Palliative Care Newsletter | Spring 2022
leaders, and we’re looking to them to help us understand where opportunities lie, where the areas for innovation are, and where the next area for growth is,” says Dr. Kelley. “This also gives us the opportunity to build a peer network of health care professionals who are tomorrow’s leaders. They are growing together and rely on each
Developing Leaders in Palliative Medicine
other as they develop skills and bump into the inevitable challenges along the way.”
Tom Gualtieri-Reed, MBA; Edith Meyerson, DMin, BCC; Amy S. Kelley, MD, MSHS; Katherine Mark, MD; Nisha Rughwani, MD; Stephanie Chow, MD, MPH; Eileen H. Callahan, MD; and Anup Bharani, MD. Not pictured: Ankita Mehta, MD
The success of the program will be measured by short-term and long-term outcomes, including
Palliative care continues to grow as
In January, Dr. Kelley and Tom Gualtieri-
the successful development of leadership
medical advances provide more effective
Reed, MBA, a partner at Spragens &
skills and the beginning stages of program
treatments, allowing patients to live
Gualtieri-Reed, health care strategists,
innovation. Longer term, the goal is to see
longer with serious illness. The Lilian and
launched a 13-month program to provide
retention and advancement of these skilled
Benjamin Hertzberg Palliative Care Institute,
training to faculty who have been
faculty, who will eventually take on bigger
recognized as a national leader in palliative
increasingly asked to take on leadership
leadership roles at Mount Sinai as their
medicine, has pioneered wide-ranging
roles despite limited business, planning,
programs and innovations take deeper root
programs to meet the needs of patients and
or leadership experience. Seven Palliative
in the Brookdale Department and become
families facing serious illness.
Care and Geriatrics faculty members who
prototypes in the field.
were accepted through a competitive
The program has multiple objectives,
application process are participating in the
explained Dr. Kelley. Participating faculty
program. The training consists of one-on-
will gain leadership skills that will, ideally,
one and group sessions on all aspects of
further their careers, while simultaneously
leadership development.
developing expertise that they can share
that very few were tailored to the skills
The trainees are working closely with Emily
with their colleagues and that will directly
needed that are specific to palliative care
Chai, MD; Audrey K. Chun, MD; and Nathan
benefit their patients. “The program has
and geriatrics,” says Amy S. Kelley, MD,
E. Goldstein, MD, all Vice Chairs in the
complementary goals. What we achieve
MSHS, Vice Chair of Health Policy and
Brookdale Department who oversee clinical
in the growth of each individual directly
Faculty Development in the Brookdale
programs across the Mount Sinai Health
feeds into what we can achieve for our
Department of Geriatrics and Palliative
System and who serve as mentors to the
patients,” she says. “We hope that this
Medicine. “We want to build a program that
program participants.
will become a model for other programs
Developing a dynamic team of leaders to bring forward innovations is a focus of the Hertzberg Institute. “When we looked at leadership training programs, both at Mount Sinai and elsewhere, we realized
develops leaders in both the clinical and health care administrative realms.” B R O O K D A L E
“We see the participants as tomorrow’s
D E P A R T M E N T
O F
G E R I A T R I C S
A N D
around the country.”
P A L L I A T I V E
M E D I C I N E
electronic medical charts, and performing
Studying Quality of Care Under Medicare Advantage Plans
Mount Sinai Improves Palliative Care Training in Kenya The Icahn School of Medicine at Mount Sinai has been a leader in training palliative care practitioners nationwide. The Center to Advance Palliative Care (CAPC) has trained more than 80,000 clinicians since its
These tasks take them away from their families, support systems, hobbies, and passions that normally reduce their stress.
More than 28 million older Americans are enrolled in Medicare
By learning to make time for good self-
Advantage plans, a privatized version of Medicare that is often less expensive and can offer a wider range of benefits than the traditional government-run program. Claire K. Ankuda, MD, MPH, Assistant Professor of Geriatrics and Palliative Medicine at Mount
New Wellness Curriculum Aims to Improve Well-Being of Palliative Care Fellows
professional fulfillment. The one-year curriculum, which began in July 2021, is taught both virtually and in person. During a series of 16 sessions throughout their training year, fellows
Sinai, recently published a study Since the onset of the COVID-19 pandemic,
learn about best practices and evidence-
of care for people enrolled in
stress has increased among health care
based interventions shown to prevent
Medicare Advantage plans vs.
professionals nationwide. This is particularly
burnout, a variety of evidence-based
To help close this gap, CAPC launched
traditional Medicare. The cross-
true in certain specialties, such as palliative
wellness practices including meditation
The John A. Hartford Foundation Tipping
sectional study of 2,119 patients
care, where doctors care for patients and
and mindfulness-based stress reduction,
and about one-third of the people with serious illness have no access to palliative care.
Point Challenge, a nationwide competition
found that family and friends of people who died while enrolled
families facing serious illness. In response to
wellness peer coaching, communication
designed to catalyze the spread of skills,
in Medicare Advantage plans reported lower quality of care in
this, many hospitals are focusing attention
skills training, and therapy-based
ideas, and solutions to improve health care
the last month of life compared with family and friends of those
on wellness, which improves the well-being
supervision. The Brookdale Department
delivery for all people living with serious
who died while enrolled in traditional Medicare.
of doctors and ultimately improves the
surveys the fellows to learn about the kinds
patient experience and health outcomes.
of group activities they feel would be most
illness. In 2021, the Academic Model Providing Access to Healthcare (AMPATH), a consortium of North American Medical
Schools, with members including Lindsay A. Dow, MD, Assistant Professor of Geriatrics and Palliative Medicine, and Global Health at Icahn School of Medicine at Mount Sinai, was a gold winner for its training initiative to improve palliative care in western Kenya. In Kenya, palliative care services are concentrated in urban areas,
“The heart of my research is trying to understand
of Geriatrics and Palliative Medicine at
how [these] plans impact our
component to the curriculum followed
older population.”
by fellows, who are doctors in training for specialization. The curricular emphasis on
American Geriatrics Society, is part of a body of research
Mulholland, MD, Assistant Professor of
that Dr. Ankuda is conducting to understand general health
Geriatrics and Palliative Medicine, and
care use patterns and specifically how Medicare Advantage
Faculty and Graduate Medical Education
plans shape home health and hospice care. She points out
Well-Being Champion at the Icahn School
that, since Black and Hispanic older adults are more likely
of Medicine at Mount Sinai.
