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Stony Brook University Hospital

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Stony Brook University's Ambulatory Care Pavilion COVID-19 Triage area. Photo from SBUH

Stony Brook University took several steps to prepare for the expected wave of patients with coronavirus.

The hospital has created a forward triage and treatment area, moving incoming patients away from the main emergency room. These patients, who have influenza-like illnesses, will move to another triage area. The staff in this section will include board-certified emergency medicine physicians and emergency medicine nurses who can safely screen patients and collect respiratory pathogen point of contact testing and offer advice and follow up.

In the last three weeks, Stony Brook Hospital has also created three units which include 45 beds in total for people under investigation. The hospital will complete another unit with 16 beds. Stony Brook has also increased its capacity for overflow bed needs and is actively working to expand its Intensive Care Unit and stepdown bed capacity.

Stony Brook has enlisted the help of numerous volunteers from its various ranks, including graduate, medical and nursing students, who are available if and when the patient numbers climb above capacity. The university also has the support of MD/PhDs and PhD graduate students from its basic science and clinical departments who volunteered to help with laboratory response for testing. For in-house testing, the hospital prioritizes work assignments for those students with relevant lab experience with the techniques necessary to perform PCR assays of the type required to assess the presence of the virus.

Stony Brook has also postponed elective surgery and procedures. Urgent procedures or operations necessary to preserve life and function will continue. The hospital is allowing non-essential personnel to work from home.

Stony Brook has developed relationships with two commercial laboratories to send their patient samples, as well as the New York State Department of Health Wadsworth Laboratories. They are working to validate instrumentation to ensure the ability to perform internal testing.

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Stony Brook University Hospital. File photo

By Carol Gomes

Carol Gomes

I often tell people that Stony Brook University Hospital and I grew up together. The hospital first opened its doors in 1980, as the region’s first academic medical center. And just five years later, I was hired as a clinical laboratory scientist. Since then, the hospital has grown exponentially. And so has my role. Today I have the honor and privilege of serving as its Chief Executive Officer. We’ve both come a long way! 

During its first year in operation, SBU Hospital employed 800 people. We now employ over 7,000 and are part of an 818-bed healthcare system. Through all the change and growth, one constant has remained, allowing Stony Brook University Hospital to achieve excellence, including recognition as one of America’s 100 Best Hospitals™ for 2019 and 2020.

That constant, the source of our greatest strength, is in the people who work at our hospital every single day and give it their all. And with their expertise, they provide the compassionate care that helps patients heal. If it weren’t for the healthcare professionals who are the fabric of the organization, we wouldn’t be a high-quality, patient safety-award-winning organization.

Did you know that when we first opened, Stony Brook University Hospital was one of the few hospitals in New York State with a nursing staff that consisted entirely of registered nurses? 

Or that in 1981, the first kidney transplant on Long Island was performed at our hospital? 

The reputation of our hospital as a research center also began to gain momentum around that time. In 1982, it was announced that the discovery of the spirochete responsible for Lyme disease was made by a Stony Brook team led by Jorge Benach, PhD. A decade before, Stony Brook University researcher Paul Lauterbur, PhD, created the first multi-dimensional image using nuclear magnetic resonance (NMR). His 1971 discovery made it possible to get a clear look inside the human body without surgery or x-rays. Dr. Lauterbur would go on to receive the 2003 Nobel Prize in Physiology or Medicine.

We have so many proud moments and milestones. Our Burn Unit, opened in 1984, is now designated as the regional center for burn care and known as the Suffolk County Volunteer Firefighters Burn Center. In 1988, our hospital was named the regional AIDS treatment center – one of only two in the state at the time. In 1989, I remember watching the first Suffolk County Police helicopter touch down on the hospital’s helipad to provide transport of the critically ill or injured to the hospital from throughout Suffolk County.

At the start of 1990, the hospital was designated by New York State as a Level I Trauma Center. That same year, the hospital opened its Comprehensive Psychiatric Emergency Program (CPEP), which became another New York State-designated service. All of the hospital’s state designations are still in place today.   

In 2001, on the heels of our 20th anniversary, we began to lay the foundation for growth. The different phases of construction, renovation and rebuilding have resulted in a multitude of new services, programs, faculty and facilities that continue to serve and benefit our communities today and into the future.

Advanced Specialty Care, our multispecialty center in Commack that opened in 2017, offers more than 30 medical specialties. Our Medical and Research Translation building, Stony Brook University Cancer Center and 150-bed Hospital Pavilion, which includes a new facility for Stony Brook Children’s Hospital opened in 2019.

