Mount Sinai Doctors Faculty Practice (MSDFP) is a multispecialty group of more than 2,000 physicians integrated within the Mount Sinai Health System. The current onboarding process can be unmanageable for administrators and confusing to doctors, and can lead to dissatisfaction and high turnover. MSDFP engaged a Capstone team to investigate and analyze the onboarding process for new physicians. The team analyzed current literature, constructed a process map from the physician’s perspective, and interviewed administrators from different hospital systems across the nation. The team produced a final report outlining best practices and recommendations to improve MSDFP’s onboarding processes for short-term and long-term success.

The Violence Prevention Initiative of the New York City Department of Health and Mental Hygiene (DOHMH) oversees NYC’s Hospital-Based Violence Interruption Programs (HVIPs). While HVIPs are an essential component of NYC’s public health-based violence prevention strategy, they are deeply underfunded and struggle with sustainability. DOHMH enlisted a Capstone team to identify ways to strengthen city-wide HVIPs with a special focus on sustainable financing. The team conducted an analysis of public datasets to explore violence at the national, state, and city levels and to better understand NYC rates of violence relative to other localities. The team completed further research and structured stakeholder interviews, and developed a database of national HVIPs. The final report includes an advocacy policy brief based on the team’s findings and sustainability recommendations, including ways to use Medicaid as a vehicle to reimburse NYC HVIPs.

Surgical technologies at the NYU Langone Orthopedic Hospital continue to evolve and expand, allowing surgeons to have better accuracy and spend less time in the operating room. Robotic-assisted total joint replacement surgery has shown additional benefits, such as faster recovery times and improved patient outcomes and satisfaction. Long-term, these technologies can be cost-saving for a hospital. The Capstone team was tasked with providing a financial analysis of the implementation of robotic technology for total joint and spine surgeries at three client sites: NYU Manhattan, NYU Brooklyn, and NYU Long Island. The team evaluated operating room volume data, reviewed current and upcoming orthopedic technologies, conducted a SWOT analysis, and researched market trends. The team’s final report outlines recommendations to guide technological implementation at NYU Langone hospitals.

Established in 2014, RIP Medical Debt has eradicated over $5.6 billion in medical debt to date, providing financial and mental relief for over three million people. Despite significant legislative changes like the Affordable Care Act, the national medical debt crisis persists, often destroying the financial stability of America’s most vulnerable communities: the sick, the elderly, and the poor. RIP Medical Debt engaged a Capstone team to provide a comprehensive overview of the medical debt crisis, including extensive research to determine the scope of the crisis, how medical debt is created, why it persists, and who is most impacted. The team conducted a landscape analysis, interviewed key stakeholders, and surveyed existing efforts to decrease medical debt. The final report includes the team’s analysis of the current state of medical debt as well as specific recommendations to guide RIP Medical Debt’s emerging public policy agenda.

How should healthcare systems in the US navigate physician shortage? The COVID-19 pandemic drew attention to this shortage, but other long-term challenges, such as an aging baby-boomer population and climate change, may further stress physician supply. These shortages are occurring at uneven rates across the US, especially in relation to geographic region and practice. A team studied relevant peer-reviewed literature and industry and government reports from the past ten years, and explored a variety of operational and technological solutions that healthcare systems can leverage to manage local physician shortages. However, in this uncertain and evolving environment, organizational strategies alone cannot remediate the national shortage. The team recommends a push for federal and state policy changes to enhance clinical worker pipelines, incentivize the equitable geographic distribution of clinical workers, and increase access to telehealth solutions.

Médecins du Monde (MdM) is a medical and humanitarian organization providing care to the most vulnerable populations in the world. For over 30 years, MdM has supported Sexual and Reproductive Health (SRH) projects, and is especially committed to providing SRH services in crisis and development settings. MdM engaged a Capstone team to identify telehealth approaches to improve SRH education and promote accessibility to SRH services for adolescents in Kinshasa, Democratic Republic of the Congo. In order to assess SRH interventions and specific needs in Kinshasa, the team conducted qualitative and literature-based research, created an environmental scan, and interviewed youth and institutional stakeholder groups. Using its research, the team created two digital survey tools and developed an annotated bibliography with existing scientific and operational studies on SRH interventions in low-resource settings. Based on its findings, the team proposed contextualized recommendations for MdM to guide future SRH strategy and efforts.

On March 20, 2020, New York State Governor Andrew Cuomo announced a statewide moratorium on both residential and commercial evictions to mitigate the spread of COVID-19 by ensuring people could remain in their homes and not face displacement. The Capstone team examined the effectiveness of the eviction moratorium in mitigating the spread of the virus in NYC by using publicly available data on the city’s evictions and COVID-19 cases. The team conducted difference-in-difference analyses to estimate the impact of the eviction moratorium on COVID-19 cases and the role of New York State’s Emergency Rental Assistance Program and other social safety net initiatives. The initial results showed that the moratorium, post ERAP start date, had significant effects in slowing the rate of new COVID-19 cases, overall hospitalizations, and deaths. The team’s final report details its findings and conclusions, as well as possible policy implications for how local, state, and federal governments can prepare and address future public health crises.

The NYC Board of Correction (BOC) is a nine-person, non-judicial oversight board that regulates, monitors, and inspects NYC correctional facilities. During the COVID-19 pandemic, the BOC modified its oversight model to document the public health crisis in jails. Priorities included monitoring the system’s evolving response, facility adherence to agency plans, and general operations and compliance with BOC Minimum Standards. With over a year’s worth of data, the BOC engaged a Capstone team to create a comprehensive report on the impact of COVID-19 in jails. The team analyzed the data, conducted a literature review, and coded interviews held with incarcerated people. Based on its findings, the team compiled a final report that outlines areas for improvement and tangible recommendations to address existing gaps in the system.