Updated on Nov 19, 2024 | Community, Diversity and Inclusion, Featured
Alexander Charney, MD, PhD
An essential part of achieving health equity is the fair collection of genomic data, ensuring that informed health care decisions can reflect the unique, diverse genomes of all cultures. Currently, there is a lack of diversity in genomic research data. This limits what we can uncover about health and potential treatments for our global population.
Expanding diversity among participants in genomic research can bridge these gaps, advancing our understanding of human genetics for all communities. One ambitious initiative that strives to diversify this data is the Mount Sinai Million Health Discoveries Program.
Mount Sinai Health System’s Health Equity Data Assessment (HEDA) team met with leaders of the program who expressed their challenge with identifying the ethnic identities of Mount Sinai patients participating in the program. HEDA was quickly able to assist in rectifying the data issue, which resulted in increasing the ethnic identities from 0.5 percent to 66 percent.
This assistance will have a significant impact on the program objectives. A hypothesis was formulated in the Measures and Outcomes section of the HEDA Hub. The HEDA team will track progress towards the program’s goal of reaching a million patients.
The Charles Bronfman Institute for Personalized Medicine at the Icahn School of Medicine at Mount Sinai leads this project and aims to sequence the genomes of one million Mount Sinai patients over the next five years. It seeks to integrate health and research data to drive discoveries that directly benefit a diverse patient population.
Lea K. Davis, PhD
Mount Sinai Million is poised to serve as a model for embedding genetics into routine clinical care. By leveraging data from one of the world’s most diverse patient populations within a massive New York City health system, this program seeks to deepen our understanding of the connections between genetics and disease.
In a recent conversation with Alexander Charney, MD, PhD, Director, The Charles Bronfman Institute for Personalized Medicine, and Associate Professor, Genetics and Genomic Sciences, Psychiatry, Neuroscience, Neurosurgery, and Artificial Intelligence and Human Health, Icahn Mount Sinai; and Lea K. Davis, PhD, Scientific Director of the Mount Sinai Million Health Discoveries Program, The Charles Bronfman Institute for Personalized Medicine, and Associate Professor of Medicine (Data-Driven and Digital Medicine), Icahn Mount Sinai, we gained further insight into this initiative.
Dr. Charney explains: “Our goal is to develop personalized treatments tailored not only to the disease but to the individual’s genetic makeup, which we know varies significantly across populations.”
“Equity is a core value of the scientific vision for the Mount Sinai Million,” says Dr. Davis. “We are thrilled to connect the program with HEDA and are looking forward to supporting equity-focused research through the development of this incredible resource.”
Reflecting on the broader impact, Dr. Charney says the initiative “isn’t just about collecting data; it’s about improving lives.” He envisions a health care system where genetic insights enable clinicians to make more informed, individualized decisions.
“With this kind of data,” he says, “we’re not just diagnosing based on symptoms—we’re diagnosing based on a person’s unique genetic and biological profile, which could mean a huge leap in effectiveness.”
With this forward-thinking approach, Dr. Charney and the Mount Sinai team are working toward a future where each person’s treatment is precise, effective, and, above all, personalized.
To enroll as a participant or to learn more about the Mount Sinai Million Health Discoveries Program, visit mountsinaimillion.org.
Oct 29, 2024 | Featured, Nursing
“I love working in a true community-focused environment,” says Jill Goldstein, RN, MA, MS, Deputy Chief Nursing Officer of Mount Sinai Queens.
Jill Goldstein, RN, MA, MS, is all about community. As the nurse leader at Mount Sinai Queens, she oversees a 225-licensed-bed hospital that provides care to the surrounding neighborhoods of western Queens. She directs and supports her team of round-the-clock nursing and support staff. And she is a passionate disruptor of the too-easily-accepted limitations that contribute to the creation of far-reaching social barriers.
“I love working in a true community-focused environment,” says Ms. Goldstein, Deputy Chief Nursing Officer of Mount Sinai Queens. “We operate under one license and share the same policies with The Mount Sinai Hospital, so Mount Sinai Queens is the community complement to their quaternary setting.”
Ms. Goldstein sees this as her hospital’s superpower. “Nearly 70 percent of our hospital staff live and work among the people they see as patients. We have a strong connection to our community that’s palpable. It’s deep, and it’s real,” she says. “We take care of the same people we see in the grocery store and the bank. This, combined with the size of the hospital itself, makes it a place where people know one another’s name. There’s a familiarity here that connects us to our work in a very meaningful and caring way, the ‘Mount Sinai Queens Way.’”
This sense of caring for ourselves and our patients, families, clinical colleagues, care team members, and local and global communities is embedded into the culture of Mount Sinai Queens nursing via the professional practice model of Relationship-Centered Care.
“This is something I’m really proud of,” says Ms. Goldstein, “an example of which I call ‘Rising Stars.’ We have about two dozen-plus nurses who started their careers in non-nursing roles, such as housekeeping, dietary, or unit clerks. Each studied and worked their way through school and subsequently up through various positions to become a registered nurse. They are incredibly inspiring, and it is the gift that keeps on giving with a better than 90 percent retention rate.”
“It’s an understatement when we say that it takes a village to become a nurse,” she says. “The Rising Stars pathway speaks to how our staff assist the different members of our hospital community, how they help them rise. They surround these individuals with encouragement to get through school, to become a better version of themselves, enabling them to improve their livelihood. It’s just amazing. And it’s part of why we see staff enjoying nursing careers here that span 10, 20, 30, and 40 years.”
