A pregnant woman was driving in the HOV lane near Dallas.
ASTORIA – For more than a century, Mount Sinai Queens has provided a medical port in the storm for Astoria’s Greeks and Greek-Americans. One barely notices the hospital wedged in among pizza shops and delis, but its unobtrusive appearance belies the A-One care within. The person at the top of the great medical facility comes as just as much of a surprise.
Slender, blonde and utterly charming, Caryn Schwab could pass as “a lady who lunches.” Instead, she’s the tough-minded, imaginative, and compassionate Executive Director of Mount Sinai Queens.
While steering the hospital into the future, she keeps her focus on the patient. Not just his or her medical needs, but the patient’s emotional needs, to the point where if someone’s worrying about a dog at home waiting to be fed, Schwab and her team will find someone to feed that dog. Even more dramatic and exciting, Schwab is in the forefront of implementing a totally new approach to the hospital as we know it. While formerly the hospital was viewed as a sleeping giant, to be avoided until one needed treatment, the new-style hospital works to prevent illness.
“The big transition is shifting care from an in-patient setting to an out-patient setting, and that’s not a natural transition for a hospital,” Schwab says. “For hundreds and hundreds of years the focus was on taking care of people who come to us when they’re sick. So it requires a huge investment in information technology, a big investment in physicians, in the community, in medical office practices. It’s doing things there are no road maps for. Health care systems haven’t done this before, so there’s not a recipe book. I think the great part about being part of the Mount Sinai Health System is that it is one of the largest health care system in the region and there’s a wealth of knowledge to support us as we go through this journey.”
At a recent visit to her office, just around the corner from the main hospital, an upbeat atmosphere prevailed. Rather than a windowed, corner suite, she occupies a modest office in the back of the building where she proudly displays a shovel and hardhat, recent gifts from the “topping off ceremony” for a new facility. Community leaders, hospital officials, and elected officials gathered to mark the completion of the steel construction phase of a $125 million Ambulatory Care Pavilion that plans to open its doors in 2015. Schwab was instrumental in bringing the new structure into existence. Because Mount Sinai is a non-profit institution, philanthropic contributions were important. The Stavros Niarchos Foundation gave a significant gift, and the new emergency department will be named the Niarchos Foundation Emergency Department.
Discussing the new facility, she radiates enthusiasm. “We’re very excited, because we’re not only going to be offering great care, but a spectacular facility. It’s going to be a gorgeous building with limestone and glass, and most important it will allow us to deliver high quality care, a great patient experience in a beautiful setting. It’s been a fifteen-year goal of mine to expand the emergency department and expand the range of services that we can offer to our community. More and more care is moving to the outpatient setting. It was Dr. Kenneth Davis, CEO of the Mount Sinai Health System, who said ‘This is the hospital of tomorrow.’ That’s how we think of the evolution of our patient health care.”
Hippocrates, the father of Western medicine, advised “First do no harm.” Mount Sinai Queens follows through on that credo. Says Schwab: “We want to make sure that patients get all the care they need, whether it’s check-ups, mammogram screenings, colonoscopies, to help people avoid needing our emergency facility, beautiful as it is. So our rule as a health care provider is not just taking care of the patients when they’re sick and acutely ill, but taking care of the health of our community.”
According to Schwab, a major effort is being made to raise awareness in the community. “There’s an extensive outreach program offering a whole calendar of events, and a newsletter that gets mailed to 150,000 households.. Beginning in January, people will be able to go on line and sign up. We offer workshops and screenings. There’s a breast screening program every month. There’s a support group for people who have had strokes, and their family members. We offer immunizations. We do blood pressure screenings in senior centers. We partner often with existing organizations.
“We partner a lot with HANAC (Hellenic American Neighborhood Action Committee). They have been very generous in allowing us to use their facilities. Evangeline Douris is on our board of advisors, and we have a close relationship with her. On our board of advisors are also Antonis Diamataris, Peter Papanicolaou, and Loucas Tsilas, as well as Dr. George Dangas, who is an interventional cardiologist but also practices. We have 35 or so physicians on our staff who are Greek – it’s a lot of Greek physicians – but I think that’s part of the tradition of Mount Sinai Queens.
