“Our teams think of AI as augmented intelligence, versus artificial intelligence,” says Robbie Freeman, DNP, RN, Vice President of Digital Experience and Chief Nursing Informatics Officer at the Mount Sinai Health System. “The goal is to leverage AI as a supportive tool to enhance clinical decision-making—not to replace it.”
He adds, “Risk assessment models and tools for guiding care have always been integral to nursing practice. By combining nursing expertise and critical thinking with the ability to analyze vast amounts of data, AI is transforming how we deliver care, elevating quality and safety to unprecedented levels. In the coming years, this technology will continue to support nursing practice by enabling the creation of highly targeted, personalized care plans for every patient.”
Shown from let: Eric Kim; Prem Timsina, ScD; Arianna Goldman; Dhaval Patel; Maria ‘Vickee’ Sevillano, RN; Kim-Anh-Nhi Nguyen, MSc; Robbie Freeman, DNP, RN; and Arash Kia, MD, MsC
“Every AI project starts with a working group,” says Dr. Freeman, “and that working group always includes the people who are delivering care. For example, if we’re working on a falls-related initiative, we sit down with front-line nurses, with geriatricians, with nurse leaders, and from day one we’re talking together about what might be helpful.”
Currently, Mount Sinai nurses are using a machine learning model that predicts which patients are most likely to fall while in the hospital. The data behind this tool largely came from examining electronic medical record (EMR) data. By combing through nursing notes using recognition algorithms, Mount Sinai also developed an AI tool to better identify which patients are at higher risk for becoming delirious while in the hospital so that tailored preventive interventions could be put in place at the earliest opportunity.
From left: Prem Timsina, ScD; David Reich, MD, Chief Clinical Officer, Mount Sinai Health System, and President of The Mount Sinai Hospital; Robbie Freeman; Matt Levin, MD, and Arash Kia, MD, MsC
Mount Sinai is leading the world in developing a variety of AI products that support nurses and keep patients safe, according to Dr. Freeman.
Another AI product came about when Maria ‘Vickee’ Sevillano, BSN, RN, CWCN, COCN, a Mount Sinai clinical nurse, proposed an idea focused on the prevention of pressure injuries, also known as bed sores.
“We embraced the idea, collaboratively explored its nuances through a co-design process, and partnered with our internal data scientists and software engineers to transform it into a fully realized product,” says Dr. Freeman. “We tested and fine-tuned it, and in early 2024 the idea brought forward was introduced to the clinical setting. This predictive software is currently embedded in our EMR at The Mount Sinai Hospital, and we hope to expand its use as we continue to evaluate the product.”
Mount Sinai has also done a lot of work with a new type of AI called large language models, which, among other tasks, can recognize and generate large amounts of text. One particular study involved examining nursing triage notes to identify predictors for which Emergency Department patients were likely to be admitted to the hospital.
“In many cases the nursing documentation can really power AI,” says Dr. Freeman. “Much of nursing documentation data reflects their expert observations and has predictive power. So, using things like natural language processing algorithms, the nursing observations and assessments are really helpful in the development of AI tools that have broader use and impact. ”Mount Sinai is also using AI to help reduce the amount of time nurses spend doing documentation by rolling out macros—a sequence of computer instructions to automate a task—and tools that can streamline the process and relieve the documentation burden.
Kim-Anh-Nhi Nguyen, MSc, left, and Maria ‘Vickee’ Sevillano, BSN, RN, CWCN, COCN
As this emerging field continues to grow, Dr. Freeman says it is important to note that Mount Sinai has governance in place to ensure there is a solid understanding of how these tools work, that they are safe, and that they are being used in ways that are ethical and sound before they are being used in patient care.
“There’s a science and methodology for ensuring AI products are used responsibly,” Dr. Freeman says. The shared decision-making structure plays a critical role. Mount Sinai is also part of the nonprofit Coalition for Health AI, which brings together a diverse array of stakeholders to drive the development, evaluation, and appropriate use of AI in health care.
“AI is here and has proven it holds promise for thoughtfully revolutionizing care delivery in ways never imagined,” he says.
Mount Sinai Phillips School of Nursing graduates attend commencement at The Stern Auditorium at The Mount Sinai Hospital on December 19, 2024.
On December 19, 2024, the Mount Sinai Phillips School of Nursing celebrated the graduation of 103 students of Cohort 12, the class of students who began their studies in September 2023. The Stern Auditorium at The Mount Sinai Hospital was filled to capacity with proud families and friends of the graduates and school faculty.
Beth Oliver, DNP, RN, FAAN, Chief Nurse Executive, Senior Vice President, Cardiac Services, while in transit, offered her congratulations virtually. She stated that nursing is a profession not just known for clinical skill but significant for the compassion, resilience, and dedication to the well-being of others. And she emphasized the importance of direct patient care.
