Friday, July 31, 2020

NYC Health + Hospitals/Lincoln Ranks in Top Percentiles of 3,282 Hospitals Ranked Nationwide


(Left) Milton Nunez, CEO of Lincoln and Dr. Lewis Marshall, MD, JD, FACP, FACHE, Chief Medical Officer.

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An innovative new hospital ranking system that incorporates civic leadership including community-minded policies, pay equity and inclusivity, traditional quality measures and high-quality care, as well as avoidance of unnecessary and costly care, has ranked NYC Health + Hospitals/Lincoln in the Bronx among the top hospitals in America by the Washington Monthly Magazine and the Lown Institute, outranking private and “prestigious” healthcare systems across the country. 

“This hospital ranking system has created new metrics never used before for health care,” noted Milton Nunez, CEO of Lincoln. “This is a welcomed addition and includes important civic leadership factors not addressed in present ranking systems. Now is the perfect time to refocus and standardize the industry on the moral/social justice issues of providing excellent, inclusive care globally to our vulnerable populations.

“Should not all hospitals be expected to care for everybody in its communities and improve the health of the population overall? The NYC Health + Hospitals of which Lincoln is a member, has a longstanding mission statement to treat anyone coming through its doors, regardless of ethnicity, race, religion or ability to pay.  Hospitals also play a significant financial role as a critical stabilizing force in a community.   

“American hospitals are admired for innovation and highly skilled physicians and nurses, but ‘the health of the nation lags behind every wealthy country on the planet.’”  

Existing hospital rankings place emphasis of hospital performance on traditional quality measures and specialty care, which often creates a financial focus on filling beds and attracting patients.

The Washington Monthly Magazine and the Lown Institute believe hospitals should also have civic responsibility to engage the needs as well as the care of the communities they serve.   

After 10 years of development, the Lown Institute Hospitals Index, its ranking system, sets “a better standard for what we should expect from our hospitals.”   

This formula ranks hospitals on how well they save lives, save money, and serve everyone. It uses 3 broad categories: patient outcomes (mortality, readmissions, patient safety), civic leadership (treating all, regardless of race, social or economic status) and value of care (avoiding unnecessary treatments).  

And it takes information that is already publicly available about each hospital, rather than what is presented by the facility.

There are also new metrics in the ranking which includes “inclusivity” (caring for all), and unusual metrics such as pay equity (CEO to worker pay is a measure for fairness and corporate citizenship), unique programs specific for the community (a Greenmarket, Guns Down Life Up program, asthma home visits, and many others unique programs geared specifically for our neighborhoods.  

“The employees of Lincoln Medical and Mental Health Center are committed to improving the health of this community as well as to the health of each other.  There is a tremendous need for Lincoln here,” says Dr. Lewis Marshall, MD, JD, FACP, FACHE, Chief Medical Officer.  

“Their selflessness and absolute heroism at all levels of Lincoln staff has shown that this is not just for a paycheck, or just a job. This is hard work. It requires focus, dedication and persistence. Staff working here want to work in and for this community.” 

Chief Nurse Officer, Lillian Diaz, DHA, RN, NEA-BC: “The staff of Lincoln Hospital are incredibly loyal and dedicated to serving our patients and the needs of this community. Our patients are our family. We take pride in the care we deliver to our patients, which includes the most vulnerable patient populations. Anyone can come to Lincoln Hospital and receive exceptional healthcare services. That is the essence and spirit of what we do.”

“As part of the nation’s largest public health system, the New York City Health + Hospitals has a longstanding and a formidable mission, vision and value statement,” reminded Milton Nunez, CEO. “We service all who walk through our doors, regardless of ethnicity, race, religion or ability to pay.”


LINCOLN’S RANKING ELEMENTS OF WASHINGTON MONTHLY BEST HOSPITALS

  • Overall Lincoln ranks 17 of 142 hospitals reviewed in NYS and 634 of 3,282 acute care hospitals in the country.
  • Its civic leadership ranking is 2 of 3,282 nationally and is #1 in NYS. 
  • Under civic leadership Lincoln scored 100, making Lincoln #1 out of 3,282 in the country.
  • Lincoln ranked in the 98th percentile for pay equity.
  • It is in the 99th percentile for community benefit.
  • Lincoln is in the 100th percentile for inclusivity, ranking #1 in the country.
  • For value of care Lincoln was ranked 958 of 3282 nationally and 52 of 142 in NYS.
  • Lincoln scored in the 71st percentile for avoiding overuse of low value services. 
  • For patient outcomes it is 87 of 142 for NYS.
Lincoln is in the 97th percentile for patient safety, ranking #1 in NYS.

