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, NYU Langone Hospital—Brooklyn. 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. NYU Langone Hospital—Brooklyn has set in motion a high-reaching plan to change that frustrating narrative.
“The pledge has always been to bring the same high level of care to southwest Brooklyn that patients receive at NYU Langone Health’s top-ranked hospital facilities in Manhattan,” says Bret J. Rudy, MD, senior vice president and chief of hospital operations, NYU Langone Hospital—Brooklyn, who assumed the leadership role when Lutheran Medical Center merged with NYU Langone Health in 2016. “The goal is one standard of care for all patients, no matter where they live.”
By all measures, NYU Langone Hospital—Brooklyn is succeeding—and in dramatic fashion. Since the merger, NYU 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. “It’s about providing the right care for the right patient at the right time,” says Dr. Rudy.
NYU Langone Hospital—Brooklyn’s Remarkable Turnaround
NYU 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 NYU Langone Hospital—Brooklyn tell a remarkable story. Today, the hospital maintains one of the lowest mortality rates not just in Brooklyn—but 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—a critical window of time for recovery.
The turnaround is all the more striking considering that NYU Langone Hospital—Brooklyn 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, NYU Langone Hospital—Brooklyn 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. “If 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,” says Frank M. Volpicelli, MD, chief of medicine at NYU Langone Hospital—Brooklyn. The patient’s multidisciplinary team—including his doctors, care manager, and social worker—spent 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. “An interdisciplinary care team stepped in and said, ‘OK, what resources do we need to marshal to make sure we can discharge this patient safely?’” adds Dr. Volpicelli.
The same rigorous approach is transforming care for patients whose cases are not so straightforward. “In the past, some patients would have to be transferred to another hospital,” says Joseph M. Weisstuch, MD, chief medical officer at NYU Langone Hospital—Brooklyn. “Now, we have the expertise to treat more complex illnesses. We’re not just a feeder for our hospitals in Manhattan.”
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 NYU Langone Hospital—Brooklyn two years ago from Memorial Sloan Kettering Cancer Center, was able to remove the cancerous tissue in a single operation. His approach—involving minimally invasive surgical techniques—allowed Battaglia to walk out of the hospital cancer free the next day and eliminated the need for chemotherapy or radiation.
“Access to care is not the same thing as access to high-quality care,” says Dr. Rudy. “It’s our mission and our duty to redefine what healthcare means for the people of Brooklyn.”