Geriatrics at Mount Sinai Fall/Winter 2020 Newsletters

G E R I ATRICS AT MOUNT SINAI

Geriatrics Newsletter • Fall/Winter 2020

The Brookdale Department Improves Care for Older Adults Under COVID-19 and Receives Esteemed Recognition COVID-19 has taken a horrific toll on the United States and its vaccine still sits on the horizon. The devastating impact of this disease highlights the urgency for high quality geriatrics care. Through innovation and flexibility, the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai continues to improve care for older adults and their loved ones in the setting of COVID-19.

In the spring, the Brookdale Department refined the scope of their clinical services with the launch of telehealth, expansion of the Mount Sinai at Home programs, and the redesign of the Martha Stewart Centers for Living to ensure safe in-person office visits when medically necessary. These

programs have been implemented into the standard operations of the department and continue to protect patients and their caregivers. The Brookdale Department also embedded geriatricians into critical care settings throughout the Mount Sinai Health System to help meet the special needs of older adults with COVID. While the need for embedded geriatricians has passed, it is available in the event of a second surge.

Welcome news came over the summer when the Brookdale Department’s commitment to patient care was reflected in the U.S. News & World Report 2020-2021 Rankings. Mount Sinai Hospital was named first in the nation for the care of older adults. The report also named Mount Sinai Beth Israel, Mount Sinai Morningside, and Mount Sinai West among the top 10 percent of all hospitals surveyed.

Since the onset of the pandemic, researchers within the Brookdale Department have been examining the impact of COVID-19 on older adults.

One such study, supported by a new federal grant from the National Institute on Aging and led by Dr. Katherine Ornstein, is specifically looking at how social resources impact the ability of individuals with dementia to live safely in the era of COVID-19.

“While we don’t know what the future holds, the Brookdale Department is prepared to meet the needs of our community once again. We have systems in place which can be rapidly implemented, our education initiatives are continuing, and our researchers are identifying gaps in community care in real time,” says Dr. R. Sean Morrison, Ellen and Howard C. Katz Chair of the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai. t

A Letter from Martha I am tremendously proud that Mount Sinai Hospital, home of the original Martha Stewart Center for Living, has been recognized as the nation’s leading hospital for the care of older adults by U.S. News and World Report. This well-deserved honor reflects Mount Sinai’s long history at the forefront of care for older adults. In fact, in 1909, Dr. Ignatz Nascher coined the term “geriatrics” and wrote the first textbook on geriatrics care here at Mount Sinai.

As the population expanded and our life expectancy lengthened, Mount Sinai continued to improve clinical care, education, research, and health policy for our nation’s older adults. When met with an unprecedented challenge: the COVID-19 pandemic in Spring 2020, they rose to the occasion once again. Mount Sinai and our two Martha Stewart Centers for Living used expertise and innovation to provide the highest level of care in the safest manner possible.

While the future for all of us is still greatly unknown, we are keenly aware that older adults are living with the risks of COVID-19 as well as the risks of isolation due to COVID-19. Now more than ever, Mount Sinai needs your support to care for patients and to advance the field of geriatrics. I invite you to join me in supporting Geriatrics Care at Mount Sinai philanthropically so that we can ensure the continuation of tailor-made care for older adults and their loved ones. If you are interested in donating to our work, please visit: http://giving.mountsinai.org/geriatrics.

Sincerely,

Martha

Telehealth and the Future of Geriatrics Care When the COVID-19 Pandemic began, health systems everywhere rushed to expand their telehealth services to minimize risky in-person visits. And while telehealth presents unique challenges for older adults, the team at Mount Sinai’s Martha Stewart Centers for Living (MSCL) established a robust virtual program during the early stages of the pandemic. These telehealth programs continue as part of the normal “living with COVID-19” operations.

Through telehealth, patients’ needs can be addressed in the safety of their own homes, throughout the hospital, and in emergency departments. Social distancing can be maintained for MSCL patients – all of whom are at increased risk for serious COVID infection. However, such care requires creativity, flexibility, and consideration of the unique needs of older adults.

“The most important lesson that we have learned is to be flexible and to adapt our services to the individual needs of our patients and their families,” says Dr. Vanessa Rodriguez, Associate Medical Director at the Martha Stewart Center for Living Downtown. “We cannot assume that every patient has access to and has comfort with the technology required for telehealth visits”.

At the onset of the pandemic, the Centers for Medicaid and Medicare Services (CMS) waived some restrictions on telehealth usage. “CMS decision gave us the flexibility to employ technology the patient was most comfortable with, such as MyChart, Zoom, FaceTime, or telephone, to conduct virtual visits,” said Dr. Veronica Rivera, Associate Medical Director at the Martha Stewart Center for Living Uptown.

The Brookdale Department administrative assistants contact patients ahead of their appointment to assess their comfort and familiarity with the telehealth platform options and counsel patients as to how to log in and access video calls.

The medical assistants to do pre-calls to gather relevant information in advance.

“Like everything we do at MSCL, it is a true team effort. We also recognized that telehealth may not be the right option for everyone,” said Dr. Rivera. “For those who need in-person examinations or are not comfortable with telehealth, we redesigned our ambulatory practices to ensure that patients are safe. We provide detailed advice as to how to minimize infection risk as they traveled to and from our Centers.”

