Administration and Healthcare Leadership Fellowship

Overview

The Mount Sinai Health System Department of Emergency Medicine Administrative Fellowship is a unique one-year fellowship designed to provide advanced training in all aspects of emergency department (ED) leadership, operations and management. The goal is to develop the skills of highly motivated emergency physicians in clinical operations, quality improvement (QI), service excellence, general leadership and financial management. Upon completion of the fellowship, the successful candidate will be prepared to take on a junior level ED administrative position and effectively improve the quality and clinical operations of their chosen institution.

Program Overview

Our fellowship is designed to provide comprehensive exposure to all aspects of ED leadership and management through dedicated didactics, exposure to local hospital and system operations, national conference attendance, committee membership, QI projects and practicum work completion.

The fellow becomes a full participating member of the ED management and leadership team. They are given a variety of committee assignments and projects, including those where they are tasked to lead meaningful change in the department. As a member of the ED management team, the physician will become proficient in issues related to clinical operations, patient safety, education, and quality improvement. Mentorship and supervision will be provided by the fellowship director and administrative leadership team. Upon graduating, the fellow will be capable of working effectively with other departments to enhance patient safety, navigate patient experience, develop strategic models and solve operational issues. The fellow will gain experience and expertise during their tenure that will provide them, upon graduation, with the ability to be an effective and transformative leader in any type of emergency department with confidence to understand important metrics, budget issues, quality and safety initiatives and implement sustainable changes.

The Mount Sinai Health System Department of Emergency Medicine is a consortium of emergency departments across the NYC Metropolitan area aimed at providing quality and innovative round-the-clock pediatric, adult and geriatric emergency care to the communities we serve. We offer two of the leading training programs in Emergency Medicine, with a reputation for innovation. The Department of Emergency Medicine consists of more than seven hospital-based emergency departments and affiliated with Elmhurst Hospital Center, part of New York City’s public health care system and located in one of the most ethnically diverse communities in the world. The Emergency Medicine Department at the Mount Sinai Health System has more than 240 faculty and treats more than 500,000 patients annually. We offer two of the leading training programs in Emergency Medicine along with fellowships in Pediatric Emergency Medicine, Administration, Global Health, Ultrasound, Informatics, Sports Medicine and Simulation. Each year, our programs train about 150 residents and more than 15 fellows. Our research division is ranked within the top five in the country based on funding from the National Institutes for Health (NIH).

Fellows are considered attending faculty and are expected to work clinically at designated MSHS emergency department(s). The fellow will have administrative responsibility and involvement at their home clinical site(s) and across the MSHS. Compensation for the fellow includes a competitive salary based on half-time attending status. In addition to fellowship related activities, the clinical duties allow for enhancement of professional skills as an academic attending physician if working at one of our two residency sites.

The administration fellowship is not an ACGME accredited fellowship. However, the fellowship is in the process of applying for SAEM Approved fellowship status.

Length of Training

One academic year (July 1st – June 30th)

Positions

1-2 fellow(s) per year

Clinical Schedule

The fellow will work as a fully credential attending physician with half-time clinical hours of fulltime faculty.

Application Requirements

Applicants should be residency trained in EM or Pediatric EM at board-certified or board-eligible status.

Fellowship Leadership

Director - Kaedrea Jackson MD, MBA, MPH, FACHE (kaedrea.jackson@mountsinai.org)

Assistant Director - Elyse Lavine, MD (elyse.lavine@mountsinai.org)

Curriculum

Didactics

The fellow will have dedicated didactic sessions taught by a member of the ED leadership, residency, nursing and/or hospital administration team. Lectures or individual meetings will typically occur on regular intervals but may vary based on the fellow’s clinical schedule and lecturer availability.

Administrative Participation

The fellow will have the opportunity to expand their training across the MSHS Emergency Medicine sites with areas of focus as detailed below.