NYC Health + Hospitals/Lincoln, located in the South Bronx, is a 362-bed, Acute Care Level 1 Trauma Center with the busiest single site emergency department in the region.   

Thursday, July 30, 2020

Summer Health Guidelines to Keep Hearts Healthy


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By Sharon Paul, RN Visiting Nurse Service of New York

With summer’s heat and humidity in full swing it is more important than ever to review heart health risks and guidelines, especially among members of the African American and Latino communities. 

Untreated and longstanding high blood pressure can lead to hypertensive heart disease (HHD), which includes heart failure, coronary artery disease, and other conditions. HHD is the leading cause of death associated with high blood pressure for all Americans. High blood pressure also puts people at risk for experiencing a stroke. The American Heart Association says the African- American population is particularly vulnerable to HHD and stroke since roughly 40 percent of African- American men and women have high blood pressure, a higher rate than any other racial group in the U.S.

Each year, approximately 100,000 home care patients in the U.S. report a prior stroke, and a recent study at the Visiting Nurse Service of New York Center for Home Care Policy & Research further shows that, at start of care, recurrent stroke risk is high for many patients and in particular, African Americans, due to uncontrolled blood pressure. 

As a registered nurse providing care at home for high-risk patients with chronic heart failure, hypertensive heart disease and post-stroke, I know how important it is to work with these vulnerable patients and their families to help them make lifestyle changes and link them to continuous, responsive hypertension care. 

My colleagues and I at the Visiting Nurse Service of New York are part of a workforce of skilled nurses, rehabilitation therapists and home health aides who work together to provide care coordination and support for more effective chronic care self-management of these health issues. 

Everyday, we visit at-risk New Yorkers in their homes to help patients and their families understand the persistent hypertension-related disparities that increase the risk for heart disease, stroke, re-hospitalization and even death. Here are a few guidelines for closing hypertensive heart health disparities in the African-American community. 

Get Educated
The most powerful weapon we have against hypertensive heart disease and stroke is knowledge. Take every opportunity to learn about your risk for high blood pressure. You can find excellent resources online at the American Heart Association’s www.Heart.org and www.VNSNY.org

Manage Your Diet
This one can be the most challenging especially when your cultural eating habits conflict with healthy eating recommendations. It’s important to manage your cholesterol levels by reducing your daily fat intake gradually over time. Talk to your doctor or home health provider about establishing dietary goals that support healthy blood pressure. Even small changes to your diet can make a big difference in your health. Learn how to read food labels and become especially mindful of salt and sodium intake, which can have adverse effects on hypertension and diabetes, respectively. 

Limit or Stop Smoking and Drinking
Smoking enhances blood pressure and can cause strokes – try to cut back or stop smoking. Limiting your alcohol consumption is important as alcohol can adversely affect some medications. Each person is different, but moderation is crucial. 

Be on the Lookout for Depression
Patients with heart disease and stroke survivors are at high risk for experiencing depression. Adapting to a new lifestyle and temporary or permanent limitations to mobility, speech or cognitive function can present significant challenges. Frustration and depression are especially common in the winter months. Talk with your health care provider about the signs and symptoms of depression and online or community resources that may be available easily accessible for you.

Move a Little
Just 15 minutes of light physical activity three to five days a week can help reduce your risk for stroke and heart disease. Small steps can lead to big progress if you just add a little activity to your life: walk to the mailbox or the corner bodega every day, get off one stop early and walk a few extra blocks if you ride the bus or subway, do stretches and “hall laps” at home if you need to in order to get started. Go slower in summer heat.

Manage Your Stress
Sometimes stress is unavoidable, especially in the midst of a global pandemic, but we can usually find a few minutes to separate from the tensions that we all face in a busy day to exhale. This is especially important when recovering from any heart-related health issue. 