And this year, our Children’s Hospital — the first and only children’s hospital in Suffolk County — is celebrating its 10th year, while combining the best practices in modern pediatric medicine with a child- and family-first philosophy. 

I can’t wait to see what the next 10, 20, 30, 40 years bring!

Carol A. Gomes is the Chief Executive Officer of Stony Brook University Hospital. 

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The spread of the new coronavirus has become increasingly likely in the United States, public health officials suggested, as the sickness that started in China has infected people in 39 countries including Italy and South Korea where an American service member has contracted the virus.

During a conference call with reporters on Tuesday, Nancy Messonnier, the director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, said it was “not a question of if this will happen but when this will happen and how many people in this country will have severe illnesses.”

Messonnier’s warning included a suggestion that people start asking their schools about plans for dismissal and for conducting classes online if the coronavirus, now called Covid-19, affects their communities.

Stocks fell sharply lower on Monday and Tuesday amid concerns about the effect on the global economy.

As of earlier this week, over 80,000 people had tested positive for Covid-19, which claimed the lives of over 2,700 people. In the United States, the number of confirmed cases, including those from the Diamond Princess cruise ship, had reached 57. None of those cases is in New York, where 26 tests have come back negative and one is still pending, according to the New York State Department of Health.

Bettina Fries, the chief of the Division of Infectious Diseases in the Department of Medicine at the Renaissance School of Medicine at Stony Brook University, said the infections in Italy and South Korea signaled a new phase in the epidemic.

“We are now having these new cases where we can’t even link them” to exposure to people who have traveled to China, Fries said. “The genie is out of the bottle. Once that happens, it’ll be that much harder” to contain the virus.

Fries described the virus, which health officials believe is transmitted through droplets from people carrying the infection, as “behaving much more like the flu,” which is why the CDC is preparing for cases in the United States.

With other coronaviruses, including severe acute respiratory syndrome and Middle East respiratory syndrome, the majority of patients who transmitted these diseases had symptoms like high fevers. That may not be the case with Covid-19, as patients that are “asymptomatic could be shedding the virus,” making it more difficult to contain, Fries said.

Medical professionals don’t have any medication or vaccine, while the world population, which hasn’t been exposed to this new virus, also hasn’t developed any kind of resistance.

If pockets of the outbreak appear in the United States, it is “conceivable that schools could shut down and that there could be rules where people self quarantine” for the required 14 days, Fries said.

Fries added that it’s important to protect health care providers who are on the front lines in this battle. Stony Brook is continuing to make contingency plans in the event of confirmed cases of this coronavirus, which includes making space available if necessary. In the event of an outbreak, the hospital would change its policy of having trainees, residents and medical students go in and out of rooms with doctors on rounds, she said.

Fries added that the warmer weather may not cause a reduction in the incidence of the virus. “Every virus is different,” Fries said.

On Wednesday afternoon, Gov. Andrew Cuomo (D) announced several measures to prepare New York for the potential spread of the new coronavirus, called Covid-19, to the Empire State. Cuomo announced a $40 million appropriation for the New York State Department of Health to hire additional staff, procure equipment and any other resources necessary to respond to the spread of Covid-19. The governor is also proposing legislation to grant authority to the Department of Health Commissioner Howard Zucker to make sure local health departments and private and public hospitals take necessary actions in response to the virus. The department will bring together local health departments and hospitals statewide to review protocols, practices and procedures to make sure they are prepared to combat the spread of Covid-19.
Cuomo is also asking the federal government to authorize the Wadsworth Center and NYC Public Health Laboratory to test for the virus, which would speed up the test results. New York State has developed and validated a test using the protocol of the Centers for Disease Control. Once Wadsworth receives Food and Drug Administration approval, it can test people under investigation in New York and other northeastern states.
The Department of Health will coordinate with the Mass Transit Authority, Port Authority and airport operators and the workforces for these public transit systems to ensure workers are trained and can access supplies such as cleaning and protective equipment, that they need to operate mass transit and airports. New York is working with all state agencies to prepare for the potential pandemic.
Updated Feb. 28 to include information about Cuomo’s measures.

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Mather is one of four separate Northwell hospitals approved for a catheterization lab. The hospitals are looking to compete for services amongst some of the larger health entities in New York state. Photo from Northwell

Mather Hospital in Port Jefferson will soon be joining nearby Stony Brook as one of the few places on Long Island to contain a cardiac catheterization lab to provide less invasive heart-related services.

New York State approved Northwell Health, which includes Mather in its group, to open four cardiac labs at different locations in New York. Alongside Mather, Lenox Health Greenwich Village, Plainview Hospital and Northern Westchester Hospital in Mount Kisco have been approved for labs. The lattermost was approved in December.