“It is a hospital that was started by physicians, many of them Greek, and they are very much an important part of the fabric of our community, and the culture and energy and vitality of the services that we offer here, and we’re very proud of that. It’s something that makes us unique and special because we have so many Greek and Greek-American physicians who are available to serve the many residents of our community, and who have the cultural sensitivity and the language skills.”
Over and over, Schwab returns to the subject of the patient and his or her needs. Says Schwab: “We never turn anyone away. Anyone who comes to our emergency room and needs care, we will treat them. We invest a lot in making sure we have a great patient experience. It’s very important that we understand patient needs. What’s important to you? What are your concerns today? How can we make this a good day for you? Are you worried about when your test is coming back? So we really want to make sure that we’re very aware of what can make you anxious, and how can we lower that stress level and focus on that.”
The most frequent complaint universally about a hospital stay is nursing neglect. If one requires help and insistently presses the buzzer only to be ignored – or have a nurse arrive a half hour later – it can be a traumatic and even life-threatening experience. According to Schwab, giving patients top attention from the nursing staff is a crucial. “It’s been a big focus of ours over the years, and our staff has been through a whole variety of training sessions. I would say that over the last few years, we’re had our biggest breakthroughs with patient-centered care. Our nurses’ assistants round on every patient every hour. They ask them if they are having pain. At night if the patient is sleeping we don’t necessarily wake them up. But if the patient is awake, we go into the room every hour and we ask them if they have everything they need. Are they comfortable? Do they need any assistance going to the bathroom? So we’re very proactive in terms of engaging the patient. We sit down at the bedside. Sometimes standing up can be intimidating. So we might have a 5-minute conversation at the bedside just to get the patient more comfortable.
“We have something called the Tree of Life. We ask about who is important to them, in terms of family and friends. We try to get to know them as a person, not just a patient. We have a nurse manager for each patient. They round on every patient every day. We have collaborative rounds. So when we go in to talk to a patient, we’ll go in with their nurse. We might go in with a physician or physician’s assistant. We want to make sure we’ve answered all their questions and we want to make sure that they know what’s going on with them, and what the plan is for them, and most important, to make them feel safe and well cared for. It’s been an important part for us in terms of our culture. It’s not optional. We’re really committed to delivering quality care as well as compassionate care.”
Schwab’s dynamic leadership and hands-on, innovative approach has been yielding excellent, measurable results, as well as special recognition as she has led the charge to modernize and transform the hospital into a high-quality, patient-centered hospital of choice. The past year saw several remarkable achievements including Magnet Recognition Program designation – the highest national recognition for nursing excellence from the American Nurses Credentialing Center; a major breakthrough in patient satisfaction scores, with Mount Sinai Queens achieving levels for measures such as nursing and pain management in the top 25% of hospitals nationwide; and major progress on the new building.
To achieve her goals, Schwab devotes herself intensely to the job. “When you run a hospital, you’re on 24/7” Away from the hospital, she indulges in a bevy of interests to maintain her own health. “I enjoy playing tennis. It’s a great outlet. I’m pretty active physically. I do some skiing. I love movies, great food, just good food and there’s certainly no shortage of good restaurants in the community. I do love the arts. My mom happens to be an artist, and my dad’s a photographer, so I enjoy both worlds. I was at Alvin Ailey last night, the dance troupe, and oh boy, I came out of there exhilarated. So it makes me ready to charge in here and get going the next day. It’s nice if you can use both sides of your brain.”
Schwab grew up in New Jersey. A Colgate University graduate, she received a master’s degree in public policy from The New School. Her initial focus was on social services and the social welfare system, but while serving as advisor on health care matters to Mayor Ed Koch, she made a new commitment. “So I really started my career then, and the love affair kind of took off. It was a natural transition for me to go into the hospital world. But it wasn’t what I started out with. It was one of those paths in a lot of our histories where you can take two different roads, and you know I took the health care role and have not regretted it a day.” Schwab enjoyed being part of Mayor Koch’s stimulating inner circle, and gathers yearly with former Koch colleagues to remember the mayor on his birthday and renew old friendships.