Give yourself 10-minute de-stressing breaks to listen to music, visit with a friend, meditate, practice gentle yoga or take care of a pet to help reduce your risk for hypertension. 

Keep a Health Journal
Take the time to write down all of your medications and any changes your doctor makes to each prescription. Don’t forget to write down over-the-counter medications you take too, from baby aspirin to vitamins. Note how you feel each day, especially on days when you feel a little groggy, tired, sad or confused. This way you have a record of your health so every health professional on your care team can understand your full medical history at any time.

It is especially important for those with high risk for hypertension to stay in communication with their physicians and be mindful of high blood pressure and related health risks. As always, it is important to consult your health provider before making significant changes in your diet or fitness routine.

Friday, July 24, 2020

Bronx Zoo Reopens with Social Distancing, Masks

BX News: Bronx Zoo Reopens with Social Distancing, Masks: The Bronx Zoo reopened to the public along with the Central Park Zoo, Prospect Park Zoo, and Queens Zoo to all guests. The official re...





Bronx Hospital Scores High in New Ranking

NYC Health + Hospitals/Lincoln Ranks in Top Percentiles of 3,282 Hospitals Ranked Nationwide by Washington Monthly Magazine
(Left) Milton Nunez, CEO of Lincoln and Dr. Lewis Marshall, MD, JD, FACP, FACHE, Chief Medical Officer.


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An innovative new hospital ranking system that incorporates civic leadership including community-minded policies, pay equity and inclusivity, traditional quality measures and high-quality care, as well as avoidance of unnecessary and costly care, has ranked NYC Health + Hospitals/Lincoln in the Bronx among the top hospitals in America by the Washington Monthly Magazine and the Lown Institute, outranking private and “prestigious” healthcare systems across the country. 

“This hospital ranking system has created new metrics never used before for health care,” noted Milton Nunez, CEO of Lincoln. “This is a welcomed addition and includes important civic leadership factors not addressed in present ranking systems. Now is the perfect time to refocus and standardize the industry on the moral/social justice issues of providing excellent, inclusive care globally to our vulnerable populations.

“Should not all hospitals be expected to care for everybody in its communities and improve the health of the population overall? The NYC Health + Hospitals of which Lincoln is a member, has a longstanding mission statement to treat anyone coming through its doors, regardless of ethnicity, race, religion or ability to pay.  Hospitals also play a significant financial role as a critical stabilizing force in a community.   

“American hospitals are admired for innovation and highly skilled physicians and nurses, but ‘the health of the nation lags behind every wealthy country on the planet.’”  

Existing hospital rankings place emphasis of hospital performance on traditional quality measures and specialty care, which often creates a financial focus on filling beds and attracting patients.

The Washington Monthly Magazine and the Lown Institute believe hospitals should also have civic responsibility to engage the needs as well as the care of the communities they serve.   

After 10 years of development, the Lown Institute Hospitals Index, its ranking system, sets “a better standard for what we should expect from our hospitals.”   

This formula ranks hospitals on how well they save lives, save money, and serve everyone. It uses 3 broad categories: patient outcomes (mortality, readmissions, patient safety), civic leadership (treating all, regardless of race, social or economic status) and value of care (avoiding unnecessary treatments).  

And it takes information that is already publicly available about each hospital, rather than what is presented by the facility.

There are also new metrics in the ranking which includes “inclusivity” (caring for all), and unusual metrics such as pay equity (CEO to worker pay is a measure for fairness and corporate citizenship), unique programs specific for the community (a Greenmarket, Guns Down Life Up program, asthma home visits, and many others unique programs geared specifically for our neighborhoods.  

“The employees of Lincoln Medical and Mental Health Center are committed to improving the health of this community as well as to the health of each other.  There is a tremendous need for Lincoln here,” says Dr. Lewis Marshall, MD, JD, FACP, FACHE, Chief Medical Officer.  

“Their selflessness and absolute heroism at all levels of Lincoln staff has shown that this is not just for a paycheck, or just a job. This is hard work. It requires focus, dedication and persistence. Staff working here want to work in and for this community.” 

