Physician Leader Takes the Reins at Mount Sinai South Nassau

Adhi Sharma, MD, shares how his background has prepared him for this role, and how he plans to lead Mount Sinai's flagship hospital.

Long Island-based Mount Sinai South Nassau has welcomed a new president.

Adhi Sharma, MD, who was elevated to lead the Oceanside, New York-based hospital at the beginning of September, is the first physician leader to command the almost century-old hospital.

Sharma, who served as the hospital's chief medical officer and executive vice president for clinical and professional affairs, is succeeding Richard J. Murphy, who is retiring at the end of the year.

Recently, Sharma spoke with HealthLeaders about how his background has prepared him for this role, and how he plans to lead Mount Sinai's flagship hospital.

This transcript has been edited for clarity and brevity.

HealthLeaders: How does your background as an emergency medicine physician impact your leadership style?

Adhi Sharma: As an emergency medicine physician, there are three things that we're used to:

1. Constant chaos

Working in that chaotic environment gives you a sense of calm within the storm, and that's helpful for us to have that mindset.

2. We work with all-comers

You never know what's going to walk through the door. You have to be prepared to take care of it and then you have to work with other team members to provide comprehensive care for certain patients. That helps because you work across the platform in the emergency department. We are not limited to one area of the hospital per se, even though it is one space in the hospital.

3. It gives you a sense of the clinical needs of an entire organization

In the emergency department, if we can't take care of that patient, we have to transfer that patient. We know what services are critical, what types of programs we need to have in place to support the community, and so emergency physicians are acutely attuned to that.

HL: After joining Mount Sinai South Nassau in 2014, you have served in several leadership positions including Medical Director for Utilization, EVP of Medical Affairs, and Chief Medical Officer. How has your internal succession history helped you to prepare to lead as president?

Sharma: From the beginning, I got an interesting introduction to Mount Sinai South Nassau, at that time South Nassau Communities Hospital. Medical utilization is an interesting space where you're looking at how effectively care is provided, where are your care efficiency gaps, and if we are doing the right things for the patients in the time that they needed done. Sometimes you're doing too much, and patients are staying longer in the hospital and are exposed to things they don't need to be exposed to. Sometimes you find the opportunities to provide more comprehensive care as well.

In the medical director for utilization role, I was able to meet with a lot of the different doctors and I was able to round on the units in a capacity where people were having candid and open care conversations. That gave me a good Introduction not only to the organization, but also to the medical staff. I got to work with every unit and department in the hospital and work with them almost on a peer-to-peer level, so I got to learn the organization from the inside.

When I stepped into my next role, which was Chief Medical Officer, that information was valuable for me to help design models of quality improvement and performance improvement. In a sense, in my previous role, I got to find out where all the skeletons were, and so I got to work on that directly with having that insider information.

Then all of that culminates into the final role, which was executive vice president in clinical professional affairs, as well as Chief Medical Officer at the same time. In that third role, I got to work with non-clinical departments, including IT, I worked closely with finance, had a lot to do with budgeting and all these other aspects of hospital operations that are non-clinical. If you add it all up, I had run the bases around the hospital and got "home" with an understanding and a perspective from each part of the ballpark.

HL: How have the COVID-19 patient surges affected the hospital?

Sharma: We were hit very hard. New York was not spared during that initial surge. Our hospital serves a population of around 900,000 in our primary and secondary catchment areas. For our size, we serve a large population of all potential patients. And we saw many of them. Thousands of COVID patients came through our doors. At our at peak in April 2020, we had 405 COVID patients in-house with nearly 100 on ventilators, and another 100 patients on top of that for other medical reasons.

While we normally run between 320-340 beds, we had a surge of over 500 at our peak. It tested our operational agility, it tested our staff, it tested our ability to provide care in all venues. I was proud to see not only how the organization responded, but also how our staff all rolled up their sleeves and got it done.

We surged to about a little less than one and a half times our normal volume, but we didn't have a single patient outside of a care area. We didn't have a patient in the cafeteria, we didn't have a patient in the hallway, we didn't have a patient in the conference room. All of our patients were cared for in areas where we provide patient care. We're proud of that fact because that demonstrated the ability of the hospital to effectively take care of these patients in spaces where they should be cared for.

HL: How have you led the hospital through the pandemic so far?

Sharma: We used our best ability to continue operations. We deployed staff. We got together in early February 2020, and we made purchases at that time including ventilators and things that we thought we might need, and we absolutely did need them. In fact, on the day when we were running out of ventilators, the shipment arrived. We had a very proactive team, leadership, and nursing leadership. We were able to secure many of the items we needed well ahead of their demand. That gave our staff the protection that they needed to care for these patients.

We are also part of the Mount Sinai Health System and being part of the system helped us tremendously with clinical protocols, getting certain treatments that were limited in access, personal protective equipment, and certain supply chain issues that we were having that the system was able to help us.

We were also able to do certain things independently and all of those things culminated in a strong response. Our staff felt they were protected and that our patients were cared for in a way that was appropriate and consistent with our commitment to quality.

We have 3,700 staff and everyone rolled up their sleeves. Our staff is just so resilient and dedicated to our patients. They've been doing this since March of 2020, so think about that. In some ways it's unrelenting; our staff are still going strong to their credit.

HL: What will your first 90-days as president look like?

Sharma: Dealing with the global pandemic, that's an ongoing concern. Despite the pandemic, we are growing the hospital and trying to provide additional services for our community. We have a $400 million capital program that's in progress. I have to make sure that we don't lose any momentum there, that we keep those programs growing and evolving and getting to fruition.

Similarly, we have this system integration with Sinai that's along a certain path, so I will have to make sure that we continue along that path. Any obstacles or hurdles that we hit for either our capital programs or system integration path will have be addressed, and we'll work our way through those and get to the objective, which is to be the flagship hospital for the Mount Sinai Health System on Long Island, and be able provide advanced tertiary care services to our community, and make sure they can get the care they need, when they need it, in their own backyard.