Mount Sinai's ED is a 'war zone,' nurse says

Current and former Mount Sinai Hospital employees said staffing shortages and high patient volumes are creating serious patient safety issues in its emergency department, which one nurse called "a war zone," reports 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," according to an internal report obtained by the New York Post. They urged New York City-based Mount Sinai to revamp the department, citing concerns with staffing ratios, infection control and patient safety.

2. The New York Post spoke with several former physicians and nurses at the ED, who said high patient volumes and care lapses are still issues. A former nurse who quit in September claims she was typically assigned nine patients on a normal shift, although this figure could be as high as 18. Other staff members described instances in which patients experienced a heart attack without clinicians noticing or were not admitted to critical care units due to a lack of space.

"Every day I go to work, I feel like I am going 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 shift, saying the hospital aims for staffing ratios of 6:1 or 8:1. The spokesperson 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. The process seeks to expedite care and lower wait times, but employees say the system creates 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 emergency department," adding that patients admitted through Mount Sinai's ED with heart attacks, heart failure, severe lung conditions and stroke have among the best survival rates in the nation. The hospital has made major investments in its ED since completing a strategic review in 2016, including the addition of more than 130 employees.

"We have also opened the Mount Sinai Express Care facility on the same block to alleviate emergency department crowding by taking care of patients with less serious conditions in a separate location," the hospital said. "Now, we have plans for a complete renovation of both our emergency department and our observation unit to more than double the number of treatment locations and further improve patient care."

6. On Dec. 9, Democratic New York Gov. Andrew Cuomo ordered state health officials to investigate the allegations against Mount Sinai after learning of the New York Post's exposé, according to a separate report from the publication.

To view the full report, click here.

Editor's note: This article was updated Dec.10 to include additional information from Mount Sinai. A previous version of this story reported that Mount Sinai has never had staffing ratios above 8:1, which is not accurate. Becker's regrets this error.

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