Mount Sinai’s Growing Partnership With Indian Health Services in South Dakota

Updated on Jun 27, 2024 | AIGH, Community, Featured

Since 2021, the Emergency Medicine Global Health Division at Mount Sinai has partnered with the Indian Health Service to provide physician and physician assistant staffing, operational assistance, and educational support at the Cheyenne River Health Center in Eagle Butte, South Dakota.

This remote, critical access hospital comprises an emergency department, a 10-bed inpatient unit, and community outpatient center. The Emergency Department serves about 30 patients daily from the local population on the Cheyenne River Sioux Reservation.

“The partnership has evolved from a few intermittent weeks of staffing to the point where we now expect to provide nearly 28 weeks of full-time attending physician staffing this year,” says John Rozehnal, MD, MS, Assistant Professor, Emergency Medicine, who leads the partnership with Indian Health Services.

John Rozehnal, MD, MS

Mount Sinai Emergency Medicine physicians and other health care providers who participate are given the opportunity to manage a wide range of emergency medical concerns and provide comprehensive critical intervention while developing knowledge of the indigenous culture to enhance their care. Other health care providers include physician assistants and residents, including four Emergency Medicine 2024 graduating residents who supported the partnership.

Recently, the team was successful in assisting with the implementation of a new point-of-care ultrasound (POCUS) equipment and programming, including training that has begun with an education project on the placement of ultrasound-guided IV lines, the performance of regional anesthesia, and the use of bedside diagnostic studies helping to assess pregnancies. Without these new services, patients would often require transfer to a hospital more than an hour away.

The growing partnership between Mount Sinai and Indian Health Services includes a variety of quality improvement projects, such as implementing clinical protocols and improving cultural competencies and quality and safety initiatives.

“We look to further integration with the local team at Eagle Butte and to help develop area-wide initiatives to further both teach and learn from the facilities and patients in the Great Plain Area,” says Dr. Rozehnal.

Learn more about the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai
Learn more about the Emergency Medicine Global Health Division at Mount Sinai

Gun Violence Awareness Month in June: A Time to Raise Concerns About Safety for Kids and Families

Updated on Jun 25, 2024 | Community

The statistics about gun violence in the United States are striking.

In 2022, firearm injuries were among the five leading causes of death for people ages 1-44 in the United States, according to the Centers for Disease Control and Prevention (CDC). There were more than 48,000 firearm-related deaths, which is about 132 people dying from firearm-related injuries each day.

Nationwide, about one person dies every 11 minutes by suicide. About 50 percent of gun-related deaths in the United States were suicides, according to the American Foundation for Suicide Prevention. Access to a gun triples the risk of death by suicide, according to the New York State Division of Criminal Justice Services.

Charla Sarabia, MPH,

These statistics are why public health experts like Charla Sarabia, MPH, Injury Prevention and Community Outreach Coordinator at Mount Sinai Morningside on Manhattan’s Upper West Side, believe it is important to discuss this issue. In addition to what they see every day on the job.

“I see the issue in the community, and we are working to address it,” says Ms. Sarabia. She works with the Trauma Team in the Department of Surgery at Mount Sinai Morningside, and spends much of her time in the community, working on initiatives to help reduce injuries, sometimes with the New York Police Department and other organizations. Among the top causes of injuries she focuses on is falls by older adults, gun wounds, and accidents involving bicyclists.

Advocates say Gun Violence Awareness Month is the time to reflect on the lives lost and families changed by gun violence, honor the victims, support survivors, and discuss ways to reduce gun violence.

Gun safety and injury prevention is also a special concern for the nation’s pediatricians. In 2020, firearm-related injuries became the leading cause of death for children and teens in the United States aged 1 to 19, according to the American Academy of Pediatrics.

“Injuries from firearms are now the leading cause of death in children aged 17 and under in the United States,” says Louis Spina, MD, Director, Pediatric Emergency Department, Mount Sinai Kravis Children’s Hospital. “The most effective way to prevent unintentional injuries from firearms is by removing them from the home and any environment where kids actively stay or play.”