“The bedside, or chairside, is where the essence of nursing comes alive. You may step into roles as educators, researchers, administrators, or leaders in the field of nursing. You will become the mentors, advocates, and champions for the next generation of nurses. But regardless of where your path takes you, always remember the foundation of your practice: bedside is the best side. Every role you take on will ultimately come back to that fundamental connection with the people you serve.”
Brendan Carr, MD, MA, MS, with Kimberly Glassman, PhD, RN, NEA-BC, FAONL, FAAN (left) and Vivian Lien, DNP, RN, CNE, Senior Associate Dean for Academic Affairs and Wellbeing and Clinical Associate Professor at the Mount Sinai Phillips School of Nursing
Brendan Carr, MD, MA, MS, Chief Executive Officer, Professor and Kenneth L. Davis, MD, Distinguished Chair, Mount Sinai Health System, spoke to the new graduates about their essential role in health care, how nurses make special connections not only to patients and patients’ families, but also to their colleagues.
“As a young physician, I learned that nurses are the engine of teamwork, especially with physician partners, because they understand the patient as a whole. You have a superpower.” He added that the graduates were very special to Mount Sinai and hoped they would continue as professional nurses in the Mount Sinai Health System.
Janet Green, Chair of the Board of the Mount Sinai Phillips School of Nursing, whose family was integral to the founding of the school, relayed congratulations, noting that nursing is a calling and “an integral part of patient health care.”
The Valedictorian, Jennifer Moffa, thanked her fellow classmates and faculty, giving them credit for her achievement. She added that it was “bittersweet” to complete her education at the Mount Sinai Phillips School of Nursing, but was thankful for “everlasting connections” and reminded her peers to “choose kindness.”
Before the recitation of the International Pledge for Nurses by the graduating class, and the flipping of their cap tassels from right to left, Kimberly Glassman, PhD, RN, NEA-BC, FAONL, FAAN, Dean, Mount Sinai Phillips School of Nursing, reiterated that there are diverse career paths open to the graduating class, saying, “the entire world is open to you.”
Zhanna Makoviy, RN, FAACM, is a case manager at Mount Sinai West, guiding patients smoothly from the Emergency Department to inpatient care. Marking her 10-year anniversary with the Mount Sinai Health System, Ms. Makoviy receives high praise from her leadership, colleagues, and patients. “Zhanna exemplifies the very best of our values and mission at Mount Sinai,” says Jose Francisco Morales, BSN, CCM, Assistant Director of Case Management at Mount Sinai West. “She has been a cornerstone of our case management and emergency departments, practicing with clinical expertise, a collaborative approach, and an unwavering commitment to patient-centered care.”
Two patient caregivers expressed gratitude for Ms. Makoviy’s efforts. “I want to praise the actions and kindness of Ms. Makoviy,” one patient’s sister wrote. “She was so helpful as we moved my brother from the ED to a room. She was empathic, working with a fellow nurse to have the forms processed quickly. I owe her a deep debt of gratitude.” Another caregiver wrote, “My experience with Ms. Makoviy was wonderful. She is a shining beacon.”
Ms. Makoviy is committed to patient experience excellence, for all patients. “Every patient we encounter in the emergency room is not just a case, but a unique individual, deserving of compassionate care and meticulous attention,” she says. “As a case management nurse, I believe in the power of collaboration and advocacy, ensuring that each patient receives not only the immediate treatment they need, but also the resources and support necessary for their ongoing recovery. Our role is to bridge the gap between urgent medical needs and comprehensive care, upholding the highest standards of professionalism and empathy in every interaction. It is beautiful and fulfilling to see the positive impact a health provider’s dedication has on a patient’s journey, and I am grateful for the opportunity to contribute to this field.”
“The impact of Zhanna’s work extends beyond her clinical abilities,” says Mr. Morales, “for her humanity and compassion lead to profound impressions. Zhanna is a testament to how one person’s dedication to always go above and beyond can transform care experiences and create lasting positive outcomes for all involved.”
In the Your Voice Counts all-staff survey across our system, Mount Sinai nurses identified psychological safety as a common and pressing concern. A packed auditorium was treated to a deep dive into the topic recently at the Health System’s 2024 Annual Nursing Conference, “Empowering Teams: Building a Culture of Safety and Collaboration.” Highlights included a two-pronged keynote approach by nationally recognized experts in the field, a lively panel discussion, and a Q&A session.
The importance of the material was relayed via introductory remarks by senior Mount Sinai Heath System leaders Beth Oliver, DNP, RN, FAAN, Chief Nurse Executive and Senior Vice President, Cardiac Services; Brendan G. Carr, MD, MA, MS, Chief Executive Officer, Professor and Kenneth L. Davis, MD, Distinguished Chair; and David L. Reich, MD, Chief Clinical Officer and President, The Mount Sinai Hospital and Mount Sinai Queens.
