Division of EMS & Disaster Preparedness

Emergency Medical Services - Prehospital Care

The Division of Emergency Medical Services (EMS) provides medical oversight for Mount Sinai Health System’s ambulance service. As a member of the New York City 911 EMS system, our ambulance service maintains 19 total units (7 Advanced Life Support and 12 Basic Life Support units), that operate 24 hours a day, 7 days a week, and respond to nearly 70,000 calls a year. Mount Sinai EMS aims to ensure that all our patients receive unrivaled, innovative, compassionate, and efficient mobile health care services. To achieve this goal, Mount Sinai physicians participate on the New York City Regional EMS Advisory Committee to develop city-wide emergency medical technician and paramedic protocols, promote quality initiatives in the five boroughs, and lead with innovative clinical research and demonstration projects in mobile integrated health care.

Research

Mount Sinai’s Division of EMS and Disaster Preparedness performs advanced research in EMS quality, disaster triage, and delivery model innovations such as alternative destinations and telehealth-enabled EMS/community paramedicine. We have received significant research funding from the National Institutes of Health, U.S. Department of Transportation, U.S. Department of Homeland Security, U.S. Department of Health and Human Services, the Patient-Centered Research Outcomes Institute, the Center for Medicare and Medicaid Innovation, and a myriad of private foundations.  

Our current projects include:

Emergency Triage, Treat, and Transport (ET3): Mount Sinai EMS was selected to participate in a Center for Medicare and Medicaid Innovation demonstration project known as ET3. In this program, selected EMS agencies will participate in a model alternate payment model for ambulance suppliers that reimburses for “treatment in place” and transport to “alternative destinations.” We are working together with Mount Sinai Urgent Care centers, Mount Sinai Express Care, our telehealth service (Mount Sinai NOW), and family medicine clinics (Institute for Family Health) as well as the Fire Department of New York and other 911-participating ambulance units to help reimagine and reinvent how we provide EMS care.

Community Paramedicine for CHF patients: In partnership with NewYork-Presbyterian, Mount Sinai Community Paramedicine is participating in a multi-center randomized controlled trial funded by the Patient-Centered Outcomes Research Institute to study whether community paramedicine can help reduce readmissions for patients with congestive heart failure.

Benchmarking/Improving EMS Quality: Using data from several national and regional EMS databases, the Division of EMS is working both to define and measure EMS quality metrics locally, regionally, and nationally, and to explore the association of those metrics with patient outcomes in everything from cardiac arrest to stroke and STEMI (ST-Elevation Myocardial Infarction) care.

Impact of COVID on EMS: Our faculty members are helping track and investigate the impact of COVID-19 on EMS provider well-being, EMS transport volumes, use of crisis standards of care, and the volume and treatment of out-of-hospital cardiac arrest.

To learn more about advanced research at Mount Sinai, contact the Division of EMS at Michael.Redlener@mountsinai.org.

Resident and Medical Student Education

The Division oversees a number of educational activities for medical students and residents. All residents from both The Mount Sinai Hospital and Mount Sinai West/Morningside residency programs participate in a two-week rotation that offers exposure to the various roles of prehospital health care providers and how protocols are developed. Students gain a deeper understanding of the EMS system in New York City and throughout the nation, appreciation for the role of online medical control and medical oversight of EMS, and exposure to quality improvement efforts in EMS. They complete their experience by participating in paramedic and EMT education sessions.  

We offer a two-week elective rotation for medical students in their third or fourth year of medical school as well. Availability and dates<link here> for the rotation may vary. We also permit visiting students to participate; the Office of the Registrar can provide further details

Emergency Management and Disaster Preparedness

Our Emergency Management program is dedicated to providing a critical response to disasters in the hospital or community. The program oversees planning, mitigation, response, and recovery from incidents. The program prepares and trains hospital employees in their response roles, and teaches employees and families how to prepare their homes and be disaster-ready. We work closely with city agencies to inform community members about our resources and training. Mount Sinai Emergency Management participates in the Greater New York Hospital Association’s Emergency Preparedness Coordinating Council and works with the New York City Department of Health and Mental Hygiene and the New York State Department of Health. The program continues to develop partnerships and grant funding to enhance our readiness and training.