Chief Nurse Officer, Lillian Diaz, DHA, RN, NEA-BC: “The staff of Lincoln Hospital are incredibly loyal and dedicated to serving our patients and the needs of this community. Our patients are our family. We take pride in the care we deliver to our patients, which includes the most vulnerable patient populations. Anyone can come to Lincoln Hospital and receive exceptional healthcare services. That is the essence and spirit of what we do.”

“As part of the nation’s largest public health system, the New York City Health + Hospitals has a longstanding and a formidable mission, vision and value statement,” reminded Milton Nunez, CEO. “We service all who walk through our doors, regardless of ethnicity, race, religion or ability to pay.”


LINCOLN’S RANKING ELEMENTS OF WASHINGTON MONTHLY BEST HOSPITALS

  • Overall Lincoln ranks 17 of 142 hospitals reviewed in NYS and 634 of 3,282 acute care hospitals in the country.
  • Its civic leadership ranking is 2 of 3,282 nationally and is #1 in NYS. 
  • Under civic leadership Lincoln scored 100, making Lincoln #1 out of 3,282 in the country.
  • Lincoln ranked in the 98th percentile for pay equity.
  • It is in the 99th percentile for community benefit.
  • Lincoln is in the 100th percentile for inclusivity, ranking #1 in the country.
  • For value of care Lincoln was ranked 958 of 3282 nationally and 52 of 142 in NYS.
  • Lincoln scored in the 71st percentile for avoiding overuse of low value services. 
  • For patient outcomes it is 87 of 142 for NYS.
Lincoln is in the 97th percentile for patient safety, ranking #1 in NYS.

NYC Health + Hospitals/Lincoln, located in the South Bronx, is a 362-bed, Acute Care Level 1 Trauma Center with the busiest single site emergency department in the region.   

Thursday, July 23, 2020

Coronavirus- Common Blood Test Identifies Benefits and Risks of Steroid Treatment in COVID-19 Patients

Research from Albert Einstein College of Medicine and Montefiore Builds on Large British Study


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A new study led by Albert Einstein College of Medicine and Montefiore Health System confirms the findings of the large scale British trial of steroid use for COVID-19 patients and advances the research by answering several key questions: Which patients are most likely to benefit from steroid therapy? Could some of them be harmed? Can other formulations of steroids substitute for the agent studied in the British trial? The research was published today in the Journal of Hospital Medicine.

The U.K. RECOVERY trial, the prospective, randomized, placebo-controlled study, involved more than 6,000 patients with COVID-19. The steroid dexamethasone reduced deaths by about one third in patients on ventilators and by about one fifth among people who needed oxygen but were not on ventilators. However, the study leaves questions about the use of steroids for treating some patients.

“Our study is consistent with the promising findings from Britain, but for the first time, we are  able to demonstrate that people can see the same life-saving benefits with steroid formulations other than dexamethasone,” said Marla Keller, M.D., vice chair for research in the department of medicine at Einstein and Montefiore and lead author of the study. “We also found that a common blood test may identify the best candidates for steroid treatment.” Dr. Keller is also professor of medicine and of obstetrics & gynecology and women’s health at Einstein and an infectious disease specialist at Montefiore.

Authors of the Einstein-Montefiore study compared outcomes for two groups selected from nearly 3,000 people hospitalized at Montefiore with a positive COVID-19 test. One group of 140 patients was treated with steroids within 48 hours of hospital admission; and a control group of 1,666 similar patients did not receive steroid therapy. Most of the patients who received steroid therapy received prednisone. Some received dexamethasone and methylprednisolone.

Nearly all patients initially had a blood test to measure levels of C-reactive protein (CRP), which the liver produces in response to inflammation. The higher the CRP level in the blood, the greater amount of inflammation. A normal CRP level reported in the study is below 0.8 milligrams per deciliter of blood.

“We found that in patients with high levels of inflammation, namely a CRP level greater than 20, steroids were associated with a 75% reduction in the risk of going on mechanical ventilation or dying,” said Dr. Keller. “Critically, we also found that for patients with a normal or low level of inflammation, CRP levels less than 10, steroid use was associated with an almost 200% increased risk of going on mechanical ventilation or death.”

