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NewYork-Presbyterian Allen Hospital and Ambulatory Care Network West

Journey of Magnet® Excellence

NYP Allen Hospital entrance

NewYork-Presbyterian Allen Hospital is located on the northern tip of Manhattan, at Broadway and 220th Street. We are a community hospital and one of the seven campuses that comprise NewYork-Presbyterian Hospital. We serve northern Manhattan, Riverdale and other communities in the Bronx, and provide services in Spanish to our Spanish-speaking patients and their families. We offer leading care in the intimate setting of a community hospital.

All Allen Hospital physicians are also on the medical staff of New York-Presbyterian/Columbia University Medical Center, one of the nation's major medical centers. In addition, each of these physicians is on faculty of the highly regarded Columbia University Vagelos College of Physicians and Surgeons.

Our Emergency Department is open around the clock to serve adults and children in need of immediate medical attention. We receive 45,000 patient visits each year. In our Fast Track area, patients with less severe injuries can receive care promptly.

In our Daniel and Jane Och Spine Hospital, we provide innovative care for spinal conditions, from the most common disorders to the rarest and most difficult-to-treat deformities.

Our obstetrician/gynecologist and nurse-midwives deliver more than 2,200 babies a year. We are also home to a Neonatal Intensive Care Unit for newborns in need of specialized care.

Our patient care services also include cardiology, family medicine, digestive care, internal medicine, infectious disease treatment and prevention, kidney care, neurology, orthopedics, foot and ankle care, psychiatry, lung care, and urology.

2019 Measures of Distinction

34%

National Board Certification Rate

93%

of RNs with BSN and Higher Degrees

20

Newly Obtained National Board Certifications

10

Formal Degrees Conferred

4

Nursing Research Studies Completed

5

Nursing Research Studies in Progress

3

Professional Publications

3

Podium Presentations

4

Poster Presentations

Contributions of Nurses

Vice President and Chief Nursing Officer (CNO), Courtney Vose

The NewYork-Presbyterian/Allen and Ambulatory Care Network (ACN) West Department of Nursing is under the direction of Vice President and Chief Nursing Officer (CNO), Courtney Vose, DNP, MBA, RN, APRN, NEA-BC. Dr. Vose is responsible for providing strategic vision, direction, and leadership for the Department of Nursing and other clinical departments. As CNO, Dr. Vose is responsible and accountable for the provision of nursing services including fiscal planning, resource allocation, staffing, healthy work environment, and employee relations.

Directors of Nursing of clinical service lines work with the CNO to plan and coordinate service line activities. Patient Care Directors manage the daily operations of nursing units.

In May 2019, the NewYork-Presbyterian/Allen Hospital team took its first steps in identifying their strategic priorities for the next few years. The team met as an inter-professional group to assure all members of the healthcare team were aligned in their purpose and goals. The established workgroups from this effort have been meeting throughout 2019 to develop goals and tactics that will drive outcomes. These workgroups formed the NewYork-Presbyterian/Allen Hospital Collaborative Council and are focused on patient satisfaction, workforce excellence, campus branding, community connection, and facilities improvement. Each workgroup is led by a nurse and a colleague from another discipline, including physicians, support team members, and physician assistants.

At the NewYork-Presbyterian/ACN West campus, the nurse practitioners continue to lead the way in nursing research, presentations, and publications. All of this work is actively being translated into the daily care for their patients. These nurses make up a high functioning clinical team and the community is fortunate to have them.

The work from nurses throughout the NewYork-Presbyterian/ Allen and ACN West Campus has enhanced the professional governance structure and is evidence of their commitment to professional growth. This focus at the unit and practice levels is making a meaningful impact on quality nursing indicators and patient satisfaction metrics. Nurses at every level have stepped up and are leading changes that are critical to their practice and practice environment.

The Comprehensive Health Program (CHP) and the NewYork-Presbyterian Ambulatory Care Network West initiated the start of their HIV Prevention Program after receiving generous grants from the New York City Department of Health and Mental Hygiene and the AIDS Institute. The goal of the grants are to increase patients’ access to Pre-exposure Prophylaxis (PrEP) and provide other important sexual health-related services with the outcome of reducing HIV incidence in New York City. PrEP is a medication that if taken daily has been proven to be up to 99 percent effective in preventing HIV transmission.