Schwab’s special contribution to the Queen’s Community has brought her honors including the Kiwanis Club of Long Island City naming her “Woman of the Year “ in 2011. The award goes to those who “have dramatically improved the well-being of the residents of Queens.” Schwab was also honored by the hospital’s Sexual Assault and Violence Intervention Program (SAVI).
“Caryn Schwab has been a stalwart supporter of SAVI,” said Wayne Keathley, the former president and chief operating officer of the The Mount Sinai Hospital. “Thanks to her leadership, the hospital-based rape crisis center at Mount Sinai Queens is dedicated to being a center of excellence in all areas that support survivors of sexual and domestic partner violence. Her support has helped SAVI’s onsite staff and advocates meet the needs of a diverse community in Queens.”
SAVI’s Mount Sinai Queens site is the single busiest program location in Queens, and busier than most sites in Manhattan. Says Schwab, Rape and domestic violence “strikes across all ethnicities. We don’t track that kind of information. Given the fact that there’s a large Greek population in our area, help would be available to them. It covers domestic violence and I think there’s more awareness of the problem. It’s always existed, but people were reluctant to come forward and acknowledge the problem.”
Along with SAVI, Schwab points with pride to two other important programs of Mount Sinai Queens, the Stroke Center, and the Cancer Center. “We’re the only joint-commission recognized Primary Stroke Center in Queens. If a person’s stricken with stroke, ideally you want to go to a hospital that can deliver specialized care. The symptoms of stroke are as important to recognize as when you’re having a heart attack. Time is of the essence, and if you can get to a hospital quickly, particularly one that’s a stroke center, there are things you can do within a time window that will very much improve your outcome.
“We have just finished production on expanding our cancer center, and it’s part of the Tisch Cancer Institute at Mount Sinai. It’s a growing service that again we’re offering to the community. What I found over the years is that residents too often have to go to Manhattan to get great care, so we’ve been making a big investment in recruiting and hiring trained physicians, and we’re expanding our facilities. It’s a beautiful facility. Patients will have privacy if they need to have chemotherapy. They can bring their family members. There are flat screen TV’s and comfortable waiting areas, and they can see their hematologist or oncologist in the same facility. Dr. John Sfakianos, a urologist who trained at Sloan Kettering, joined us this year and we’re excited about that.”
Another major advance: the hospital’s records are completely electronic. “We’re totally paperless,” exults Schwab. “We got national recognition for that about a year ago. Everything about your care is going to be documented electronically. All of your images and x-rays, all of the doctors notes are electronic so whether you get care in a doctor’s office in Manhattan or Queens, your labs can’t get lost. It’s all about communicating clearly. That way we can deliver great care. Suppose a patient doesn’t understand English. With the electronic record, the patient can be treated instantly.”
Under Schwab, the future looks bright for Western Queens residents. It is a great gift to know that your local hospital cares about your well-being and is there to support you at life’s most difficult moments, and will help you maintain good health. Last year, Mount Sinai Queens announced that its new Ambulatory Care Pavilion entrance would be named for the nearby Kaufman Astoria Studios, which declared it was “thrilled to support Mount Sinai and look(s) forward to helping provide better health care for the people of Western Queens and throughout the borough.” And later this month, Mount Sinai Queens will cut the ribbon on its renovated Infusion Center, a state-of-the-art treatment center for cancer and blood disorders – the latest example, Schwab says, of Mount Sinai Queens’s commitment to the community.
“We’re always taking the pulse of our community, to learn what the changing needs are. That’s part of our outreach. We’re active partners in the community, doing things, getting involved. We have a wonderful program where we’re working with Musicians on Call. In the evening they come into our hospital with volunteer musicians, and they’ll do a one-on-one concert for our patients. It is fabulous.
“So much of getting well is a physical process, but it’s also a mental process,” says Schwab. “We do what we can to support both aspects of wellness.”
A pregnant woman was driving in the HOV lane near Dallas.
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