In rethinking the delivery of geriatrics care, Mount Sinai has recognized the need for easy access for older adults who often find getting to medical appointments a challenge. The problem was particularly severe for this population on the Upper West Side of Manhattan, which lacked the convenience of a nearby site for comprehensive care.

The Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai responded by opening an outpatient center for geriatrics in 2019 at Mount Sinai Morningside, a leading provider of inpatient health care in the community and one of the eight hospital campuses of the Mount Sinai Health System in the New York metropolitan area.

“With the success of our Martha Stewart Center for Living on the East Side of Manhattan, we saw the opportunity to expand to other parts of the city,” says Nisha Rughwani, MD, Associate Medical Director for the Morningside Geriatrics Practice. “That resulted in our launch of this new outpatient practice on the West Side to provide the same level of holistic, integrative care as the two Martha Stewart Centers for Living in Manhattan.”

Like those models, the Mount Sinai Morningside practice treats patients in an interdisciplinary manner, putting at their service a clinical team that includes doctors specializing in geriatrics medicine and palliative care, nurse practitioners, registered nurses, and social workers. Each patient over the age of 75 receives a full assessment from clinicians skilled in the management of dementia, depression, osteoporosis, and fall and balance problems. For patients between 64 and 75, the new center offers geriatrics consultation, especially if multiple chronic conditions are involved.

The Morningside outpatient practice is not only easier for patients to reach, but also to access other medical specialists once they arrive. The center is co-located with the cardiology clinic on the second floor, for example, allowing for greater collaboration between the two disciplines. The practice is also establishing a co-management clinic with the Endocrinology Department, as well as fall and dementia clinics enabling staff to work more closely with the Neurology Department and the Emergency Department.

“It’s all part of our emphasis on one-stop care for older adults,” says Dr. Rughwani. “When patients come here, we can refer them to all the specialists they need, and coordinate that care for them.” In the 18 months since the practice opened, there have been nearly 3,000 patient visits. Serving the needs of this population are four bilingual (Spanish and English speaking) physicians, matching the demographics of the Morningside community.

Following the example set by the Martha Stewart Centers for Living, practitioners at the Morningside practice also tend to the social, functional, and psychological needs of patients. A social worker who is an integral part of the geriatrics team assesses what patients may need in their home environment, such as grab bars and proper lighting, to ensure their safety and independence. In addition, the social worker supports caregivers, helping them manage the stress of their daily roles without experiencing burnout.

Education also plays an important role in the new center’s ambitious mission. That translates into community outreach activities such as lectures by Mount Sinai specialists at senior centers on how to stay healthy—and out of the hospital. These clinicians also share their expertise with other health care providers in the surrounding neighborhoods.

“There aren’t enough geriatricians to go around,” says Dr. Rughwani, who is also an Associate Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine, “so the next best thing we can do is train non-geriatricians in areas they need to know about.”

Efforts like these have not gone unnoticed. Open less than two years, the outpatient geriatrics practice at Mount Sinai Morningside has been named an “Age-Friendly Health System Committed to Care Excellence” by the Institute for Healthcare Improvement, while Mount Sinai Morningside’s Geriatric Emergency Department has earned accreditation from the American College of Emergency Physicians.