NewYork-Presbyterian’s HIV Prevention Program provides culturally sensitive sexual health care for individuals of all ages, insurance status, and documentation status. These services include immediate antiretrovirals upon HIV diagnosis (iART) (, primary care for HIV-positive individuals, gender affirming care, post-exposure prophylaxis (PEP), PrEP, STI testing and treatment, family planning, and HIV testing. Since the program’s start in 2015 through August 2019, 2,731 patients have been assessed for PrEP and 1,880 individuals initiated PrEP. NewYork-Presbyterian’s HIV Prevention Program has the second largest number of individuals starting on PrEP in New York City.

Recently, the U.S. Food and Drug Administration expanded the indication for PrEP to include adolescents. Caroline Carnevale, DNP, MPH, RN, AAHIVS, Principal Investigator, HIV Prevention Program, NewYork-Presbyterian’s Comprehensive Health Center and Project STAY, created and implemented an expert validated curriculum to train medical providers on the administration of PrEP in an adolescent cohort. This curriculum was published in the Journal of Pediatric Health in May 2019. Dr. Carnevale presently works with NewYork-Presbyterian’s Comprehensive Health Center and Project STAY, providing primary care to youth and adults with HIV. She has been working with New York City’s efforts to end the HIV epidemic and facilitated the start of the PrEP/PEP and HIV Prevention Program at NewYork-Presbyterian for those individuals at high risk of acquiring HIV.

The clinical team in the Post Anesthesia Care Unit (PACU) administers a vast amount of high alert medications in a fast-paced environment. The team has traditionally utilized safety measures, such as completing the five rights when administering medications, observing the zone of silence, and identifying high alert look-alike/sound-alike medications.

The PACU nurses were not initially part of the NewYork-Presbyterian medication safety mandate, which includes the use of the Patient Safety Solution (PSS) application. The PSS application is a scanning tool located on all hospital-issued phones and allows for the user to scan the patient’s identification band and medication prior to administration. PSS is a useful tool in patient safety because if there is an error noted prior to the administration of the medication, the PSS application will alert the user.

The absence of PSS within the PACU led to medication errors – two occurring in July and August 2019. A need for additional medication administration safety was initially brought to the attention of the Patient Care Director, Jihan Asante MSN, RN, NEA-BC, by the PACU Unit Council after the nurses learned about the PSS application from a campus wide pharmacy meeting.

The patient care director facilitated the acquisition of the necessary resources and PSS utilization in the PACU was implemented in September 2019. Since the introduction of PSS, there have been zero medication administration errors. The nurses attribute the decrease in medication errors to having access to PSS in their daily workflow.

In 2019, the endoscopy nursing team noted an increase in the frequency of procedure cancellations and late case start times. The most common reasons for cancellations were due to bowel preparation not obtained and/or completed; patient consuming food too close to the start of the procedure; no show; no escort; and insurance clearance. Noting these as barriers to patients receiving optimal care, the endoscopy nursing team began to assess their current workflow and initiated conversations with colleagues.

At the time, the workflow consisted of pre-procedure phone calls placed by endoscopy nurses to patients one day prior to the procedure and the admission assessment information entered the day of the procedure. The admission assessment completed by the nursing team on the day of the procedure was lengthy, ranging from 20 to 45 minutes in duration. This admission assessment often led to late case start times.

A change in workflow was initiated that now involves endoscopy nurses calling patients three days in advance of the procedure. The goal of these phone calls is to discuss bowel preparation, diet restrictions, appointment times, past medical history, and current medications. The three-day time frame gives the nursing team time to troubleshoot any issues that may prevent that patient from having their procedure. The endoscopy nurses are also changing their practice to include entering home medications and patient medical history prior to the patient’s arrival. This change in practice decreases the time it takes to complete the admission assessment on the day of the procedure. Since initiating the new workflow, the endoscopy department has seen a decrease in patient procedure cancellations as well as improved case start times.

Publications

Amado, A.P., Vose, C., Mastro, K.A. The DNP Nurse Leadership Potential: Evolution and Challenges. In Johnson, J.E. & Costa, L.L. (Eds). The DNP Nurse in Executive Leadership Roles. Lancaster, PA: DEStech Publications, Inc.

Bahar, Y.Z. (2019). Increasing follow up for moderately effective reversible contraception in adolescents at a school based health center. University at Buffalo Doctor of Nursing Practice (DNP) Scholarship Projects.

