Featured | Mount Sinai Today

Women With Disabilities Experience Barriers to Access and Disparities in Health Care

Updated on Jun 30, 2022 | Community, Diversity and Inclusion, Featured

Arianny Ramirez, right, a Clinical Research Coordinator in the Spinal Cord Injury Program at The Mount Sinai Hospital, demonstrates patient care in a staff training video with physical therapist Alexandra McGivern.

Intersectionality is a crucial consideration as providers treat patients and understand their needs inside and outside health care facilities, said Arianny Ramirez, a Clinical Research Coordinator in the Spinal Cord Injury Program at The Mount Sinai Hospital, who was the featured speaker for a virtual talk hosted by the Office for Diversity and Inclusion (ODI) at Mount Sinai. The session, “Health Care Disparities and Women with Disabilities,” is available here.

The talk was part of the Raising Disability Awareness Virtual Talk Series, launched by ODI in 2020 for Disability Awareness Month, featured speakers from around the Mount Sinai Health System and the community to promote an inclusive and equitable workplace and health care environment for people with disabilities.

Arianny Ramirez

Ms. Ramirez, a woman of color with a physical disability, discussed health care challenges at both a personal level and a population level. She said the health care community must work together to understand the intersection of sexism, racism, and ableism, and its effect on women with disabilities. “The biggest obstacles I face in my life as a woman with a disability are the barriers and limits society places on me,” she said.

After an accidental fall that paralyzed her from the waist down at age 18, Mrs. Ramirez realized that her life and the lives of many others would be easier if the world were designed with disabilities in mind.

According to the Centers for Disease Control and Prevention, about 36 million women in the United States have disabilities. This number is expected to continue growing, says Mrs. Ramirez, and “women with disabilities face more difficulty than women without disabilities in accessing health care screenings.” Routine physical exams, mammogram, Pap smears, sexually transmitted infection (STI) testing, and eye exams are just a few of the screenings that are more challenging to access for women with disabilities.

Physical and attitudinal barriers often prevent this population from seeking and receiving equitable and appropriate health care. The necessary equipment, machinery, and devices to care for these women are not always present in doctors’ offices, Mrs. Ramirez said of clinical care in the United States.

Additionally, stereotypes and discrimination are often directed toward people with disabilities in health care settings, making them feel uncomfortable and excluded, and there are limited training and guidelines in place to address the specific needs of women with disabilities.

“Let’s start with our physical barriers,” Mrs. Ramirez said. “They consist of a lack of adaptive examination tables and scales, inaccessible testing rooms, and inaccessible diagnostic equipment. Over 90 percent of physicians’ offices do not have wheelchair-accessible scales.”

The Mount Sinai Health System is working to address these disparities with a variety of measures, including a course created by the Department of Rehabilitation and Human Performance for Mount Sinai physicians and other providers in fields such as family medicine, internal medicine, obstetrics and gynecology, and emergency medicine. Mount Sinai employees can register for the course, “Improving Health Care Access for Women with Spinal Cord Injury” on Mount Sinai’s PEAK site.

Mount Sinai’s Spinal Cord Injury Research Center also offers information to the public about support groups, exercise, and clinical trials, including one addressing access for women with spinal cord injuries.

Ultimately, Mrs. Ramirez called for the public to consider the world from a different perspective.

“I invite all of you to just look around your environment. Whether it’s in the office, the structure that you live in, you work in, or your commute, and think ‘what if I did have a disability? What if I did have knee surgery and there wasn’t a lip in the sidewalk that I couldn’t get over or something?’” she said. “Be mindful of the experiences other people are having and remember that a disability can happen to anyone. One can become disabled at any point in your life, and you can be a part of this community in the future as well. If you do your part and advocate for structural change, this can improve the environment around us and open the door for women with disabilities to get the care they need and live their lives.”

Speaking as a woman with a disability and a professional in rehabilitation, Ms. Ramirez called on the health care community to take four measures: Increase professional education, training, and technical assistance so providers understand disability cultural competency; implement new monitoring and accountability laws and practices to increase oversight; use accreditations to ensure health care facilities comply with accessibility guidelines; and create a universal design that can be applied to any facility to care for and welcome people with disabilities uniformly.