A large percent of the people who succumb to COVID-19 die from the body’s intense inflammatory response, which can overwhelm and severely damage the lungs. “Our findings suggest that steroid therapy should be reserved for people with high inflammation, as indicated by markedly elevated CRP levels,” said William Southern, M.D., M.S., professor of medicine and chief of the division of hospital medicine at Einstein and Montefiore and the study’s senior author. “It’s a different story for people who do not have significant inflammation: for them, any benefit is outweighed by the risks from using steroids.”

Study co-author Shitij Arora, M.D., associate professor of medicine at Einstein and a hospitalist at Montefiore, noted that the Einstein-Montefiore study included approximately equal numbers of male and female patients. In addition, nearly 40% of patients studied were Black and 36% were Hispanic. “The demographic diversity of the patients in this study suggests that steroid therapy benefits hospitalized COVID-19 patients affected by significant inflammation regardless of their race or ethnicity,” he said.

The title of this paper is “Effect of Systemic Glucocorticoids on Mortality or Mechanical Ventilation in Patients With COVID-19.” Other Einstein and Montefiore authors were Jen-Ting Chen, M.D., M.S., Elizabeth Kitsis, M.D., M.B.E., Shivani Agarwal, M.D., M.P.H., Michael Ross, M.D., and Yaron Tomer, M.D.

Sunday, July 19, 2020

Covid 19 Scares Poor from Getting Emergency Care

Another Hidden Tragedy Behind the Pandemic
File Photo


By Mario J. Garcia, MD, July 16, 2020

We are all aware of the excess deaths caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19), which has been widely covered by the media and has disproportionally affected the socially disadvantaged communities of the Bronx. 

On the other hand, we are just beginning to discover the indirect impact of this pandemic on other areas of healthcare. 
Among them, is the increase in deaths caused by heart attacks, which was initially noted by researches in Northern Italy and more recently brought to our attention in an article published on June 1st by Denise Lu in The New York Times. In her article, Ms. Lu reported an increase in non-COVID deaths from March 15 to May 2, 2020 compared to the same period in 2019. Accordingly, there were 6,000 deaths in New York and New Jersey alone attributed to heart disease above the number reported during the same period in the previous year. 

More recently, investigators from the FDNY, Montefiore Health System and Albert Einstein College of Medicine reported in the scientific journal, JAMA Cardiology, that in the first two months of the COVID-19 pandemic in NYC, there were three times more cases of cardiac arrest compared to the same period in 2019. In this study, which was approved by the institutional review board of Montefiore and Einstein, the authors also reported a significantly lower number of patients who survived after first responders attempted CPR (below 10%); we believe this lower survival rate could be attributed to a delay in seeking emergency medical care. 


At the height of the pandemic, Montefiore, the largest healthcare network in the Bronx, reached a peak number of nearly 1,200 hospitalized patients with COVID-19 in a single day. Since then, the number has been steadily declining and for the last several weeks has remained below 50 patients hospitalized with COVID-19.

In the meantime, patients with other conditions, even potentially life-threatening ones, have been reluctant to seek medical care in inpatient or outpatient areas. This is understandable, after having witnessed numerous images depicting illness and death in the hospitals. But the truth is that the risk of contagion today is very low. In fact, as pointed out by Governor Cuomo in one of his many inspiring addresses, healthcare workers have a much lower risk of becoming infected than the rest of the population in New York, by the fact that personal protective equipment, proper hygiene and disinfection protocols are followed more strictly inside healthcare facilities than in most other locations. Our healthcare workers are following these strict guidelines so that our patients can safely seek care at our facilities. 

Montefiore continues to lead in our efforts to provide a safe environments for people who require a range of services including, being admitted to the hospital, outpatient medical care or more advanced care requiring a clinical consultation. Patients now have many safe options, from remote consultations via telehealth in their own home, to in-person visits, testing and treatments in COVID-19-safe environments (details provided at the COVID-SAFE website: https://covidsafecare.montefiore.org/covid-safe and at the 24/7 hotline: 844-444-2819).

