verbal de‑escalation, meds, and restraints PRN. Those responding include providers, nursing, security, patient services, pharmacy and +/- psychiatry. Document all events in Epic using .EDBERT + real‑time orders (including restraints/observation). Use "ED Adult Agitation/Behavioral Health Emergency" Order Set to order medication . Order set includes a mandatory manual hold order (required if security assistance needed for medication administration).

LCC Registration & Testing

Please see the below links if interested in becoming a Linguistic Clinical Communicator after which you can communicate with patients without the use of an interpreter.

Review the LCC eBFAC expectation and testing instructions

 Follow this link to the vendor portal to self-schedule the test

These job aides provide information about the registration process.