“Until ableism becomes a conscious thought in nondisabled people’s minds, only then will true equality be achieved,” she said.

Get more disabilities-related resources from the Mount Sinai Office for Diversity and Inclusion

Mount Sinai West Earns National Accolades for Obstetrical Care

Updated on Jun 30, 2022 | Community, Featured, Mount Sinai West

Mount Sinai West earned a High Performing rating, the highest rating available, from U.S. News & World Report in the publication’s inaugural assessment of hospitals that provide obstetrical care. Mount Sinai West, along with Mount Sinai Morningside, which are ranked together, are among 237 of 2,700 hospitals in the United States to receive this rating.

To achieve the High Performing rating for maternity care, hospitals had to excel on multiple metrics that are important to families, including complication rates, C-section rates, whether births were scheduled too early in pregnancy, and breast feeding support for new parents.

Mount Sinai West has a culture that prioritizes low-intervention births and shared decision-making between providers and their pregnant patients and has a longstanding tradition of using midwives. Examples of how the hospital puts this into practice include offering nitrous oxide as an alternative pain-control measure to an epidural and wireless monitoring that enables patients to walk around during labor rather than having to stay in bed.

The labor and delivery unit’s providers are also trained in TeamSTEPPS, a teamwork model developed by the U.S. Department of Defense and the Agency for Healthcare Research and Quality, to optimize patient outcomes by improving communication among providers.

“We are proud to be included in the inaugural edition of Best Hospitals for Maternity Care,” says Holly Loudon, MD, MPH, Site Chair, Obstetrics, Gynecology and Reproductive Medicine, Mount Sinai West. “To be recognized on a national level is a tribute to our outstanding team of obstetrical faculty, nursing staff, and support staff and their dedication to quality, safety, and patient experience.”

Learn more about pregnancy and childbirth at Mount Sinai West

Advancing Artificial Intelligence Through Philanthropy

Updated on Jun 30, 2022 | Featured, Research

David Windreich

Thanks to the outstanding generosity of the Windreich Family Foundation, the Icahn School of Medicine at Mount Sinai will advance its vision of integrating Artificial Intelligence (AI) and machine learning into research and clinical practice to amplify patient-centered care. This multi-million dollar gift will establish the Windreich Department of Artificial Intelligence and Human Health at Mount Sinai.

By establishing one of the first departments devoted to AI in a medical school, this gift represents Mount Sinai’s exceptional commitment to integrating AI throughout the Mount Sinai Health System. It will enable the recruitment of dedicated faculty, novel research initiatives, and the acquisition of any equipment and software that are mission critical to ensuring Mount Sinai continues to lead bold initiatives that embrace the power of technology to accelerate advances in both scientific research and clinical care.

Oversight of the newly named Windreich Department of Artificial Intelligence and Human Health will fall under the purview of its inaugural Chair, Thomas J. Fuchs, Dr.sc, who is also the Co-Director of the Hasso Plattner Institute for Digital Health at Mount Sinai. The new department was formed under the vision and guidance of Dennis S. Charney, MD, the Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine. “This gift will ensure Mount Sinai continues to be at the forefront of the AI-driven revolution of health care to the benefit of Mount Sinai’s diverse patient population,” says Dr. Charney.

“Our duty at the new department at Mount Sinai is to ensure that our patients are the main beneficiaries of the enormous impact AI will have on health care,” says Dr. Fuchs. “To realize this vision, we are tremendously grateful for the gift from the Windreich Family Foundation. Mr. Windreich’s forward looking support will allow us to build a unique AI infrastructure at Mount Sinai and attract the world’s leading talent in this space.”