Like in many other advanced healthcare facilities, Montefiore is performing rigorous screenings and practicing physical distancing and proper disinfection to minimize the risk of spreading this virus so that our patients can receive attention to their healthcare issues.

The COVID-19 pandemic has been devastating to many families in the Bronx. But let’s remember that even though over 135,000 men and women have died in the U.S. since March 1st, over the same period of time, the number of deaths normally expected to be caused by heart disease was about 215,000. That number could get to be much higher if we do not pay adequate attention to our healthcare needs now, leading to be another, even larger, “hidden tragedy.”

Thursday, July 16, 2020

Hospital Remembers Patients and Staff Who Lost in the Battle with COVID-19

Jacobi Hospital Remembers Patients and Staff Who Lost in the Battle with COVID-19
An attendee places the battery operated candle in honor of the lives lost to COVID-19.--Photo by David Greene


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By David Greene, July 14, 2020

Staff members of Jacobi Hospital were joined by local elected officials and a handful of community members for a candlelight vigil to remember the Bronx residents and staff of the hospital who lost their lives to COVID-19.


Held along the Pelham Parkway Pedestrian Mall outside of Jacobi Hospital the event was presented by The Jacobi Summer of Hope Coalition with support from The Helping Healers Heal Team.

Assemblywoman Nathalia Fernandez and Councilman Mark Gjonaj stood shoulder to shoulder, allowing for social distancing of course, with hospital officials-- many who spoke like the city had just fought a battle with a nation, instead of a virus.
Attendees, mostly staff members of Jacobi Hospital place lit electronic candles on a table in honor of those who died during the coronavirus crisis.--Photo by David Greene

Chris Mastromano, the Chief Executive Officer of New York City Health and Hospitals Corporation - Jacobi, told attendees, "This event that we've gone through is a life transforming event. One that ordinary words are unable to describe, but yet we cannot remain silent."

"This vigil by intent," Mastromano continued, "is a remembrance of those lives lost here in the community, here at Jacobi and for the three lives of the staff who we also lost."

The fallen staff members were a behavioral health nurse and former head nurse of the psychiatric unit Freda Ocran; Maria Cintron, the operating room patient care technician and Louise Thomas, described as a "beloved laborer."
Chris Mastromano, the Chief Executive Officer of Jacobi Hospital pays homage to the patients and staff who succumbed to COVID-19.--Photo David Greene

Dr. Robert Faillace, the Chair of the Department of Medicine, recalled that battle-- fought one patient at a time, saying, "Jacobi Hospital in all our differences, whether it be age, gender, race, religion, we all became one unified force in fighting, clamping down and even beating the COVID scourge."

Clergy members from several different faiths then offered prayer and after a moment of silence, electronic candles were lit and placed on a table in honor of the fallen. 





Remembering Larry Kramer: A Legacy in LGBTQ Health 


Larry Kramer




By Chandra Wilson, July 14, 2020

As a clinical field nurse caring for AIDS patients in the early days of the epidemic, Arthur Fitting, LGBTQ Program Director for the Visiting Nurse Service of New York, witnessed firsthand the fear and devastation that accompanied “the plague,” as pioneering AIDS activist, playwright and author Larry Kramer termed the then emerging HIV/AIDS crisis. Kramer’s powerful advocacy for people with AIDS during that time made an indelible impression on Fitting. For him, Mr. Kramer’s passing this year is a reminder and call-to-action for continued diligence in the fight for LGBTQ Healthcare rights.

One of the most essential lessons Fitting learned from Kramer was how to advocate for people, and what it means to truly support a cause one cares about. “It’s wonderful that I’m working at VNSNY, which advocates for all patients and plan members today as it has for 127 years. We are consistently engaging the community, asking questions, listening, caring for people in all communities, including the LGBTQ community,” Fitting explains. “These endeavors, and the efforts VNSNY is making toward connecting with older members of the LGBTQ community to inform and ensure proper access to healthcare and provide safe, comfortable care in the home, are strengthened by Kramer’s work.”