According to a Northwell release, these labs specialize in using X-ray guided catheters help open blockages in coronary arteries or repair the heart in minimally invasive procedures — ranging from stenting to angioplasty and bypass surgery – that are less traumatic to the body and speed recovery. 

The approval means a big leap for the Port Jefferson hospital, which plans a $11.4 million, 3,644-square-foot addition that will include catheterization and electrophysiology labs. The construction is expected to finish and both labs be open by early 2021.

“With the investment in these four new PCI programs, we are able to advance our mission of improving access, as well as bringing high quality complex cardiovascular services to our patients in their local communities,” William O’Connell, executive director of cardiology services at Northwell Health, said in a release. 

Mather president, Kenneth Roberts, has said in a previous interview with the Port Times Record that a big reason the hospital signed on with the health care network is to have the ability and room to innovate at the hospital and keep up with the times. He echoed that sentiment in a statement.

“With Northwell’s guidance and the diligence of our Mather team, Mather received approval from the New York State Department of Health to provide advanced cardiology programs which include cardiac catheterization, PCI and electrophysiology services,” he said. “Approximately 150 patients every year are [currently] transferred from Mather or St. Charles to have these services elsewhere.”

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Employees who began at Stony Brook Medicine 40 years ago, wearing red flowers, were honored at the hospital’s celebration. Photos from Stony Brook Medicine

Stony Brook University Hospital has come a long way in its four-decade history. On Feb.14, past and current employees of SBUH gathered at the Medical and Research Translation building to celebrate the 40th anniversary of the opening of the facility.

The idea of the region’s academic medical center was an ambitious undertaking, beginning in 1973 when construction began. Five years later, the two iconic hexagonal structures were completed. From there, a yearlong mass recruitment process began in which about 800 people were hired.

Many of the hospital’s first employees didn’t know what to expect or in some cases how to get there.

“They said you take the Long Island Expressway then go north on Nicolls Road and when you get to the Star Wars set you’ll know you’re there,” said Lawrence Hurst, professor and chair of the Department of Orthopaedics at the Renaissance School of Medicine.

Hurst came to SBU in 1979 with the intent of being the hospital’s firsthand surgeon.

An attendee looks at a time line display. Photos from Stony Brook Medicine

“It was an exciting adventure, the opportunity to become the first in a specialty was something I couldn’t pass up,” he said. “I was lucky enough to take full advantage of it.”

Extensive logistical planning began before the hospital opened the following year.

“When we came here, there were no patients, no equipment, we had a very small group of physicians in the beginning, now we have over 500,” Hurst said.

As part of the celebration, hospital officials showcased a video presentation highlighting the facility’s accomplishments throughout the years and included interviews with employees who shared their favorite memories.

Some notable accomplishments included: doctors performing the first kidney transplant surgery on Long Island in 1981; the first Suffolk County police helicopter touching down on the hospital’s helipad in 1989; and in 1990, New York State designating the hospital a Level I Trauma Center. This past year, SBU opened the Children’s Hospital and MART Building.

In addition to the presentation, a time line and exhibit were on display throughout the building showcasing the hospital’s history.

Kenneth Kaushansky, senior vice president for health sciences and dean at the Renaissance School of Medicine, spoke about the reason he left San Diego to come to Stony Brook

“I saw incredible potential when I decided to come here 10 years ago,” he said. “It had a good medical school and good health care facilities.”

“We have become one of the best hospitals in the country, a premier health center.”

– Kenneth Kaushansky

Kaushansky said the further development of the medical school and the hospital over the years has been a “powerhouse.”

“We have become one of the best hospitals in the country, a premier health center,” he said.

Going forward, the senior vice president of health sciences said that SBU will continue to strengthen the hospital network throughout the Island and continue to advance the Renaissance School of Medicine.

“As technology improves, I believe the future of health care will be more geared toward tele-help, tele-EMS and wearable devices,” he said.

Carol Gomes, CEO of Stony Brook University Hospital, said she met many lifelong friends and colleagues when she began to work in the laboratory in 1985.

“I’ve been very fortunate to meet people along the way that have become great mentors to me,” she said. “I’ve been able to connect with them on a daily basis.”

Gomes said as she has progressed in her own career the hospital has done the same.

“We have continued to flourish as a health care organization,” Gomes said. “This celebration was a very special moment for me. I just think about the connections I’ve made over the years.”

The CEO of the hospital credited the facility’s staff.

“The employees are the lifeblood of the organization, they come to work every day,” Gomes said. “Our greatest strength is our staff.”

