Emergency Departments are pivotal links in Mount Sinai’s chain: their position at the crossroads of inpatient and outpatient care presents both unique challenges and unique opportunities to foster a culture of excellence across the organization. By understanding all the factors that influence patients’ experiences of care, EDs can better focus on key areas to optimize care. The Mount Sinai Emergency Departments, led by Brendan Carr, MD, MS, partnered with the Office of Patient Experience to accomplish this shared goal: driving patient-centered, data-driven processes to improve what matters most to patients.

“We are rethinking how care is delivered by our Emergency Departments,” says Dr. Carr, Chair and Professor of Emergency Medicine, Mount Sinai Health System.

Studying the ED Patient Experience Survey data, the Office of Patient Experience found that patients’ overall perception of care was strongly influenced by the degree to which they felt that staff cared about them, worked together as a team to care for them, and kept them informed about their care plan.

The EDs leveraged these insights—now known as key drivers—to set strategic priorities and support patient experience goals. In 2020, despite the COVID-19 crisis, all Mount Sinai Emergency Departments achieved their annual goals in these critical key drivers.

As the teams celebrated and reflected on these accomplishments, there was acknowledgment of the year’s unprecedented communication, teamwork, innovation, and agility. For example, many of the ED patients’ family members could not be with them during the height of the crisis, so ED teams initiated phone and video calls to continuously let them know how their loved ones were doing. This helped reduce the uncertainty, anxiety, and fear that many ED patients and their families face.

Dr. Carr knew that the EDs needed to sustain this positive momentum and that he needed committed, transformative leaders by his side. He called upon two Patient Experience champions, Kaedrea Jackson, MD, MPH, Medical Director of the Mount Sinai Morningside ED, and Deborah Dean, MD, Medical Director of the Mount Sinai Brooklyn ED, to help forge the path forward.

“Every day in the ED is different. There is variety in patients, clinical presentation, and acuity,” Dr. Jackson says. “What remains the same is our commitment to caring for whoever presents at the door and the chance to impact their life.”

Dr. Jackson and Dr. Dean established an ED organizational structure to rally their diverse teams across Mount Sinai to collaborate on patient experience efforts. This infrastructure was key to system-wide communication, teamwork, and alignment. A crucial committee born from this infrastructure was the multidisciplinary Patient Experience and Service Excellence Committee, led by Dr. Jackson and Dr. Dean, which convenes every other week to prioritize and implement best practices in patient experience.

To date, the committee has partnered with the Office of Patient Experience to improve the ED Patient Experience Survey tool and use it to prioritize the key drivers, and design and carry out interventions. For example, the Committee uses improvement storyboards as a framework for thinking and as a tool to record problem-solving efforts. This helps foster the Committee’s culture of problem solving, develop critical thinking, and create the common language needed for improvement.

“The Office of Patient Experience celebrates the continued accomplishments of the Emergency Departments, Dr. Carr, Dr. Jackson, and Dr. Dean in meeting their patients’ needs at extraordinary moments and engaging their teams wholeheartedly in this work every day and in every encounter,” says Erica Rubinstein, MS, LCSW, CPXP, Vice President, Service Excellence and Patient Experience.

“It was the start of the coronavirus, and I realized that the hospital was going to be under
stress. But every nurse was exceptionally kind. And the ED staff was fantastic. They
were always responsive and supportive.”

– Mount Sinai Hospital inpatient