Ms. Sarabia offers these four basic reasons for addressing this issue, based on analysis by the CDC:

 

  • Many gun-related injuries and deaths are preventable through education, safe storage practices, and community interventions.
  • Gun violence is a major public health crisis, leading to physical injuries, long-term disabilities, and emotional trauma for victims and their families.
  • Promoting responsible gun ownership and safe practices can significantly reduce accidental shootings, especially among children and adolescents.
  • By fostering a culture of awareness and prevention, organizations can help create safer communities where everyone feels secure and supported.

If you do chose to keep a gun in your household, you can help keep kids safe by doing the following:

• Always keep your gun unloaded, locked away and out of reach of children.

• Always keep the ammunition in a separate location from the gun.

• Use a gun lock box or gun safe for the firearm; keeping all lock box codes, combinations, and/or keys out of reach of children.

• Talk to your children about guns and teach them to tell an adult immediately if they see one.

• Most importantly, always keep an eye on the children and never leave them unsupervised in a home or location with a gun.

Learn more about the Mount Sinai Kravis Children's Hospital

Closing the Disparity in Patients’ Use of the Health App MyMountSinai

Updated on Jun 18, 2024 | Community

Mount Sinai’s Digital and Technology Partners (DTP)-Digital Experience Team, with guidance from the Digital Equity and Accessibility (DEA) Committee, seeks to improve underrepresented patient cohorts’ access to Mount Sinai digital products. The team is taking a data-driven approach to address equity gaps by identifying patient cohorts with proportionally low digital engagement.

The usage of MyMountSinai is the current priority, as patients will benefit greatly from accessing a digital entry and patient portal. MyMountSinai is offered in seven languages, allowing patients to receive in-person and virtual care and to message providers.

Building relationships with our communities is a key health equity priority. Stakeholders partnered to prioritize Central Harlem as a starting point based on the strength of our existing Community-Based Organization (CBO) partnerships. They plan to collaborate with other CBOs to better reach and engage patients in Central Harlem and other marginalized communities. The Digital Experience Team seeks to understand the unique needs of these communities and build awareness of MyMountSinai’s usefulness in accessing care.

In the first quarter of 2024, they identified gaps in MyMountSinai usage. In the second quarter, they created an engagement plan and identified potential CBOs with which to partner. In the third quarter, they plan to connect with CBOs to discuss how to best build awareness and engagement around MyMountSinai. The goal is to increase Central Harlem Mount Sinai patients’ usage of MyMountSinai from 54 percent to 70 percent. Heading into 2025, as they make progress on this metric, they seek to increase adoption of MyMountSinai in other underrepresented neighborhoods.

This effort is led by Jordan Randall in partnership with Gary Gravesandy, Arianna Goldman, Huma Sohrwardy, Eric Kim, and other members of the Digital Equity and Accessibility committee. For more information, please contact Jordan Randall (jordan.randall@mountsinai.org) about this project, and Eric Kim (eric.kim@mountsinai.org) about the DEA Committee.

Advancing Health Equity With Data: Improving Patient Care in the Emergency Department

Updated on Jun 17, 2024 | Community, Engagement, Featured

At Mount Sinai, active collaboration with department stakeholders drives the efforts of the Health Equity Data Assessment (HEDA) team to advance health equity through data-driven initiatives.

Yvette Calderon, MD

Yvette Calderon, MD, Vice President and Dean for Equity in Clinical Care at the Icahn School of Medicine at Mount Sinai, recently discussed how the Emergency Department (ED) partnered with the HEDA team to apply an equity lens to evaluate Left Without Being Seen (LWBS) patients.

Together, they are reviewing data integrity in emergency medical records and applying an equity lens to effect meaningful change.

“This commitment underscores Mount Sinai’s ongoing dedication to fostering health equity through collaborative, data-informed strategies,” said Pamela Y. Abner, MPA, CPXP, Senior Vice President and Health Equity Officer for the Mount Sinai Health System.

LWBS is defined as a patient leaving the ED before completing a medical screening exam. When this metric is not met, it can represent quality and safety concerns, according to Lyndia Hayden, Senior Director, Data Integrity and Equity Analytics.

LWBS patients may also have an undiagnosed medical condition and may experience undesirable health outcomes outside of the hospital. Hospitals can also face penalties if they fail to meet certain quality metrics, like LWBS. The Centers for Medicare & Medicaid Services can reduce reimbursement rates for hospitals that do not meet these standards, having a direct impact on the hospital revenue stream.