Gomes said if it weren’t for the staff, the hospital wouldn’t have had the clinical outcomes or the reputation for which it is known.

“Everyone has the same goal … The dedication of the staff to our patients will always remain the same, it has been our one constant,” she said. “Stony Brook has been my home away from home.”

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Dennis Dillon, left, thanks the people who helped him survive a near-fatal heart attack last year. Photo by David Luces

“The kindness and compassion in these people’s heart is why I’m here [today],” Dennis Dillon, 62, said of the group of good Samaritans who he said rushed to his aid after he went into cardiac arrest during a boating trip at Port Jefferson Harbor Aug. 31 over Labor Day weekend. 

The Mount Sinai native, along with his family, reunited Feb. 8 with the rescuers for the first time since the incident. The 10 individuals were presented with the Stony Brook University Heart Institute’s Heart Saver Community Award. 

Mount Sinai native Dennis Dillon stands alongside the good Samaritans and doctors who saved his life a year ago. Photo by David Luces

After Dillon returned from a swim, he went into cardiac arrest after experiencing back and arm pain as well as nausea. His wife, Tricia, immediately began CPR and within minutes good Samaritans began assisting with CPR and sent up a flare to ensure that an ambulance would be standing by. Dillon’s heart was then shocked twice by an AED (defibrillator) and was brought back to shore where he was taken to the heart institute. 

Doctors said the father of three had a 100 percent blockage of the left anterior descending coronary artery, a key artery known as LAD that moves blood to the heart. The condition is dangerous because of its low survival rate, and is often referred to as “the widowmaker.”

“Out-of-hospital cardiac arrest, which Mr. Dillon suffered from, is associated with a 5 to 9 percent survival rate,” said Dr. Puja Parikh, interventional cardiologist and co-director of the Transcatheter Aortic Valve Replacement Program at the heart institute. “It is a true
testament to the bystanders that were present that day, the measures they took before he [Dillon] came to the hospital definitely helped.”

Dillon’s treatment included a drug-eluting stent to his LAD, a tiny metal tube coated with a medication to clear the artery and keep it clear, and tracheal intubation to ensure an open and unobstructed airway. His body temperature was lowered when brought to the coronary care unit, to allow time for his brain and body to heal. Prior to discharge, the catherization team implanted a small internal cardioverter defibrillator in order to avert another cardiac crisis. After 11 days, the Mount Sinai native was released Sept. 11. 

According to the heart institute, a heart attack victim’s chances of survival goes down by about 10 percent for every minute that CPR is not initiated. 

Officials from the institute reiterated that anyone can use an AED if need be. Pictures on the device gives individuals a visual guide on where to put the pads. It also talks to you and won’t go to the next step until the previous task is completed. 

The Dillon family said they planned on buying an AED for their boat in case they ever find another person in a similar situation who needs aid. “I will never be able to repay any of these people, but I can pay it forward by trying to help someone else,” Dennis said.

Doctors will be hosting community events throughout what is American Heart Month. On Feb. 26 from 9 to 10 a.m. Brittany Kickel, chest pain center coordinator, will host Avoiding Common Heart Health Mistakes at the Smith Haven Mall food court. For more information, visit heart.stonybrookmedicine.edu. 

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As the number of people infected with the new coronavirus climbs in China and countries limit travel to the beleaguered country, the incidence of infection in the United States remains low, with 11 people carrying the respiratory virus as of earlier this week.

“While the risk to New Yorkers is still low, we urge everyone to remain vigilant.”

— Gov. Andrew. Cuomo

American officials stepped up their policies designed to keep the virus, which so far has about a 2 percent mortality rate, at bay in the last week. For the first time in over half a century, the government established a mandatory two-week quarantine for people entering from China’s Hubei Province, which is where the outbreak began. The United States also said it would prevent foreign nationals who are not immediate family members of American citizens from entering within two weeks of visiting China.

Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, called the viral outbreak an “unprecedented situation” and suggested that the American government has taken “aggressive measures” amid the largely expanding outbreak.

The actions, Messonnier said on a conference call earlier this week, were designed to “slow this down before it gets into the United States. If we act now, we do have an opportunity to provide additional protection.”

The number of deaths from coronavirus, which has reached almost 500, now exceeds the number for the sudden acute respiratory syndrome, or SARS, in 2003. The number of infected patients worldwide has reached above 25,000, triggering concerns about a pandemic. More than 1,000 have recovered from the virus.

The CDC, which has been coordinating the American response to the virus, has been testing potential cases of the disease. Symptoms include fever, coughing and shortness of breath.