• Mount Sinai Morningside – Quality Improvement and Patient Experience with Dr. Kaedrea Jackson

• Mount Sinai West – Disaster and Emergency Management with Dr. Michael Redlener

• Mount Sinai Hospital – Clinical Operations with Dr. Deepa Ravikumar and Dr. Jolion McGreevy; Informatics with Dr. Nicholas Genes

• Mount Sinai Beth Israel – Social and Public Health with Dr. Erick Eiting

• Mount Sinai Brooklyn – Quality Improvement and Community Emergency Medicine with Dr. Deborah Dean

• Mount Sinai Queens – Equity, Diversity & Inclusion, Community Emergency Medicine with Dr. Ugo Ezenkwele

Practicum/Research

At the core of the fellowship is meaningful area of focus or practicum in which the fellow will design, develop and implement one major process, quality or safety project to completion with national abstract presentation or publication. If interested, they can also participate in any one of a number of established administrative-based research efforts across the system. A minimum of one scholarly project should be successfully initiated during the 1-year fellowship.

Early in the fellowship, the fellow and fellowship director will review fellow’s interests and development to identify project proposals that support future professional aspirations. The practicum should allow the fellow to assume primary responsibility of data collection/ analysis of a reported metric.

MSHS EM Fellowship Core Curriculum

The Mount Sinai Health System Department of Emergency Medicine offers fellowships in Global Health, Ultrasound, Pediatric Emergency Medicine, Research, Medical Education and Simulation, Sports Medicine, Administration and Informatics. Each fellowship has its own dedicated faculty and program requirements. However, to help foster the development of all Emergency Medicine fellows within the Mount Sinai Health System, a Core EM Fellow Curriculum has been devised. Fellows in all above fellowships will take an active part in the curriculum by being both learners and educators in collaboration with faculty mentors. Fellows will also participate in the MSHS Emergency Medicine Fellows Research Methodology Lecture Series. The annual lecture series is an opportunity for fellows/residents to acquire knowledge and skills that will assist them in their research endeavors.

National Conferences

The fellow is expected to attend the following meetings that will be funded by the department.

• ACEP Director’s Academy (Phase I) or EDBA Innovations in Emergency Management

• NY ACEP Director’s Forum (One-day course held at NYAM)

Although not sponsored directly, if desired and clinical schedule permitting the fellow can participate other recommended conferences.

• ACEP Coding & Reimbursement Webinar

Certifications

The fellow will be expected to obtain their Lean Green level certification from the Mount Sinai Morningside Lean Lab. Participation in departmental kaizen events is strongly recommended.

Textbook

Strauss and Mayer’s Emergency Department Management by Robert Strauss and Thom Mayer, McGraw-Hill Education (pending new edition)

Expectations/Responsibilities

Clinical

• Provide competent and compassionate care at the level of an attending emergency physician

• Comply with administrative, regulatory and hospital mandates, e.g. peak modules, health clearance, policy and procedures

• Maintain appropriate clinical metrics and billing expectations. Perform appropriately on departmental OPPE

Administrative

• Attend and actively participate in assigned ED meetings and committees at local and system level

• Work on administrative tasks as assigned by the fellowship directors, Chair and/or Site Directors

Quality, Safety & Risk Management

• Complete the Institute for Healthcare Improvement (IHI) wed-based modules on quality improvement

• Attend Root Cause Analysis (RCA) events as assigned

• Perform case reviews for presentation at quality meetings/M&M under the direction of the Fellowship Director (specific to MSMW)

• Attend hospital and system quality and PI meetings as available

• Attend Patient Safety / Risk Management meeting with HRA

• Serve as co-facilitator of a resident CQI project (specific to MSMW)

• Attend the system-wide ED performance improvement committee

• Participate in risk management presentations such as FOJP or other similar programs

Residency Education (specific to MSMW and MSH)

• Contribute to resident education by attending weekly conference at least twice a month and participating in journal clubs, trauma conference and in-service reviews as available

• Actively participate in education of medical students on clinical shifts

• Assist in the development of administrative mini-fellowship for current residents (specific to MSMW)

• Meet quarterly with the residency PD and/or Associate PD to understand residency program development and evaluation/improvement of residency elements.

• Deliver 1-2 lectures (prepared at the Grand Rounds level) during the year on a quality, process improvement, operations or another administrative topic

Professional Development and Projects

• Participation encouraged in a committee of a national EM organization such as ACEP, SAEM, AAEM or national healthcare administration organization such as ACHE or AAPL Monthly readings on administrative topic.