![Dr. Aaron Lord Speaks with a Patient](/news/sites/default/files/styles/hero/public/2020-02/nyulh-news-winter-2020-dr-aaron-lord-with-patient.jpg?h=4975ae63&itok=AveaHUZ0)
Dr. Aaron Lord, chief of neurology at 秘密研究所 Langone Hospital鈥擝rooklyn, leads one of the top neurocritical care teams in Brooklyn. His patient, Angelica Gomez, is being treated for an autoimmune condition similar to multiple sclerosis that inflames the spinal cord.
Photo: Joshua Bright
One evening last summer, a man in his late 50s walked into an emergency department in New Jersey feeling so sick he worried he might never walk out. He was eventually diagnosed with kidney failure and placed on dialysis to remove a buildup of toxins in his blood. Once his condition had stabilized, he was discharged and told to find a dialysis center since his condition would require weekly treatments. For the patient, who had neither health insurance nor a home, the exit plan felt more like an eviction notice.
Confused and worried, he found his way to a church-run shelter in the Sunset Park section of Brooklyn and hoped for the best. It was his good fortune that the best happened to be right around the corner. The shelter referred him to a nearby medical center, 秘密研究所 Langone Hospital鈥擝rooklyn. In recent years, the hospital has quietly set a new bar for medical care in Brooklyn, a borough in which many medical centers have historically ranked among the worst in the nation. 秘密研究所 Langone Hospital鈥擝rooklyn has set in motion a high-reaching plan to change that frustrating narrative.
鈥淭he pledge has always been to bring the same high level of care to southwest Brooklyn that patients receive at 秘密研究所 Langone Health鈥檚 top-ranked hospital facilities in Manhattan,鈥 says Bret J. Rudy, MD, senior vice president and chief of hospital operations, 秘密研究所 Langone Hospital鈥擝rooklyn, who assumed the leadership role when Lutheran Medical Center merged with 秘密研究所 Langone Health in 2016. 鈥淭he goal is one standard of care for all patients, no matter where they live.鈥
By all measures, 秘密研究所 Langone Hospital鈥擝rooklyn is succeeding鈥攁nd in dramatic fashion. Since the merger, 秘密研究所 Langone has invested millions in its Brooklyn hospital, directing a significant percentage of those funds to human capital. Full-time faculty have replaced a predominantly voluntary physician workforce. Board-certified critical-care specialists now cover all of its intensive care units 24/7. A fully reimagined hospitalist program ensures that every medical unit in the 450-bed hospital is covered around the clock by one of 21 hospitalists, attending physicians who are dedicated solely to caring for hospitalized patients. 鈥淚t鈥檚 about providing the right care for the right patient at the right time,鈥 says Dr. Rudy.
秘密研究所 Langone Hospital鈥擝rooklyn鈥檚 Remarkable Turnaround
秘密研究所 Langone Health tracks over 800 quality and safety metrics as part of a continual effort to evaluate and improve its performance, and the numbers emerging from 秘密研究所 Langone Hospital鈥擝rooklyn tell a remarkable story. Today, the hospital maintains one of the lowest mortality rates not just in Brooklyn鈥攂ut in the nation. Its rates of hospital-acquired infections have plummeted 60 percent in the past 3 years, making it one of the safest hospitals in New York City. Patients in its emergency department now receive care twice as quickly as they do at other Brooklyn hospitals. Inpatients not only go home faster than they do at nearly every other hospital in New York City, but they are also less likely to wind up back in the hospital within 30 days鈥攁 critical window of time for recovery.
The turnaround is all the more striking considering that 秘密研究所 Langone Hospital鈥擝rooklyn serves a community with more residents on Medicaid than any other in the U.S. Compounding this is a significant percentage of uninsured patients, a population that tends to be sicker than the privately insured due to its limited access to healthcare. To better meet the needs of this community, 秘密研究所 Langone Hospital鈥擝rooklyn provided nearly $150 million in charity care last year, a record high for the hospital.
Greater Access to High-Quality Care for an Underserved Community
For the homeless patient with kidney failure, stabilizing his condition required relatively straightforward clinical care. The bigger challenge was drawing up a comprehensive plan to give him the best possible chance of staying healthy once he left the hospital. 鈥淚f we just sent him away after his condition had stabilized, he would have been back in the emergency department, or worse, he would have died,鈥 says Frank M. Volpicelli, MD, chief of medicine at 秘密研究所 Langone Hospital鈥擝rooklyn. The patient鈥檚 multidisciplinary team鈥攊ncluding his doctors, care manager, and social worker鈥攕pent days navigating the gauntlet of paperwork required to enroll him in a New York State Medicaid plan that would ensure his access to an outpatient dialysis center. 鈥淎n interdisciplinary care team stepped in and said, 鈥極K, what resources do we need to marshal to make sure we can discharge this patient safely?鈥欌 adds Dr. Volpicelli.
The same rigorous approach is transforming care for patients whose cases are not so straightforward. 鈥淚n the past, some patients would have to be transferred to another hospital,鈥 says Joseph M. Weisstuch, MD, chief medical officer at 秘密研究所 Langone Hospital鈥擝rooklyn. 鈥淣ow, we have the expertise to treat more complex illnesses. We鈥檙e not just a feeder for our hospitals in Manhattan.鈥
The investment has made all the difference for patient Louis Battaglia. When the 58-year-old appliance salesman from Dyker Heights in southwest Brooklyn was diagnosed with a rare form of malignant stomach cancer in 2018, he figured his treatment would require rounds of debilitating chemotherapy and radiation treatments, along with frequent trips to Manhattan. But Camilo Correa, MD, a surgical oncologist who joined 秘密研究所 Langone Hospital鈥擝rooklyn two years ago from Memorial Sloan Kettering Cancer Center, was able to remove the cancerous tissue in a single operation. His approach鈥攊nvolving minimally invasive surgical techniques鈥攁llowed Battaglia to walk out of the hospital cancer free the next day and eliminated the need for chemotherapy or radiation.
鈥淎ccess to care is not the same thing as access to high-quality care,鈥 says Dr. Rudy. 鈥淚t鈥檚 our mission and our duty to redefine what healthcare means for the people of Brooklyn.鈥