In New York, 17 samples have been sent to the CDC for testing, with 11 coming back negative and six pending. New York created a hotline, 888-364-3065, in which experts from the Department of Health can answer questions about the virus. The DOH also has a website as a resource for residents, at www.health.ny.gov/diseases/communicable/coronavirus.

“While the risk to New Yorkers is still low, we urge everyone to remain vigilant,” Gov. Andrew Cuomo (D) said in a statement.

The CDC sent an Emergency Use Authorization to the Food & Drug Administration to allow more local testing during medical emergencies. Such an effort could expedite the way emergency rooms respond to patients who they might otherwise need to isolate for longer periods of time while they await a definitive diagnosis.

By speeding up the evaluation period, the CDC would help hospitals like Stony Brook University Hospital maintain the necessary number of isolation beds, rather than prolonging the wait period in the middle of flu season to determine the cause of the illness.

As for the university, according to its website,  approximately 40 students have contacted the school indicating they are restricted from returning to the U.S. With university approval, the students will not be penalized academically for being out or for taking a leave of absence.

“The most important thing is to keep your hands clean.”

— Bettina Fries

Testing for the new coronavirus, which is still tentatively called 2019-nCoV, would miss a positive case if the virus mutated. In an RNA virus like this one, mutations can and do occur, although most of these changes result in a less virulent form.

The CDC, whose website www.cdc.gov, provides considerable information about this new virus, is “watching for that,” said Bettina Fries, the chief of the Division of Infectious Diseases in the Department of Medicine at Renaissance School of Medicine at Stony Brook University. At this point, there “doesn’t seem to be much mutation yet.”

In the SARS outbreak, a mutation made the virus less virulent.

Fries added that the “feeling with SARS was that you weren’t infectious until were you symptomatic. The feeling with this one is that you are potentially infectious” before demonstrating any of the typical symptoms.

Fries assessed the threat from contracting the virus in the United States as “low,” while adding that the danger from the flu, which has resulted in over 10,000 deaths during the 2019-20 flu season, is much higher.

In the hospital, Fries said the health care staff puts masks on people who are coughing to reduce the potential spread of whatever is affecting their respiratory systems.

While Fries doesn’t believe it’s necessary to wear a mask to class, she said it’s not “unreasonable” in densely populated areas like airports and airplanes to wear one.

Masks don’t offer complete protection from the flu or coronavirus, in part because people touch the outside of the masks, where viruses condense, and then touch parts of their face. Even with the mask on, people touch their eyes.

“The most important thing is to keep your hands clean,” Fries suggested.

Fries believes the 14-day quarantine period for people coming from an area where coronavirus is prevalent is “probably on the generous side.” Scientists come up with this time period to establish guidelines for health care providers throughout the country.

Fries suggested that the only way these precautions are going to work is if they are aggressive and done early enough.

“Once the genie is out of the bottle” and an epidemic spreads to other countries, it becomes much more difficult to contain, Fries said.

The best-case scenario is that this virus becomes a contained problem in China. If it doesn’t spread outside the country, it could follow the same pattern as SARS, which abated within about eight months.

While there is no treatment for this new coronavirus, companies and governments are working on a possible vaccine. This, Fries estimated, could take about a year to create.

Looking out across the calendar, Fries wondered what would happen with the Olympics this year, which are scheduled for July 24 through Aug. 9 in Tokyo. Athletes who have been training for years certainly hope the virus is contained by then. A similar concern preceded the 2016 Olympics, when Zika virus threatened to derail the games in Brazil.

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In a Q&A with TBR News Media, Carol Gomes, interim chief executive officer at Stony Brook University Hospital, discusses a variety of topics including patient safety, quality control and curbing infections. Here is what she had to say. 

1. Being the interim chief executive officer at the hospital, how important is patient safety and  quality control to the day-to-day operations?

Stony Brook Medicine physicians and staff are committed to providing high-quality, safe patient care.

SBU Hospital CEO Carol Gomes discusses what the hospital is doing to reduce infection potential. Photo from SBU Hospital

Quality and patient safety is priority number one, and we focus on safe patient care every day. The Stony Brook Medicine team convenes a safety huddle that is part of the day-to-day operations in every area, which includes critical leaders from all over the hospital.

We start the day with approximately 35 care team members from nursing leadership, physician leadership and operational leadership who report on important safety or quality opportunities.  Our huddles are highly structured meetings that allow the hospital to focus on process changes with direct follow-up. This drives accountability to help ensure that adequate safety measures are in place for our patients at all times. 

2. Interim SBU President Michael Bernstein mentioned to us that you were making an effort to curb infections at the hospital among other things. Could you discuss some of the initiatives you’ve been implementing to improve in that area?