It is also this sense of teamwork and community that contributes to the hospital being Magnet® designated by the American Nurses Credentialing Center since 2014, the longest continuous designation of any hospital in Queens. Magnet designation is the highest available recognition of nursing excellence, achieved by only 10 percent of hospitals in the United States.
Mount Sinai recently announced that Mount Sinai Queens earned its third consecutive Magnet Recognition®. Click here to read more about the news. “I am so very proud of our nurses for this incredible achievement,” says Ms. Goldstein. “This redesignation is a tribute to our entire nursing staff and support teams, and it perfectly demonstrates their empowerment and commitment to nursing excellence.”
“Magnet® designation represents an interdisciplinary team supporting nurses to do their best work, to have optimum outcomes for patients, and to advance the delivery of care through purposeful process improvements,” says Ms. Goldstein. “The nursing leaders and their teams focus on a journey of continuous progress versus perfection. And our Magnet Champions and their respective unit practice councils bring voice to practice and drive optimum bedside care through their shared decision-making to truly create excellence together.”
Affecting the Broader Community
Among her many responsibilities, Ms. Goldstein is perhaps most passionate about her efforts to advance diversity, equity, inclusion, and belonging, both within and beyond the hospital’s walls. “I firmly believe that everything we do needs to be threaded through this work,” says Ms. Goldstein. “Diversity, equity, inclusion, and belonging are the foundation for everything we are trying to accomplish.”
In 2020, Ms. Goldstein experienced an “aha moment” after reading the book White Fragility, assigned reading for a Mount Sinai Health System C-suite meeting. “I was deeply upset by what I read. I had a true awakening. How could I have known so little about this issue? This is when I knew that I had to act. I had to be part of something bigger. I had to throw myself into places where I may have never seen myself and learn, learn, learn, and then take those learnings and pay it forward by doing something.” This was a very personal goal.
And there is plenty of work to be done. According to the National Commission to Address Racism in Nursing, 63 percent of nurses surveyed said they personally experienced an act of racism in the workplace. More than 50 percent said that racism in the workplace has affected their professional well-being. “This is unacceptable, and I’m determined to do be a disruptor in that world,” says Ms. Goldstein.
And disrupt she has.
“I got involved in a space I knew nothing about. I just inserted myself, listened more, read more, joined more, raised my hand more. I don’t always know what I’m talking about, but I do know that I’m very intentional about listening, learning, and leveraging my role to make a difference.”
Two years ago, Ms. Goldstein and colleagues started a systemwide council called Nurses Against Racism (NAR). “Nurses comprise the largest segment of the hospital workforce and are at the bedside 24/7,” she says, “and while we know racist behaviors toward nurses are prevalent, these issues can easily get swept under the rug. We want to create safe space for nurses to share their stories, their pain, their success.” Today, each entity within Mount Sinai Health System sponsors a local branch of NAR—also known as an employee resource group—that offers a safe space to share, listen to one another, and have difficult conversations.
The work of NAR also prompted the formation of a subcommittee to advance equity through quality measurement. “Alongside colleagues from the Office for Diversity and Inclusion, we embarked on a deep analytical data dive, initially looking at systemwide hospital-acquired pressure injuries (HAPI). A detailed review revealed that patients with a preferred language other than Spanish or English were at a 40 percent higher risk for HAPI than English-speaking patients. A team is in the process of confirming that practices related to HAPIs are consistent hospital-wide and engaging front-line clinical nurses to develop tests of change for improvement.
Ms. Goldstein has also been active in promoting the Health System’s Policy 130, which expressly empowers and supports nurses and other staff to speak up and directly address acts of racism and discrimination.
In collaboration with the Office of Patient Experience, Office for Diversity and Inclusion, and NAR, the Health System developed a first-of-its-kind pocket card with tips to guide nursing staff through these challenging encounters. “It’s about immediate escalation to leadership for support, zero tolerance, and de-escalating skills. Nurses agree that seven or eight times out of 10, the approach will be effective,” she says, “and when nurses share a story of when they or a leader used the policy, and it worked, those are our victories. And when it doesn’t work, we talk about it, learn from the experience, and bring that knowledge forward to take action.”
She adds, “I am determined to help make a very real and lasting difference. We have to.”
Pathway to Leadership
Ms. Goldstein moved into a leadership position relatively early in her career, and has not looked back.
A health care veteran with more than 38 years of tertiary hospital and home health care services experience, Ms. Goldstein brings a legacy of leading and delivering innovative, influential, and celebrated programs and clinical services. She has been a catalyst for change with a proven ability to drive quality improvement, fiscal fitness, patient-centered care, and lead teams to achieve positive patient experiences.
As the nurse leader at Mount Sinai Queens, Ms. Goldstein leads a nursing staff of more than 400, overseeing nursing practice, education, quality, and safety of care. She is one of many critical players in maintaining the hospital’s Magnet® designation. She is also a key player in the development and implementation of hospital-wide performance improvement programs.
Prior to joining Mount Sinai Queens, Ms. Goldstein was a vice president of operations at the Visiting Nurse Service. She is a Fellow of the Robert Wood Johnson Foundation Executive Nurse program, and she holds a Master of Science in Health Services Management and a Master of Arts in Nursing Administration from New York University’s Wagner Graduate School of Public Service.
Ms. Goldstein is a member of the American Organization of Nurse Executives and past president of the Greater New York Nassau Suffolk Organization for Nursing Leadership, the American Nurses Association, and a Fellow of the New York Academy of Medicine. In her spare time, you can find her in Aruba—her “happy place” for the last 20+ years—or with a pair of binoculars studying avian life near and far.