On average, non-white patients tend to have a disproportionally higher rate of LWBS than white patients. As such, LWBS must be examined through an equity lens to ensure optimal patient outcomes for all patients.

Dr. Calderon emphasized the critical role of data integrity as a foundational step before delving into metrics analysis. With invaluable support from the HEAD Hub, the Department of Emergency Medicine at Icahn Mount Sinai implemented a comprehensive dashboard system, empowering ED service lines across the Mount Sinai Health System to closely monitor performance indicators, identify key drivers, and establish clear accountability measures.

For example, guided by these insights, each ED tailored interventions to their unique context, with initiatives such as Provider-in-Triage (PIT) protocols, mandatory unconscious bias training, and enhanced education for registration staff on demographic data collection emerging as effective strategies at Mount Sinai Beth Israel.

This work was presented to the Joint Commission during the Mount Sinai Downtown survey. It impressed the surveyors to see that Mount Sinai had already started integrating the new standard from the Joint Commission.

“The data integrity piece had to happen first before we could look at any of the metrics,” said Dr. Calderon. “Through diligent implementation, these interventions have proven instrumental in addressing pertinent issues within the emergency departments that identified a need.”

New Teen Lounge Unveiled at Mount Sinai Kravis Children’s Hospital

Updated on Jun 14, 2024 | Community, Featured

The Mount Sinai Child Life and Creative Arts Therapy team recently opened a newly constructed Teen Lounge at the Mount Sinai Child Life Zone at the Mount Sinai Kravis Children’s Hospital. The team celebrated the opening with a ribbon-cutting ceremony on Thursday, June 6.

Thanks to a generous gift from the Garth Brooks Teammates for Kids Foundation, a longtime partner and collaborator, the lounge meets the unique developmental needs of teenage patients and helps to minimize the stressors that they feel during a hospital stay. Promoting creativity, self-expression, and connectivity, the lounge offers teenage patients a place to socialize and connect, escape from their patient room, explore creative outlets, and relax and unwind.

The newly designed Teen Lounge features pods for patients to relax, read, and take photos; gaming stations with gaming systems and seating; and lounge seating for patients to watch movies and entertainment. There are also two large communal tables for art, games, and other activities, three colorful wall murals, and additional storage cabinets for art, music, play, and technology supplies.

“Being in the hospital, whether as an inpatient or outpatient, can be difficult and overwhelming for a teenager,” said Lisa M. Satlin, MD, Chair of Pediatrics for the Mount Sinai Health System and Pediatrician-in-Chief of the Mount Sinai Kravis Children’s Hospital. “We are delighted that we can give all of our adolescent patients a chance to unplug, forget why they are at the hospital, feel inspired, and have fun, even though they are in the hospital.”

“We have long recognized that adolescent patients face a unique set of challenges when coping with illness and hospitalization, and this new space allows us to provide a place that teens can call their own,”  said Morgan Stojanowski, MS, CCLS, Director of the Child Life and Creative Arts Therapy Department. “They can relax and interact with their peers and escape from the rest of the hospital. Especially for teens adjusting to a difficult illness or medical condition, this space gives them a safe haven to relax and be themselves.”

Learn more about Mount Sinai Kravis Children's Hospital

Dear Mount Sinai: Thank You

Apr 9, 2024 | Community, Featured

For National Doctors’ Day, Mount Sinai asked patients how they felt about their doctor. About 300 people responded by leaving short notes of thanks for doctors, their staff, and for all those who made it possible. You can read the notes here on a special website.

Notes like this: “Mount Sinai doctors have saved my life on more than one occasion. First when I had a brain aneurysm and then when I had an appendectomy. Thank you to all of them and to my present team of care. Gratitude to all the staff at Mount Sinai.” – Gladys Franceschi

Or this: “I am beyond blessed to have the following Mount Sinai physicians: Dr. Thomas Schiano has pulled me through so many rough times since my liver transplant. Dr. Kevin Dunsky has literally saved my life. Mount Sinai saved my life at least 3 times!”  – Colleen Jackson

Or this: “Dr. Kathryn Dubowski, your care at Mount Sinai changed my life. I arrived struggling to breathe, but thanks to your dedication, I can now breathe normally. Your compassion is unmatched, and I’m endlessly grateful.” – Bryan Medina

Their reasons for giving thanks were many and varied. Some expressed thanks to their doctor for saving their life. Or giving them back their life. Some for helping them get through a very difficult period in their life.