Stony Brook University Hospital has three primary strategic quality priorities — clinical outcomes, patient safety and the patient experience.

Proactively, Stony Brook works to provide safe and effective care to every patient via our patient safety work groups. These groups analyze processes, review relevant data and implement process changes to enhance patient safety and prevent patient harm.

The vast majority of projects and improvement efforts are aimed at reducing hospital associated infections. There are teams that implement best practices for CLABSI, or central line associated bloodstream infections; hand hygiene; CAUTI, or catheter-associated urinary tract infections; C. diff, or Clostridium difficile infections; SSI, or surgical site infections; and sepsis. 

Working groups incorporate real-time data to implement best practices to ensure hospital units continue to drive improvement efforts in achieving patient safety goals.

3. In general could you talk about the threat of infections to patients at hospitals? Most people view hospitals as a place of recovery and necessarily don’t think of other germs, sick people around them. Can you speak on that and the challenges you and others face?

As a matter of standard practice, the hospital adheres to rigorous infection control guidelines every day to ensure a clean environment for patients, staff and visitors. These practices are especially important during the flu season.

Being within the close quarters of a hospital, there is an increased incidence of transmission for infections. Many patients have recent surgical wounds, IVs and other catheters placing them at higher risk of infection. These risks may be enhanced by the acquisition of an infection from a visitor.

Family members and other visitors who suspect they may have the flu or other viruses are advised to not visit the hospital.

To lessen the spread of the flu virus, hand hygiene and attention to reducing the effects of droplets from respiratory illnesses such as the flu can enhance patient safety.

Hand washing prevents infection. It is one of the most important actions each of us can implement before and after every encounter with a patient.

The goal is to minimize that transmission while the patient is in the hospital.

4. Other practices/guidelines at the hospital?

The flu virus most commonly spreads from an infected person to others. It’s important to stay home while you’re sick, not visit people in the hospital and to limit close contact with others.

Visitors should wash their hands before entering a patient room and after seeing a patient, whether or not there is patient contact. 

As added protection, patients who have been identified as having infections are isolated appropriately from other patients in order to prevent accidental spread.

Therefore, if a patient has the flu or flulike symptoms, the hospital will place them in respiratory isolation. Likewise, a patient with measles or chicken pox is kept in appropriate isolation.

Visitors may be asked to wear masks on certain units.

5. How do patient safety grades affect how the hospital looks to improve
its quality? 

Stony Brook University Hospital supports the public availability of quality and safety information about hospitals. We are constantly looking for ways to improve and ensure the highest quality of care.

There is a wide variation of quality reports with different methodologies and results.

Clinical outcomes define our success as a hospital. Better clinical outcomes means we’re taking better care of our patients. Stony Brook Medicine initiated a major initiative to improve clinical outcomes. We have multidisciplinary groups improving outcomes in the following areas:

•  Increasing our time educating patients prior to their discharge in order to prevent hospital readmissions.

•  Improving the care of our patients receiving surgery to reduce postoperative complications.

•  Enhancing the diagnosis and care of patients with diabetes.

•  Improving the speed of diagnosis and treatment of sepsis.

In short, great effort is expended in identifying opportunities for improvement with a detailed and focused approach on enhancing patient outcomes.

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While the risk from the new deadly coronavirus that has closed cities in China remains low in New York, Long Island hospitals, including Stony Brook, are working with the New York Department of Health to prepare in case it makes its way to the New York area.

The respiratory virus, which originated at a seafood market in Wuhan Province in China during contact between humans and an animal that reportedly could have been a snake, has claimed the lives of 132 people as of Jan. 29. The virus has spread to three states, with single cases in Seattle, Washington, and Chicago, Illinois, and two cases in California.

The reported deaths from the virus are all in China, although people have also tested positive for coronavirus in countries including Australia, Canada, France, Japan and Vietnam, among others.

As of earlier this week, New York State had sent samples for nine people to the Centers for Disease Control and Prevention for testing. Four samples tested negative, while the state is awaiting results for the other five.

A Q&A with  Susan Donelan, Medical Director of Health Care Epidemiology, Stony Brook University Hospital, About the New Coronavirus

1. Is the outbreak plan for this new coronavirus any different than the plan for SARS or MERS at Stony Brook?

The 2019 novel coronavirus (2019-nCoV), a new virus that causes respiratory illness in people and can spread from person to person, shares a lot of similarities to other coronaviruses we have seen such as SARS and MERS-CoV. At Stony Brook Medicine, our teams are incorporating best practices from the Pandemic Influenza Plan. These practices are especially important during the flu season.

2. Is everyone in the emergency room taking a history on admission, particularly for people presenting with respiratory infections and a fever, that includes questions about travel to China?