Then, the two keynote speakers recognized Mount Sinai’s reputation as a leading health care organization and set their sights on the future: How to leverage that standing to ensure delivery of care that is stronger, better, always.
Amy Edmondson, PhD, Novartis Professor of Leadership and Management, Harvard Business School, began with an engaging, no-nonsense, and at times humorous keynote, “Work Without Fear: Why Psychological Safety Matters for Safe High-Quality Care.” With a focus on work environments, she made the important point that psychological safety involves a healthy friction, creating a place where people feel comfortable pointing out mistakes to further the team’s goals. She went on to discuss key related elements:
How high standards and psychological safety go hand in hand
How various work environments function
How we as individuals deal with them
How we band together in teams to respond and excel
Thomas Lee, MD, Chief Medical Officer of Press Ganey, the patient-satisfaction survey firm—which also conducted Your Voice Counts for Mount Sinai—seamlessly picked up where Dr. Edmondson left off with his keynote, “How Do We Hard-Wire What Amy Thinks We Should Do?” He shifted the discussion from the organizational perspective to that of teams and individuals and how staff can work together to prevent errors. Dr. Lee particularly noted the concept of social capital and the importance of empowering team members to speak up if they see something out of place, and to innovate for improvement.
The two then joined Mount Sinai experts, including Pam Abner, MPA, CPXP, Senior Vice President, System Health Equity Officer, Chief Diversity Operations Officer, Mount Sinai Health System, Jonathan Nover, MBA, RN, Vice President of Nursing for Emergency Services, Mount Sinai Health System, and Beth Degen, RN, Senior Clinical Nurse, The Mount Sinai Hospital, for an engaging interdisciplinary panel discussion and Q&A session, moderated by Rebecca Anderson, MPH, Vice President of Strategy Operations, Office of the Chief Medical Officer. The overarching themes were about building inclusive, supportive care environments—setting the foundation for a safer, more unified health care future.
The conference was a practical, idea-packed day for clinicians looking to foster stronger teams and safer patient outcomes.
Three aspiring nurses studying at the Mount Sinai Phillips School of Nursing (PSON) were accepted into the 2024 Phillips Evidence-Based Practice/Quality Improvement (EBP/QI) Fellowship Program earlier this year and presented their projects along with nurse researchers at The Mount Sinai Hospital’s annual Nursing Research Day on Friday, November 15.
The Program, also known as the Phillips Fellowship, at PSON was developed in 2017 to increase pre-licensure nursing student experience in evidence-based practice and nursing science. Under the direction of Aliza Ben-Zacharia, PhD, DNP, ANP-BC, FAAN, and supported by lecturing professors, selected fellows undergo the development and implementation of an EBP/QI project. All projects are submitted to the review committee at the Mount Sinai Health System’s Center for Nursing Research and Innovation (CNRI) for ethical approval before implementation. At the end of the fellowship, students present their projects along with nurse researchers at The Mount Sinai Hospital’s Nursing Research Day; this year taking place on Friday, November 15. Alyssa Ramkissoon, Jessica Jurgens, and Kathryn Cole are the 2024 fellows.
The objective of Alyssa Ramkissoon’s project, Enhancing Nursing Communication in Palliative Care by Empowering Nurses Through the COMFORT Model’s Connect Module, is to increase palliative care knowledge by nurses and nursing students. Alyssa, who worked at the Mount Sinai Health System for six years as a Cardiology Research Associate and in the Department of Neuropathology/Manhattan HIV Brain Bank before enrolling in PSON, explains that in palliative care, effective communication is essential to the efficacy of nursing interventions. “Palliative care is frequently a difficult subject for new nurses to understand, and occasionally even for seasoned nurses. In their conversations with patients at the bedside, nurses frequently encounter challenging questions from the patients. Knowing how to adequately answer these questions is crucial since it affects the patient’s course of treatment. Further, hospice and palliative care are sometimes confused. It is critical to bridge this informational gap and promote confidence in nursing communication.”
Jessica Jurgens also focuses on communication for her project, Bridging the Communication Gap Between Nursing Students and Spanish Speaking Patients. She explains, “Effective communication is the cornerstone of patient care. But miscommunication between providers and patients can result in insurmountable problems, and a language barrier can compound these consequences. The Hispanic population in the United States has grown to 65 million, so there is close to a one in five chance a provider will be treating a Spanish speaking patient. While Spanish translators are often provided by hospitals, there are times when knowing simple/common phrases, similar to those that a nurse would use in their daily practice, would benefit the nurse in providing expedited answers or care, without needing to take the time to reach a translator for every interaction. This project aims to teach nursing students basic medical Spanish phrases in hopes of building their confidence and self-reliance, while addressing the language barrier. This will also save time that might be spent locating a translator, at times when only a simple question might be asked.”
