Becker's Hospital Review

49 FINANCE CMO / CARE DELIVERY Mount Sinai's ED is a 'war zone,' nurse says By Mackenzie Bean C urrent and former Mount Sinai Hos- pital employees said in December 2019 that staffing shortages and high patient volumes had created serious patient safety issues in its emergency department, which one nurse called "a war zone," reported the New York Post. Six things to know: 1. In April 2016, outside medical consultants said the conditions at Mount Sinai's ED were "among the worst we have ever seen," accord- ing to an internal report obtained by the New York Post. ey urged New York City-based Mount Sinai to revamp the department, cit- ing concerns with staffing ratios, infection control and patient safety. 2. e New York Post spoke with several for- mer physicians and nurses at the ED, who said high patient volumes and care lapses were still issues at the end of 2019. A former nurse who quit in September claimed she was typically assigned nine patients on a normal shi, al- though this figure could be as high as 18. Oth- er staff members described instances in which patients experienced a heart attack without cli- nicians noticing or were not admitted to criti- cal care units due to a lack of space. "Every day I go to work, I feel like I am go- ing to a war zone," one nurse, who wished to remain anonymous, told the New York Post. 3. A spokesperson for Mount Sinai disputed claims that nurses have ever had as many as 18 patients on a shi, saying the hospital aims for staffing ratios of 6:1 or 8:1. e spokes- person said leaders have been receptive to past concerns staff members raised about workloads. In response, the hospital added 20 nurses in 2019, along with a second nurse manager and four assistant nurse managers. 4. Employees told the New York Post they believe the issues stem from Mount Sinai's switch to "split flow" ED operations in 2016. e process seeks to expedite care and lower wait times, but employees say the system cre- ates a dangerous overload of patients due to staffing and bed shortages. 5. In a direct statement to Becker's, Mount Sinai said the New York Post's report "in no way reflects the current status of our emer- gency department," adding that patients ad- mitted through Mount Sinai's ED with heart attacks, heart failure, severe lung conditions and stroke have among the best survival rates in the nation. e hospital has made major investments in its ED since completing a stra- tegic review in 2016, including the addition of more than 130 employees. "We have also opened the Mount Sinai Ex- press Care facility on the same block to al- leviate emergency department crowding by taking care of patients with less serious con- ditions in a separate location," the hospital said. "Now, we have plans for a complete ren- ovation of both our emergency department and our observation unit to more than dou- ble the number of treatment locations and further improve patient care." 6. On Dec. 9, 2019, Democratic New York Gov. Andrew Cuomo ordered state health officials to investigate the allegations against Mount Sinai aer learning of the New York Post's exposé, according to a separate report from the publication. n DMC neurosurgery residency allegations are 'out of context,' 'blatant lies,' ex-director says By Emily Rappleye T he longtime director of Detroit Medical Center's neurosurgery residency program, who stepped down in September 2019, wants to set the record straight after the program lost accreditation in November. In an interview with The Detroit News, he said allegations against the program were "blatant lies." Murali Guthikonda, MD, is Detroit Medical Center's chief of neurosurgery and for 15 years served as director of the Wayne State University neurosurgery residency program, which is sponsored by DMC. Dr. Guthikonda left the role Sept. 5, 2019, after he received a letter in July 2019 from the Accreditation Council for Graduate Medical Education outlining complaints about the program, according to The Detroit News. Allegations included: The program had an atmosphere of intimidation, overwork and coercion. Residents were bullied, forced to work excessive hours, and discouraged from reporting and documenting safety concerns. In his interview with The Detroit News, Dr. Guthikonda said he was "floored" by the allegations. "That's an appalling, disheartening character assassination of me to the degree that I don't even have a description for that," he said, ac- cording to the report. Dr. Guthikonda instead speculated that the program lost accreditation due to conflict between Wayne State and DMC. After the faculty group practice, University Physi- cians Group, declared bankruptcy in November 2018, the residency lost all six of its faculty physicians. Four of the six, including Dr. Guthikonda, sought employment at DMC, and their faculty contracts were not renewed. Two left both organizations altogether, according to the report. Jack Sobel, MD, dean of Wayne State's medical school, previously told The Detroit News the program's loss of ac- creditation was due to the "failure of one or two teaching individuals," not the relationship between the two organi- zations. n

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