Bahar, Y.Z., Mays, A., and Gold, M.A. (2019). Adolescent IUD delivery in non-traditional health settings. In Coles, M. & Mays, A. (Eds.), Optimizing IUD Delivery for Adolescents and Young Adults: Counseling, Placement, and Management. Switzerland: Springer International Publishing.

Ku, B., Phillips, K.E., and Fitzpatrick, J.J. (2019). The relationship of body mass index (BMI) to job performance, absenteeism and risk of eating disorder among hospital-based nurses. Applied Nursing Research, 49, 77-79.

Pathania, S., Slater, L.Z., Vose, C., Navarra, A.M. (2019). Music therapy and pain management in patients with end-stage liver disease: An evidence-based practice quality improvement project. Pain Management Nursing, (20)1, 10-16.

2019 Awards and Recognition

Clinical Excellence Recognition

  • Clinical Nurse Excellence Award:  Falila Yaya, BSN, RN-BC Medical-Surgical Nursing
  • Nurse in Advanced Practice Role:  Gerard De la Cruz, MSN, RN-BC, CNOR Nursing Professional    Development
  • Rising Star Award:  Rockson Bonsu, BSN, RN Medical-Surgical Nursing
  • Nurse Preceptor Award:  Edna McCaskey, BSN, RN Medical-Surgical Nursing
  • Nurse Leader Award:  Jihan Asante, MPA, RN, NEA-BC Patient Care Director, Perioperative and Endoscopy
  • Nursing Support Partner Award:  Janelle Brown Unit Assistant, 2 River West
  • Structural Empowerment Unit Award:  2 River West
  • Friend of Nursing Award:  Rick Leung, PA, Spine Physician Assistant, 2 River West

Daisy Award Winners

Q1 2019
Jane Chan, BSN, RN-BC, 2 Field East

Q2 2019
Wardalina Reyes, BSN, RN, 2 River West

Q4 2019
Jerry Piramide, BSN, RN, CMSRN, 2 River West

Employee of the Month

July 2019
Christian Bourgeois, MSN, RN, CRNA, Nurse Anesthetist

September 2019
Iris Rojas, BSN, RN, C-EFM, Newborn Nursery

Podium Presentations

Yasmin Bahar, DNP, RN, NP, FNP-BC. Enhancing IUD Services at Your SBHC: A Team Approach to Clinical Care. October 2019: New York City/Department of Health/Office of School Health Reproductive Health Training Program, New York, NY.

Yasmin Bahar, DNP, RN, NP, FNP-BC. The Big 5: Colds, Flu, Viral Gastroenteritis, Strep Throat, and Seasonal Allergies. July 2019: NewYork-Presbyterian Peer Educator Training Program, New York, NY.

Karen McKearney, DNP, CPNP, PMHS, BCB. The Effect of Thermal Biofeedback on Migraine, Disability, and Quality of Life in an Underserved Pediatric Neurology Population. September 2019: International Society of Neurofeedback and Research Annual Conference, Denver, CO.

Poster Presentations

Heather Beckford, MSN, RN-BC; Steffy Jean Baptiste, BSN, RN-BC; Toni-Anne Feliciano, BSN, RN-BC; Monique Graham, MPH, RN-BC. Efficacy of Intentional Care Rounding in Decreasing Falls. 2019: ANA Quality and Innovation Conference, Orlando, FL.

Ebele O. Benjamin, MPH, RN-BC; Andrea Craig, PA-C; Elaine Rincon, BSN, RN-BC; Marie Linton, MSN, RN-BC; Leon George, MBA, BSN, CPXP; Esmeralda Ndoci, BSN, RN; Wilson Bourjolly, MD. Streamlining Interdisciplinary Communication Using Smartphone Technology. 2019: American Nursing Informatics Association Annual Conference, Las Vegas, NV.

Marie Linton, MSN, RN-BC; Monique Graham, MPH, RN-BC; Heather Beckford, MSN, RN-BC; Elaine Rincon, BSN, RN-BC; Ebele O. Benjamin, MPH, RN-BC. A Multifaceted Approach Towards Patient Safety. 2019: International Council of Nurses, Singapore.

Sydney Shope, MSN, RN-BC, PMHNP-BC. Language as a Social Determinant to Treatment. 2019: Association for Behavioral and Cognitive Therapies Conference (ABCT), Atlanta, GA.