As a matter of standard practice for many years, the hospital has asked all patients with any influenza-like illness [ILI] about recent travel history and is well versed in obtaining this information. Additionally, regardless of the presence or absence of travel, any patient presenting with an ILI immediately will be given a surgical mask to place over the nose and mouth, in order to limit the spread of any respiratory pathogen they may be harboring.

3. How much space could Stony Brook make available if the hospital needed to isolate people who might have this virus?

Stony Brook Medicine has already performed a walk-through of our facility to identify where patients could be cohorted if there were suspicions for this illness, and should they need hospitalization. As per the [CDC], people confirmed to have the 2019-nCoV infection, who do not need to be hospitalized, can receive care at home.

4. What is the current recommended treatment plan if someone either has or is suspected to have this virus?

Currently, there is no vaccine available to protect against 2019-nCoV and no specific antiviral treatment is recommended for the infection. People infected with 2019-nCoV should receive supportive care to help relieve symptoms.

“These five individuals remain in isolation as their samples are tested at CDC,” Gov. Andrew Cuomo (D) said in a statement. “While the risk for New Yorkers is currently low, we are still working to keep everyone informed, prepared and safe.”

China has been working to contain the virus by enforcing lockdowns in cities like Wuhan. Indeed, an unnamed Stony Brook scientist, who was visiting his family, has been unable to leave China to return to Long Island. Through a spokeswoman, Stony Brook said it is grateful for the help of Sen. Chuck Schumer (D-NY), the State Department and the university community in trying to bring him home.

When he returns to the United States, the professor will remain in quarantine until he could no longer be a carrier for the virus. 

Area hospitals, meanwhile, are watching carefully for any signs of coronavirus.

“There are procedure plans in place in every hospital,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases in the Department of Medicine at Stony Brook University’s Renaissance School of Medicine. “There is always a concern when these outbreaks are announced.”

At this point, however, the World Health Organization has not declared the outbreak an emergency. The CDC has classified the new coronavirus threat level as “low.”

The coronavirus, called 2019-nCoV, is in the same family as sudden acute respiratory syndrome and the Middle East respiratory syndrome. The initial mortality rate from the current coronavirus is lower than the 10 percent rate for SARS, which spread in 2002, or the 30 to 35 percent rate from MERS, which started in Saudi Arabia in 2012.

The timing of the virus is challenging because the symptoms are similar to those for the flu, which has become more prevalent in New York and around the country this winter. Coronavirus symptoms, according to the CDC, include coughing, fever and shortness of breath.

While airports like John F. Kennedy Airport in Queens are screening people who arrive from Wuhan, efforts to determine whether they may be carrying the virus could be limited, in part because the incubation period could be as long as two weeks, during which time an infected person could be contagious.

Infectious disease experts suggested practicing the kind of hygiene that would reduce the likelihood of contracting the flu. This includes: washing hands for at least 20 seconds, using hand sanitizer and maintaining a distance of about 3 feet from anyone who has the sniffles or appears to be battling a cold. Infectious disease experts also suggest cutting back on handshakes, especially with people who appear to be battling a cold.

“If you have immunocompromised people, they should be extra careful,” Fries said, adding that the CDC, which has been regularly updating its web page, www.cdc.gov, has been working tirelessly with national and state health officials to coordinate a response to this virus, wherever it hits.

“The New York State Department of Health and the CDC need to be praised for all the work” they are doing, she said. “They have a task force that doesn’t do anything else but prepare for patients coming from outbreak areas.”

Scientists around the world have also been working to develop a vaccine for this new virus. According to a recent report in The Washington Post, researchers anticipate developing such a vaccine in as little as three months, which is considerably shorter than the 20 months it took to develop a vaccine for the SARS virus. The Post, however, suggested that the development of a vaccine would require testing before it received approval.

Fries said the concern about the coronavirus comes less with the current death toll than it does with the effect as it continues to spread.

“It’s important to see how far it spreads and what the real mortality is,” which is tough to track because the outbreak is still at the beginning and scientists and public health officials are still processing new information, she added.

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Hospital Prez Looks Back at His 34 Years, End of Community Hospitals Across LI

Kenneth Roberts, Mather Hospital president, signs a banner that will be hung shortly outside the hospital to celebrate its 90th year. Photo by Kyle Barr

By Julianne Mosher

It all started with a dream from a local businessman and third-generation shipbuilder who lived in Port Jefferson. 

John Titus Mather passed away in 1928, but he was a huge part of the shipbuilding community during the later 19th century and early part of the 20th century. Before he died, he knew that he wanted to leave a legacy that would help the Port Jeff community for years to come. If only he could see it nine decades later. 