The Martha Stewart Centers for Living will continue to offer telehealth options as part of standard practice. t

Geriatrics at Mount Sinai • Fall/Winter 2020

PROVIDER SPOTLIGHT

DR. MARTINE SANON Associate Professor of Inpatient Geriatrics Clinical Services Dr. Martine Sanon joined the Brookdale Department of Geriatrics and Palliative Medicine in 2009 for her Geriatrics Fellowship. Immediately following, she was recruited as a clinician educator and currently, she serves as the Director of Inpatient Geriatrics Clinical Services. Dr. Sanon has been instrumental in expanding clinical services and in developing several initiatives to improve care for older adults in the Emergency Department. She has shared her expertise in the unique needs of older adults and their loved ones with countless fellows, residents, and medical students.

“My passion as an academic geriatrician has been in training frontline clinical providers in the acute care setting. With high quality, evidence-based care, we continue to improve the care and healthcare outcomes for our most vulnerable patients,” said Dr. Sanon. “I feel honored to lead a wonderful interdisciplinary team who help care for our older hospitalized patients and address the complex care needs during what is often considered an uncertain and frightening time in their health trajectory. It is a privilege to train the next generation of physician leaders in the care most dear to me across various disciplines and settings.”

Dr. Sanon has received Advanced Membership in the Institute for Medical Education at the Icahn School of Medicine at Mount Sinai, recognizing her outstanding contributions to education. She was recently named a Tideswell Emerging Leaders in Aging Program scholar, a highly selective program of the American Geriatrics Society and the Association of Directors of Geriatric Academic Program which identifies emerging national leaders and provides them with coaching and professional development. She also serves on the American Geriatrics Society Clinical Practice and Models of Care Committee. t

Kudos: ¢ Su Su Aung, MD, Eileen Callahan, MD, and Holly Konicki, MD – received the 2020 Cullman Family Award for Excellence in Physician Communications, which is awarded to Mount Sinai physicians who rank in the top 1% in provider communication as measured in CMS’s Patient Experience Survey. ¢ Kenneth Boockvar, MD – awarded a National Institutes of Health grant to investigate the possibility that behavioral and psychological symptoms in dementia increase blood pressure in nursing home residents. ¢ Rosanne Leipzig, MD and Joyce Fogel, MD – received an UJA Federation Grant for “Building a Dementia-Friendly NORC”.

Special Faculty Awards and Achievements ¢R . Sean Morrison, MD, Kenneth Covinsky, MD, MPH, from the University of California, San Francisco, and multiple other departmental members – awarded a National Institute on Aging multi-million dollar program grant to understand coexisting medical, social, and health system factors that affect outcomes for people with dementia and their families.

¢C hristopher Woodrell, MD – awarded a GEMSSTAR (Grants for Early Medical/ Surgical Specialists’ Transition to Aging Research) by the National Institute on Aging.

¢ Katherine Ornstein, PhD – awarded a supplement from the National Institute on Aging to study “Homebound with Dementia in the Context of COVID-19”. ¢ Katherine Wang, MD – awarded American Academy of Homecare Medicine Educator of the Year.

Geriatrics at Mount Sinai • Fall/Winter 2020

Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place Box 1070 New York, NY 10029 Tel. 212-659-8552 www.mountsinai.org/geriatrics @MSHSGeriPalCare

Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place, Box 1070 New York, NY 10029

GERIATRICS AT MOUNT SINAI Fall/Winter 2020

MOUNT SINAI VISITING DOCTORS CELEBRATES 25 YEARS SERVING NEW YORK CITY For the past 25 years, Mount Sinai Visiting Doctors (MSVD) has provided the highest quality primary care to homebound persons throughout New York City. The award-winning program began in 1995 when three Mount Sinai residents recognized the need and sought to improve care for persons unable to leave their homes. Since then, MSVD has evolved into one of the largest academic home-based primary and palliative care programs in the nation, with its clinicians making more than 6,000 home visits to over 1,100 patients annually and training hundreds of clinicians through the years.

MSVD has also served as a clinical model for recent home-based initiatives and the flagship of the Mount Sinai at Home clinical center, which includes Hospitalization, Palliative Care, Pediatrics, and Rehabilitation at-home. Each program reflects the MSVD model and mission with various specialty care, varying degrees of care intensity, and caregiver support. At the onset of the COVID-19 Pandemic, athome services became more important than ever. MSVD adapted and expanded services to ensure greater population health and continue to improve the quality of life of homebound persons, as well as their caregivers.

“Seeing a patient in their home gives a very different perspective to their care, and I believe because of that we are making a difference in the lives of our patients and their families,” says Dr. Linda V. DeCherrie, Clinical Director of Mount Sinai at Home. “Our programs also teach trainees the importance of understanding the context of the patient’s lives in their care. Even if the trainees don’t make a career in home-based service, they gain invaluable learning experiences through their time with us.” t

(Left to Right) MSVD Founders: David Muller, MD, Laurent Adler, MD, MS, Carmen Andujar, RN, BSN, and Jeremy Boal, MD