David Windreich, who serves on the Boards of Trustees at Mount Sinai, has a history of supporting AI and big data solutions in health care. His philanthropy extends to naming the Windreich Center for Bioinformatics at Mount Sinai. This Center is singularly focused on developing cutting-edge, web-based software tools and databases to facilitate the collection and analysis of diverse and complex data from human cells and tissues that will inform precise treatments for patients based on their unique genetic makeup. Mr. Windreich is also a former member of the Board of Directors for Sema4, a platform that uses machine learning and AI tools to analyze a database of more than 10 million patient genomic profiles and clinical records. Sema4 spun out of Mount Sinai in 2017 and went public at a $3 billion valuation in 2021.

“We have not yet reached the tipping point of how AI can play a major role in health care,” says Mr. Windreich. “My family is excited to play a role in supporting Mount Sinai’s initiative of being at the forefront of delivering technology solutions that will ultimately improve care and save lives.”

How to Stay Safe as the Omicron Variant Spreads in New York

Updated on Jun 30, 2022 | COVID-19, Featured, Your Health

Bernard Camins, MD, Medical Director for Infection Prevention at the Mount Sinai Health System, discusses how to stay safe in your day-to-day routine and clarifies new guidelines from the Centers for Disease Control and Prevention (CDC).

How safe is public transportation? Are there any new measures New Yorkers should take?

As a New Yorker, I take public transportation all the time. I take both Metro North and the subway. I believe that it’s safe, otherwise I wouldn’t be taking them. I agree with the guidance that masking should be mandatory in every form of public transportation. Masking has made an impact in keeping us safe through the entire pandemic. So, if we all continue to wear face coverings while taking public transportation, we will continue to be safe.

How safe is it for parents to send their kids to school?

All schools in New York City, private or public, should be following the guidelines set forth by the New York City Department of Education and the recommendations of the New York City Department of Health and Mental Hygiene. If I had a child who was school age, I would feel safe sending them to school based on those guidelines. I would also follow all the recommendations for parents made by those organizations. The New York City Department of Education summarizes much of the guidance here.

Are there any additional measures parents can take to protect their children?

It’s important that if your child is eligible to be vaccinated, you should vaccinate your child as soon as possible against COVID-19. And now that certain age groups are eligible to get the booster, parents should take advantage of that as well.

Have the recommendations changed in terms of what type of mask people should wear?

Because Omicron is more infectious, there have been some reports in the media that cloth masks may no longer be appropriate or adequate insofar as protecting us from this particular variant of COVID-19. But right now, we don’t have enough data to be sure. If people want to be better protected, they should first make sure their mask is well-fitted. You may want to consider double masking in which you would wear a medical or surgical mask underneath a cloth mask. This would simulate, or be equivalent to, a KN95 mask which is 95 percent effective in filtering respiratory droplets. But no matter what mask you wear, it will be ineffective if you don’t wear it properly—meaning that it should cover your nose and your mouth.

What should I do if I come into close contact with a person who is positive for COVID-19? What defines a close contact at this time?

If you haven’t received your booster shot, and you have a close contact with someone who has tested positive for COVID-19, you should quarantine for five days, according to new CDC recommendations. Afterwards, you should wear a mask in public for another five days. The CDC also recommends that you should get tested five days after the exposure. A high-risk contact or high-risk exposure is defined as being within six feet of someone who tested positive for COVID-19 for more than 15 minutes, and this could be cumulative over a 24-hour period. If you have received your booster shot, you do not need to quarantine following an exposure, but you should wear a mask for 10 days after the exposure and get tested at day 5 if you still do not have symptoms, according to the CDC. This is why it is important to get a booster shot as soon as you are eligible.

Is there anything else that has changed recently that people should know?

One thing that I want to highlight is the new CDC recommendation that if you were found to be infected with COVID-19, you only need to isolate for five days. To correctly count these five days, you should consider the date of symptom onset as Day Zero. If you are asymptomatic, Day Zero would be the date of your positive test. On the day after Day Five, you can leave isolation as long as you keep your mask on when you’re in public. And you should avoid places where you would have to take your mask off, such as restaurants.