Mather held its cornerstone dedication ceremony May 4, 1929. Photo from Stu Vincent

This year celebrates the 90th anniversary of Mather Hospital, formally known as the John T. Mather Memorial Hospital, named after the man who envisioned the institution. His will clearly outlined that his family and loved ones were to be taken care of, and instructed his executor to “incorporate under the laws of the State of New York a nonsectarian charitable hospital, to be located in said village of Port Jefferson … so designed and constructed as to permit future enlargement, assuming that future needs may justify such action. It is my sincere hope that the citizens of Port Jefferson and vicinity will give their liberal and devoted support to said institution and endeavor to make it a success and a credit to the community,” the Mather website stated. Today, the hospital is decorated with a nautical theme to honor its founder. 

Opening Dec. 29, 1929, the hospital became a staple on Long Island, featuring 54 beds and state-of-the-art technology of its time. 

“Mather Hospital was the first community hospital in the Town of Brookhaven,” said Kenneth Roberts, president of the hospital. “So, for a long time, it was the gem of the community and it remains so to this day.”

And every 10 years or so, it seems like the hospital is adding a new service or wing, constantly evolving to become better than before. In 1962, a new surgical suite, emergency facility and an intensive care unit joined in. The expansion resulted in additional beds, totaling 110. A new psychiatric unit was added in 1973, upgrading the hospital to 203 beds and by 1997, the hospital reached its
current bed count of 248 spots. 

The reason for the constant upgrades was to continue better serving the community, the hospital president said. 

“Technology has changed dramatically,” Roberts said, “And has changed the delivery of health care here.”

Roberts became president of Mather in 1986 and has pioneered dozens of changes throughout the campus. For starters, people don’t smoke on the campus, anymore, which if one weren’t around at that time, came as a shock to the multitudes of hospital staff who weren’t shy of smoking. 

Mather Hospital was also the first hospital on Long Island, including Brooklyn and Queens, to have a successful in vitro fertilization program that started up in 1988. Being a leader in that program, it eventually became available elsewhere, so in 2008, the program closed to make room for others. 

“We just change with what the community needs,” Roberts said. 

Alongside the hospital, Roberts has also seen the community expand. 

Mather Hospital’s original facade. Photo from Stu Vincent

“I think it’s grown a lot,” he said. “Obviously the traffic, the expansion, the adding of lights on 347, the construction of the third lanes… there’s been a lot of growth in housing and in population out in this area. So basically, we made an attempt to change with the needs of the population.”

As the area grew, so did the competition from St. Charles Hospital down the road, and Stony Brook University Hospital just 15 minutes away. 

“We were the first community hospital and then St. Charles converted itself from a polio institution to a community hospital and we work closely with them to not compete in major services,” Roberts said. “But at the same time, to provide all the services that the community needed.” 

When St. Charles redesigned itself to a hospital in the 1940s, it actually ended up helping Mather which was at 120 percent patient occupancy. 

In 2013, it was recognized as a Magnet-designated hospital by the American Nurses Credentialing Center, which recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. 

Mather employs over 2,600 people, and has more than 600 staff and affiliated physicians. In 2016, the hospital cared for more than 12,500 inpatients and over 40,000 emergency patients. 

In December 2017, Mather formally joined the Northwell Health system as its 23rd hospital, something the hospital president constantly lauded. 

“It was a once-in-a-century decision going from an independent hospital to joining a larger system,” Roberts said. “Once you join a larger system, you’re in that larger system forever and it’s a big decision to make. We were extremely happy and pleased with the amount of resources that Northwell brings to the table.”

A group of nurses at Mather during its early years. Photo from Stu Vincent

Roberts added that there are no independently owned community hospitals on Long Island anymore. It’s a trend that’s predicated on costs and need, something, he said, a single standalone hospital would have a very difficult time doing on its own. Roberts said he sees a future where all hospitals and similar institutions are consolidated under just four or five health care companies.

“There’s a whole host of reasons why hospitals are going the same route, like all the other industries,” he said. “We see in the whole economy everybody’s changing: Airlines are basically consolidating, the big accounting firms … newspapers are consolidating.”

And although things have changed at Mather, Roberts is happy with what the
future holds. 

“I think that the future of Mather Hospital looks very good because of our affiliation with Northwell,” he said. “The services we will provide on a very high-quality basis, and we will continue to innovate and provide the services that the community needs.” 

He added that he is waiting on an approval to start a cardiac catheterization and electrophysiology service at Mather, and plans to grow its outpatient care over the next decade.

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