Leadership Conference Keynoter: Room for Improvement in Patient-Centered Care

Julie Mirkin, vice president of care coordination at NewYork Presbyterian.

Public healthcare is “stuck on an escalator,” according to Julie Mirkin, vice president of care coordination at NewYork-Presbyterian, the keynote speaker at the Leadership Conference in April 2016. 

The theme of the conference—co-presented at The Garden City Hotel by the Adelphi University College of Nursing and Public Health and Sigma Theta Tau International’s Alpha Omega Chapter—was “Creating Our Future: New Directions in Healthcare.”

Although her own hospital system is ranked No. 1 in New York City by U.S. News & World Report, Mirkin said, “That’s not good enough.” The hospital network still needs to improve the level of care being offered, and that means increasing efficiency and communication.

“We have four different branches, and do you think any of them talk to each other?” she asked a full room at The Garden City Hotel. “No.”

The solution Mirkin was there to offer fell under the banner of “patient-centered care,” which she identified as “a theme that goes throughout the whole institution. In essence, we’re all one coordinator.”

While coordinators ensure that nothing falls through the cracks in some areas of healthcare provision, like billing, such continuity is not ensured where it’s needed most. Hospitals need someone checking that a patient understands symptoms to watch for, related risks and what to expect from prescribed medication. Someone has to make sure follow-up appointments are scheduled before a patient is discharged.

One consequence of not doing so, according to Mirkin, is patient dissatisfaction—which these days can quickly translate to negative rankings on the Centers for Medicare & Medicaid Services (CMS) website. She explained that the result is like someone reading restaurant reviews online and saying, “I’m not going to go to a two-star restaurant.”

Most New York State hospitals rate two to four stars on the CMS site, Mirkin said. With patients becoming wiser consumers, the level of care is beginning to rise.

“Hospitals are beginning to understand that the only way to fix this is to hire skilled care coordinators and skilled nurses,” Mirkin said to enthusiastic applause.

Also helping to improve conditions is the New York State Caregiver Advise, Record and Enable (CARE) Act, which went into effect just a week before the conference. The law makes New York the second state (after California) to regulate, for example, what information is provided to a patient during discharge. But Mirkin was not applauding the fact that patient education and empowerment are now required under legislation.

“How sad is that?” she said. “Shame on us.”