Get more information from Mount Sinai about COVID-19

Mount Sinai Beth Israel Is Recognized by 2020 HealthFirst Quality Incentive Program

Updated on Jun 30, 2022 | Featured, MSBI

Members of the pediatrics, nursing, and dedicated P4P teams, left to right: Merlyn Nesbitt, Marie Tejada, Kathryn Gariba Benjamin, Raquel Falesbork, and Damilola Fenwa. Not pictured: Desiree Chow, MD, Yazmin Guzman, Yahaira Tejeda, and Lititia Satpathy.

Each year the Mount Sinai Health System participates in HealthFirst’s Quality Incentive Program, which rewards top performers for achieving the highest overall quality among their peers in clinical care, preventive cancer screenings, and effective management of chronic illnesses.

Mount Sinai Beth Israel earned the distinction as a “Top Performing Hospital” and was the number one performer in the Medicare program from HealthFirst’s 2020 Quality Incentive Program.

“This recognition reflects the amazing work of so many people and departments including Adult Primary Care, Pediatrics, Radiology, Gastroenterology, Gynecology, Nursing, and our terrific Care Coordinators,” says Paul Zucker, Vice President of Ambulatory Operations at Mount Sinai Beth Israel.

He adds, “Most importantly it demonstrates our ability to provide extremely high quality and well-coordinated care to those who have entrusted us to partner in their journey to health and wellness. As 2020 tested both the depth of our resilience and the agility with which we could counter the challenges that COVID-19 presented, this recognition takes on a very special meaning. I’m very proud to be associated with this distinguished group.”

Mount Sinai West Opens New Unit to Improve the Experience of Patients After Giving Birth

Updated on Jun 30, 2022 | Featured, Mount Sinai West, OB/GYN

The new rooms feature large, digital communication boards that enhance communication among patients and families and their care teams.

Mount Sinai West has opened a new unit specifically designed to enhance the overall experience for parents and their newborns. The new unit features 21 spacious rooms with sleeping accommodations for a partner, renovated bathrooms, modern fixtures, and digital communication boards.

“We focused on providing a soothing environment for parents and babies that is conducive to bonding as well as patient healing, and optimizing the way we care for our patients,” says Holly Loudon, MD, Site Chair for Obstetrics, Gynecology and Reproductive Health at Mount Sinai West. “The new unit was specifically designed to enhance communication between patients and their care teams and provide the best possible experience.”

For example, new digital communication boards are used to improve patient and provider collaboration. The boards automatically pull key information from the patient’s medical record like names and photos of the care team.

They also display goals that the patient has identified, such as breastfeeding; goals for the baby, such as status of screenings and blood tests; and care team goals, such as progress on walking. A special touch screen section of the board allows patients, family members or others to write questions or updates. The screen serves as a reminder to both the family and the care team to address important items.

The new unit is just the latest in a number of improvements at Mount Sinai West, which has a culture that prioritizes low-intervention births and shared decision-making between providers and their pregnant patients and has a longstanding tradition of using midwives.

“We expect to have more than 4,000 births this year, so having an environment that reflects the high quality of care and service we have always provided is important,” says Evan Flatow, MD, President at Mount Sinai West, who led a recent ribbon-cutting ceremony at the new unit, known as 11A. “The new unit is among several projects to improve the full range of care for new parents and babies, including a new neonatal intensive care unit (NICU) that opened in 2019 and improvements to the labor and delivery unit.”

Mount Sinai West was included on the inaugural list of high-performing Maternity Care hospitals released recently by U.S. News & World Report. Mount Sinai West, along with Mount Sinai Morningside, which are ranked together, are among 237 of 2,700 hospitals in the United States to this achieve this rating.

The official opening of 11A was celebrated by Mount Sinai West and Maternal Child Health leadership, physicians, and staff, from left to right: Erin Figueroa, MSN, RN NE-BC, Senior Director Nursing, Obstetrics and Gynecology; Evan Flatow, MD, President, Mount Sinai West; Holly Loudon, MD, MPH, Site Chair, Obstetrics and Gynecology; Linda Valentino, MSN, RN, NEA-BC, Chief Nursing Officer, Tim Day, Chief Operating Officer, and Cheryl Seredy, Marketing and Communications.

Take a virtual tour of Mount Sinai West’s childbirth units