Mount Sinai Hospital Launches Initiative to Improve Transitions of Care for Venous Thromboembolism Patients
The Department of Medicine at the Icahn School of Medicine at Mount Sinai has been awarded a half-million dollar grant funded by Pfizer Independent Grants for Learning & Change (IGLC) and Bristol-Myers Squibb Independent Medical Education (IME). The grant focuses on accelerating the development and adoption of evidence-based approaches to improve the safety and effectiveness of patients with the diagnosis of venous thromboembolism (VTE) as they move from one care setting to another. The Joint Commission led the evaluation process, provided oversight of the committee that made funding decisions and is solely responsible for administering and overseeing project activities for Mount Sinai and four other institutions that are receiving similar grants. The $500,000, 24 month award will fund a novel, multi-faceted initiative which includes the development of a care bundle and a smartphone app focused on transitions of care for patients with venous thromboembolism, a potentially life-threatening condition which frequently requires hospitalization and post-discharge management with medication.
VTE includes two conditions. Deep-vein thrombosis (DVT) is the formation of blood clots in the deep veins of the legs; pulmonary embolism (PE) occurs when a blood clot detaches from the wall of the leg vein and moves to the lungs, causing difficulty breathing. The treatment of both conditions involves the use of intravenous or oral anticoagulant medication and can take several months. While treatment often begins in a hospital setting, most patients transition to home or another outpatient setting immediately after discharge.
“Successfully treating venous thromboembolism requires a great deal of coordinated care,” said Eric Goodman, MD, Instructor of Medicine in the Division of Hospital Medicine at the Icahn School of Medicine at Mount Sinai and the study’s principal investigator. “It can be hard for many patients to manage their treatment on their own. We feel that this program will help provide high quality and well-coordinated care as VTE patients leave the hospital and continue their treatment as an outpatient.”
The grant, which is the largest ever received by the Department of Medicine at the Icahn School of Medicine at Mount Sinai for a quality improvement initiative, will be used to develop a new program to help VTE patients leaving the hospital to successfully continue complex treatment regimens in an outpatient setting. The study team, which also includes co-Investigators Beth Raucher, MD, Vice Chair of Medicine for Quality and Clinical Affairs; Andrew Dunn, MD, Chief of the Division of Hospital Medicine; Julie Pearson, MPH, Quality Data Analyst; Ashish Atreja, MD, Director of the Sinai AppLab and Chief Technology Innovation and Engagement Officer in the Department of Medicine; and Milan Patel, MS, Senior Systems Software Specialist for the Mount Sinai AppLab, will develop and oversee the VTE transitions of care bundle. The goal of the study is to reduce recurrence of VTE and to minimize serious medication-related adverse events, as well as to reduce hospital readmission by staying in close contact with the patient using the smartphone app. Mount Sinai has successfully used a similar app to help patients with Inflammatory Bowel Disease manage their health.
The cloud-based smartphone app will be used to collect patient data on medication adherence and symptom progression, and will facilitate communication with the care team. Data from the app and other components of the VTE Bundle will be aggregated into an electronic dashboard, which will be fully integrated with the electronic health record system used at Mount Sinai to facilitate coordination of care.
In addition, a licensed clinical social worker will meet the patients at their bedside to help them and family members become acquainted with the app and other aspects of the transition to outpatient care and necessary follow-up. Through the app, the navigator will remain in contact with patients to help them adhere to their medication plans and attend their follow up appointments, and will help facilitate communication with their primary care provider for medical issues related to VTE.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology, Mount Sinai St. Lukes and Mount Sinai West are ranked 23rd nationally for Nephrology and 25th for Diabetes/Endocrinology, and Mount Sinai South Nassau is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and Mount Sinai South Nassau are ranked regionally.