Kramer was a 1981 co-founder of GMHC (Gay Men’s Health Crisis), the first service organization for HIV-positive people, having later found ACT UP (AIDS Coalition to Unleash Power). As an early and remaining member of ACT UP, Fitting reflects on how Kramer was able to give the HIV/AIDs community a voice. “Having lost a partner to AIDS and working as a clinical nurse in the West Village at the height of the epidemic, I will never forget how helpless, fearful, and directionless our community was. Kramer’s work helped to ignite fires within us at a time when we were all living in the dark,” Fitting recalls. “I and some of my co-workers were able to help develop new programs for VNSNY, so that AIDS patients could receive quality care and, in so many instances, be able to pass on in their own homes with dignity.”


Known for his outspoken, irascible nature, Kramer’s relentless pursuit of equality for members of the LGBTQ community has not only helped make marriage equality a reality and reinforced the LGBTQ Healthcare Bill of Rights, it has helped pave the way for special needs programs like VNSNY CHOICE SelectHealthHealth Plan that are designed for Medicaid-eligible New Yorkers living with HIV/AIDS and/or who identify as transgender or live in a Homeless shelter.

We have made enormous strides since the height of the AIDS epidemic and still, the need for advocacy persists. Larry Kramer reminded us that there was always more work to be done, not tomorrow, but today, and his legacy lives on in the efforts of all who continue to advocate and serve to help ensure that members of the LGBTQ community have access to the health care they need and are free to live without fear of discrimination.

“It is clear to me that, even after generations, ‘fires of hope’ can still roar,” Arthur Fitting reminds us.

For more information about Home Health Care services from the not-for-profit Visiting Nurse Service of New York, please visit www.VNSNY.orgor call 1-800-675-0391.

Tuesday, July 14, 2020

Remembering Victims of Covid-19

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Saturday, July 11, 2020

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Thursday, July 9, 2020

Coronavirus- Health Care Teams Needed to Reduce Overdoses

Covid 19 Caused Spike in Overdoses
Grant Combats Rise by Training Health Pros

Every six hours, a person dies from a drug overdose in New York City, with more deaths in the Bronx than any other borough. COVID-19 has made the overdose epidemic even more dangerous because many people feel isolated and uncomfortable going to hospitals to get care.

To ensure people get the substance use disorder treatment they need, Montefiore Health System and Albert Einstein College of Medicine have been awarded a $4 million grant from the United States Department of Health and Human Services (HHS) to train physicians in addiction medicine and strengthen relationships with community partners. The Montefiore-Einstein Addiction Medicine Fellowship, started in 2019, continues to expand our commitment to advancing substance use disorder treatment in the Bronx community.

"We are proud of our long-established programs, but now more than ever, we need to increase the number of physicians equipped to treat those with substance use disorders and our presence in community-based settings," said Shadi Nahvi, M.D., M.S., director, Addiction Medicine Fellowship program at Montefiore and Einstein, and associate professor of medicine and of psychiatry and behavioral sciences at Einstein.   

The five-year HHS grant will fund an Accreditation Council for Graduate Medical Education (ACGME)-addiction medicine fellowship program to train new doctors on a team approach which includes nurses, counselors, social workers, nursing homes, pharmacists and community-based organizations so treatment can start as early as possible, regardless of where people are seeking help.

Training will occur at clinical settings like the Montefiore Einstein Division of Substance Abuse and the Montefiore Buprenorphine Treatment Network, which for decades been a leader in using medication to support treatment of opioid and alcohol abuse disorders and providing primary care.

The fellows will then complete their training at organizations like New York Harm Reduction Educators, which provides safe syringes and engages people who use drugs. Additionally, the fellows will partner with community groups, including BronxWorks, the Harm Reduction Coalition, the Osborne Association, the Drug Policy Alliance, and the NYC Department of Health and Mental Hygiene to improve care. 

By having clinicians in community locations that provide critical services like food and shelter, Montefiore doctors can prescribe buprenorphine to prevent withdrawal and block the pleasurable effects of using opioids and be primary care doctors when needed, treating conditions such as HIV and Hepatitis C.

"Our hope is that by partnering closely with our community, our addiction medicine fellows can become change agents - and rethink how to deliver the best care possible during this pandemic and well into the future," said Dr. Nahvi. 