Kathryn Cole also worked at Mount Sinai prior to enrolling at PSON; she was a medical scribe for the Department of Urology. The goal of her project, Cloudy Judgment: Addressing Gaps in Awareness of Cannabis Use and Surgical Patients is to enhance nursing students’ and nurses’ understanding of cannabis, particularly regarding perioperative screening and its implications. She discusses the rationale for her initiative: “As more people use cannabis for both recreational and medicinal purposes, there’s a growing need to understand how this impacts pain management during and after surgery. However, current preoperative assessments often do not adequately address cannabis use, which could lead to less effective pain management strategies. Additionally, the opioid crisis remains a significant public health issue, with nearly 75 percent of drug overdose deaths involving an opioid in 2020. This crisis continues to affect communities nationwide and addressing potential interactions between cannabis and opioids is crucial in ensuring safer pain management practices. My project explores whether incorporating simple, standardized marijuana screening tools into the nursing curriculum can lead to better pain management outcomes for patients undergoing surgery, potentially mitigating the risks associated with opioid use.”
Dr. Ben-Zacharia is understandably proud of these student fellows. “We only choose two to three fellows each year, based on numerous highly selective criteria, including GPA, faculty and peer recommendations, and a personal interview. They do most of their work in the span of one semester, including literature searches, survey implementation, and analysis, and, of course, preparing their presentations. All while they are simultaneously doing their final semester requirements and clinical rotations. We are so fortunate to have these and many other students at PSON who are committed to improving the field of nursing.”
The Mount Sinai Hospital Department of Nursing has once again distinguished itself in nursing excellence by earning its fifth consecutive Magnet Recognition®, a prestigious designation achieved by less than 1 percent of hospitals nationwide. However, what makes this achievement truly remarkable is the hospital’s receipt of nine exemplars—additional marks of excellence within the Magnet framework.
The Magnet Recognition® program, administered by the American Nurses Credentialing Center (ANCC), is the ultimate credential for nursing excellence. Earning Magnet status is a rigorous process that reflects a health care organization’s commitment to providing outstanding patient care, fostering an innovative health environment, and supporting dedicated nursing staff. ANCC uses nationwide benchmarks to determine if an organization is meeting these rigorous standards. Our recent Magnet Survey showed that we are exceeding and leading the nation in nine, underscoring Mount Sinai Nursing’s exemplary performance:
Advanced Nursing Education: Mount Sinai maintained a clinical nurse staff in which 97 percent of registered nurses have a baccalaureate or higher degree, significantly surpassing the standard requirement of 80 percent.
Professional Development and Improved Patient Outcomes: Innovative practices like the “Nursing Attending Model” improved patient outcomes by reducing nurse-sensitive indicators, such as falls and infections, and enhanced patient experiences in communication, teamwork, and responsiveness.
Clinical Quality Indicators for Patient Burns: Mount Sinai outcomes data for ambulatory patient burns consistently outperformed national benchmarks comparison cohorts provided by the national database for the majority of eight quarters on 100 percent of the units.in managing patient burns across all units.
Ambulatory Surgical Errors Management: Mount Sinai’s outcomes data on surgical errors consistently exceeded national benchmarks, demonstrating exceptional clinical performance.
Patient Experience Category-Inpatient Care Coordination: The hospital excelled in inpatient care coordination, with outcomes significantly surpassing national benchmarks, showcasing their commitment to integrated and personalized patient care.
Patient Experience Category-Inpatient Pain Management: Mount Sinai enhanced patient experience through exemplary inpatient pain management, outperforming national standards over eight quarters.
Patient Experience Category-Inpatient Patient Education: Mount Sinai demonstrated excellence in inpatient patient education, leading to superior patient experience outcomes against national benchmarks.
Patient Experience Category-Inpatient Patient Engagement and Centered Care: Mount Sinai’s approach to inpatient patient engagement and personalized care consistently led to higher patient satisfaction and exceeded national standards.
Nursing Research Infrastructure: The exemplary support from the Center for Nursing Research and Innovation has led to substantial contributions to nursing knowledge, supported by significant research funding and numerous publications.
With unwavering dedication and innovative practices, the Department of Nursing at The Mount Sinai Hospital has once again established a benchmark for nursing excellence. These nine exemplars not only highlight the remarkable quality of care within our institution but also serve as a model for health care organizations worldwide. As we celebrate this significant achievement, we honor the tireless efforts and pioneering spirit of Mount Sinai’s nursing staff. Their relentless pursuit of excellence creates an environment where nurses aspire to work and patients receive the highest standard of care.