Some for diagnosing a problem others outside Mount Sinai had been unable to find. Some for many years, even decades, of expert medical treatment. Some for contributions to the community.

Some for advocating on their behalf, for giving them confidence, for understanding their pain, for offering relief.

Even some out of towners who ended up in a Mount Sinai emergency department expressed thanks. “In the past few years, I have become so disenchanted with our medical system. In a visit to NYC last year, I fell and hit my head. While at the ER, my faith was restored. Everyone there was so supportive and caring. I have never been treated so kind.” – Catherine Patrick

Many expressed thanks to their Mount Sinai doctors and staff for just listening, for answering their questions, for spending extra time with them, for always offering a friendly greeting, for expressing compassion.

In a word, for caring.

Here are some more notes:

Dr. Fabian at the Dickenson Center for MS has been a life changing doctor. She goes above and beyond to listen, understand, have compassion for and offer compassion to her patients. She is the greatest medical professional I’ve ever worked with. – Kirsten Hughson

Dr. Irie has been my oncologist for the past 5 years. In those 5 years she has shown me nothing but empathy, respect, and compassion. As a young cancer survivor I’m grateful to have a doctor who I can trust. Thank you for all that you do Dr. Irie!  – Roshni Kamta

Dr. Dubinsky was my doctor throughout my two pregnancies, including between my pregnancies when my Crohns was out of control, and she gave it all to get it under control and I’ve been in remission ever since – deepest remission I’ve ever been in!

Dr. John Mascarenhas made a difference in our lives. When my husband was dealing with leukemia, Dr. Mascarenhas was not just a doctor but acted as a family member. He put the best team together, he came on a day he was not for a consult. Incredible  – Kikelomo Ogundiran

I had a 14 hour surgery to remove a cancerous tumor from my nasal septum. Dr. Genden and his surgical team were absolutely amazing! They saved my life and I am forever grateful to them for all their top notch skills and dedication! Awesome doctors!  – Claire Lisanti

Dr. Blair Hammond is an incredible physician. She listens to our needs, concerns, and makes us feel as she has all the time in the world for us despite having a bustling waiting room of sick children. She’s just simply a pediatric gem! – Jacqueline Rose Zeigler

Dr. Kapka is passionate about population health and encourages changes towards it. Her effort in promoting healthy behaviors and addressing social determinants of health is commendable. She is making a real difference in the lives of patients/community

Dr. Anuradha Singh has been my specialist doctor for many years, I followed her from Bellevue Hospital. She has been empathetic, a good listener, an encourager, and my supportor thru out the years. She has help me feel empowered to improve my health – Felipe Rosado Jr.

I want to express my heartfelt gratitude to my father’s highly skilled and compassionate surgeon Dr. Ismail El-Hamamsy and his entire cardiac team for safely repairing his ascending aortic aneurysm and valve. Dr. El-Hamamsy and his team are the best! – Lucia Panico

Happy Doctors’ Day! Dr. Zaw Naing – Thank you for your almost 30 years of incredible service to our healthcare community. Your dedication, compassion, and expertise have improved countless lives, and we are grateful for all that you do.  – Michele Ramirez

Dr. Mocco has been my doctor and he and his team have been fantastic pre, during, and post! I’d like to give a toast to them all! I saw him late in the fall and he dealt with my blocked right artery and ended up putting two stents in to open it up! – Dave Sweeney

Dr. Ripp does more than just listen to my complaints– many because I am almost 103! He acts on them promptly and thoughtfully. I feel totally cared for since Dr. Ripp and his team have become part of my team. – Sophie Gerber

My right hand was painful and swollen to the point I could use it. My local rheumatologist prescribed prednisone, but couldn’t find the cause. At Mount Sinai, Dr Olivia Ghaw was able to diagnose and treat me for psoriatic arthritis. I am so grateful! – Sheryl Rain Worthington

Read all of the notes to Mount Sinai doctors and staff. The annual observance is March 30.