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Wednesday, July 8, 2020

Coronavirus- Pandemic Dramatically Increased Out-of-Hospital Cardiac Arrest Cases and Deaths Study Says

EMS Heart Attack Calls Tripled From Year Before
File Photo

The COVID-19 pandemic in New York City caused a surge in out-of-hospital cardiac arrests and deaths, according to a study co-authored by researchers at Albert Einstein College of Medicine, Montefiore Health System, and the Fire Department of the City of New York (FDNY).

The study, published online in JAMA Cardiology, found a three-fold increase in out-of-hospital non-traumatic cardiac-arrest cases in March and April 2020 compared to the same period in 2019. 

On the worst day— April 6—cardiac arrests peaked at 305 cases, an increase of nearly 10-fold compared with the same day one year earlier. The mortality rate for cardiac-arrest cases also rose, from 75 percent in 2019 to more than 90 percent during the same period in 2020.

“Relatively few, if any, patients were tested to confirm the presence of COVID-19, so we couldn’t distinguish between cardiac arrests attributable to COVID-19 and those that may have resulted from other health conditions,” said study senior author David Prezant, M.D., professor of medicine at Einstein, a clinical pulmonologist at Montefiore, and the Chief Medical Officer at the FDNY. “We also can’t rule out the possibility that some people may have died from delays in seeking or receiving treatment for non-COIVD-19-related conditions. However, the dramatic increase in cardiac arrests compared to the same period in 2019, strongly indicates that the pandemic was directly or indirectly responsible for that surge in cardiac arrests and deaths.”


The study used data from the New York City emergency medical services system. Run by the FDNY, it is the largest and busiest EMS system in the U.S., serving a population of more than 8.4 million people and responding to more than 1.5 million calls annually. 

Data was analyzed for patients 18 years or older with out-of-hospital cardiac arrest who received EMS resuscitation from March 1, 2020 (when the first case of COVID-19 was diagnosed in New York City) through April 25, 2020 (when EMS call volume had receded to pre-COVID-19 levels). For comparison, cardiac-arrest data was also analyzed for the same time period during 2019.

Between March 1 and April 25, 2020, 3,989 patients underwent EMS resuscitation attempts for out-of-hospital cardiac arrests—compared to 1,336 patients who were treated during that period in 2019.

Compared with cardiac arrests in 2019, cardiac arrests occurring during the pandemic were associated with several risk factors. On average, the 2020 patients were: 

  • Older (average age of 72 vs. 68 for the 2019 cardiac-arrest patients)

  • Less likely to be white (20 percent white vs. 33 percent)

  • More likely to have hypertension (54 percent vs. 46 percent)

  • More likely to have diabetes (36 percent vs. 26 percent)

  • More likely to have physical limitations (57 percent vs. 48 percent)

  • More likely to have cardiac rhythms that don’t respond to defibrillator shocks (92% vs. 81%)

  • More likely to die (90% vs 75%).

Why might a respiratory disease like COVID-19 trigger heart problems? In addition to overwhelming pneumonia and acute respiratory failure, COVID-19 damages the lining of blood vessels, leading to blood clots that can trigger heart attacks even in people with no previous cardiopulmonary diseases.

“Our findings show that it’s clearly important to intervene early in the course of COVID-19 infection, before often-fatal cardiac arrests occur,” said Dr. Prezant. “They also underline the critical need, particularly during a pandemic, to provide better access to healthcare and outreach for vulnerable patients with chronic conditions. Early, targeted interventions for those at-risk individuals—regular telemedicine visits and home-based monitoring of vital signs including oxygen saturation levels, for example—might help to reduce out-of-hospital fatalities.”


The study is titled “Characteristics Associated With Out-of-Hospital Cardiac Arrests and Resuscitations During the Novel Coronavirus Disease 2019 Pandemic in New York City.” Other authors are: Pamela H. Lai, M.D., Ph.D., M.Sc., and Elizabeth A. Lancet, Dr.P.H. M.P.H., from FDNY; Michael D. Weiden, M.D. M.S., from FDNY and NYU Langone; and Mayris P. Webber, Dr.P.H. M.P.H.; Rachel Zeig-Owens, Dr.P.H., M.P.H.; and Charles B. Hall, Ph.D., all from Einstein-Montefiore and FDNY.

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