The AMPATH initiative began in May 2018 when the team met with local
to be insured by Medicare Advantage plans, these quality
Kenyan clinicians and educators and proposed a curriculum combining
“We launched this curriculum to improve
differences could lead to racial disparities in care.
fellows’ well-being as they care for patients
The palliative care specialists created a training program for Kenyans,
The primary goal of Dr. Ankuda’s research, which frequently
with serious illness, as well as to develop
including nurses, clinical officers, and physicians as well as community
examines various aspects of Medicare, is to inform public
their leadership skills and empower them
health volunteers. In addition to providing medical skills, training
policy. “How can we ensure that the plans are all providing the
to become change agents driving a
will include management, advocacy, and research skills to prepare
best care possible for people with serious illness? How do we
graduates for roles in administration, government, or academia.
measure that, and how do we set up regulations around that?”
care services. “Our goal is to create clinicians and leaders in the field of palliative care,” says Dr. Dow. “We want to ensure access to treatment, not just to control pain, but to enable patients to live a longer and better life.”
classroom learning and clinical rotations across health care settings.
The goal is for graduates of the initiative to sustain the program by increasing awareness, inspiring new trainees, and expanding clinical services in palliative care. Short- and long-term benefits
she says. “The heart of my research is trying to understand how the plans impact our older population.”
and rock climbing, which encourage social connectedness among their peers.
Mount Sinai is incorporating a wellness
wellness is being spearheaded by Christie
with only 3 percent of health care facilities nationwide offering palliative
beneficial, including yoga, pottery, painting,
To address this, the Brookdale Department
The award-winning study, which was recognized by the
are anticipated.
care, physicians are contributing to their
that examined end-of-life quality
founding in 1999. However, the global need for palliative care is growing,
Lindsay A. Dow, MD
clerical work and other administrative tasks.
Lilian and Benjamin Hertzberg Palliative Care Institute Advisory Board Members
Wellness activities, while encouraged, are not mandatory. health care culture that prioritizes clinician wellness,” Dr. Mulholland says. “It all comes back to patient care. We invest in our doctors and other clinicians so they can take care of themselves and, in turn, their patients.”
Mount Sinai is a leader in initiating and implementing best practices regarding wellness. In addition, as members of the largest palliative medicine training program in the United States, nearly all Mount Sinai graduates advance to leadership positions
Dr. Mulholland cites studies showing that
around the country within 10 years. “It’s
more than 96 percent of palliative care
especially important to train our fellows
doctors find meaning in caring for their
in leadership skills and to put wellness
patients and connecting with them and their
programs in place so that when our fellows
families. However, additional tasks beyond
are in those leadership positions, they can
those involving patient interaction can be
then advocate for resources to train future
stressful as doctors spend hours updating
generations of doctors,” says Dr. Mulholland.
Susie West, Chair Emerita Meryl Rosofsky, MD, Co-Chair Saskia Siderow, Co-Chair Deborah Berg Jeannie Blaustein, PhD, DMin
Beth Dannhauser Peggy Danziger Joseph Hertzberg David Mitnick Lois Perelson-Gross, DMin
Daniel Rube Stephen Siderow Jennifer Steingart Zena Wiener
Chaplains Provide Support to Palliative Care Patients and Their Loved Ones When patients are coping with serious illness, they often feel overwhelmed by symptoms, pain, and stress. The chaplains at the Hertzberg Institute provide spiritual guidance as well as psychological and emotional support to help patients and their loved ones find comfort and navigate difficult decisions they may need to make. “Patients and families who experience
Lance Kaplan, MA; Mindy Chettih, JD, LCSW; Edith Meyerson, DMin, BCC; Max Reynolds, MA, BCC; and Evan Zazula, MAPCC, DMin. Not pictured: Sam Haddix, MFA
serious or complex illness may find
listen as they seek, or be reminded of, their
with unit chaplains across the Mount Sinai
themselves in stressful, challenging, or life-
own inner strength.” The chaplains are an
Health System and offer a deeper level of
altering situations and the role of the chaplain
integral part of the Mount Sinai Palliative Care
attention and spiritual support.
is to assist them in finding connection, hope,
team of doctors, nurses, and social workers
meaning, and comfort,” says Rabbi Edith M.
“As chaplains, we sit with those experiencing
who work together to manage symptoms
Meyerson, DMin, BCC, Director of Pastoral
pain—physical, spiritual, emotional, and
and maximize patients’ quality of life.
psychological—and, when possible, we
Palliative care chaplains meet with patients
facilitate moments of connection and
and their loved ones in person, via Zoom, or
wholeness, which ultimately aid in the
by phone. They work in close collaboration
healing process,” says Rabbi Meyerson.
Counseling and Bereavement Services at the Hertzberg Institute. “Sometimes people need guidance, a hand to hold, or an ear to
Lilian and Benjamin Hertzberg Palliative Care Institute Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place, Box 1070 New York, NY 10029 (212) 241-1446 mountsinai.org/care/palliative-care @MSHSGeriPalCare