National EMS Policy

Our faculty members are working with the National EMS Quality Alliance to develop EMS quality metrics (EMS Agenda 2050), aid in overcoming barriers and promoting innovation in EMS (emsinnovations.org), and transforming the future of EMS through the EMS Agenda 2050 and National EMS 3.0 Initiative

Community Paramedicine

In partnership with Mount Sinai Health Partners, the Mount Sinai Transfer Center, and SeniorCare EMS, the Division has developed and oversees a model of care known as Community Paramedicine. 

The Community Paramedicine program is available 24/7 to help physicians and nurses throughout the Mount Sinai Health System better manage patients with acute symptoms at home. Rather than referring a patient with acute unscheduled needs to the Emergency Department, our clinicians and partner organizations can send a community paramedic, who responds to households anywhere in the five boroughs of New York City within 60 minutes, performs a comprehensive patient assessment, and connects with our Mount Sinai NOW telehealth physicians and the referring provider to coordinate care. The program has helped more than 1,500 patients. It has helped patients avoid transport (68 percent of the time), Emergency Department visits (55 percent of the time), and hospital admissions (17 percent of the time).

To learn more about this service, contact our operations manager at Ari.Breslauer@mountsinai.org.

Wilderness Medicine

Within the Division of EMS and Disaster Preparedness exists the Section of Wilderness Medicine. Dedicated to education, training, research, and field-work, the section focuses on patient care, stabilization, and evacuation in remote and austere environments. Within the Mount Sinai Health System, the program prepares medical students, residents, and faculty to respond to medical emergencies regardless of the environment or available resources. Faculty partner with New Jersey Search and Rescue to provide its members with the most up-to-date medical education. The section's mission is to give the community the best medical care possible no matter where it is needed.

Kevin G. Munjal, MD, MPH, MSCR
System Director, Division of EMS
Dr. Munjal is an Emergency Medicine Services physician. He did his EMS fellowship at the New York City Fire Department. He also holds two master’s degrees, in Health Policy and Management and Clinical Research. He is Associate Professor in both Emergency Medicine and Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai. the System Director for the Division of EMS, Director for Mount Sinai Community Paramedicine, and Online Medical Control He also serves as Director for Acute Unscheduled Care for Mount Sinai Health Partners. A prolific health services researcher focused on community paramedicine, telehealth, and other innovations in EMS, he has received funding from the National Heart, Lung and Blood Institute; the National Institute on Aging; the Center for Medicare and Medicaid Innovation; the U.S. Departments of Health and Human Services, Transportation, and Homeland Security; and the Patient-Centered Outcomes Research Institute, as well as numerous foundations. He is the Founder and Chair of the New York Mobile Integrated Healthcare Association. He has led the development of a national framework document for “Promoting Innovations in EMS,” and serves on the Technical Expert Panel, which developed the national EMS Agenda 2050. He is also the former chair of the National Association of EMS Physicians Mobile Integrated Healthcare/Community Paramedicine (MIH/CP) committee and has authored the chapters on MIH/CP in two EMS textbooks.

Michael Redlener, MD, FAEMS
Associate EMS Medical Director, Quality Improvement
Dr. Redlener is an Associate Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai.  Dr. Redlener serves as Associate Medical Director of the Mount Sinai West Emergency Department and the Medical Director for EMS Quality in the Mount Sinai Health System. He received his medical degree from Albert Einstein College of Medicine in the Bronx, New York, then completed a residency program in Emergency Medicine at New York University/Bellevue Hospital followed by a fellowship in Prehospital and Emergency Medical Services (EMS) Medicine with the New York City Fire Department. He is double-board certified in both Emergency Medicine and EMS Medicine. 

Dr. Redlener serves as Interim President for the National EMS Quality Alliance and is the former chair of the National Association of EMS Physician (NAEMSP) Quality and Safety Committee, in which he co-founded and co-directs the NAEMSP Quality and Safety Course, a year-long course to introduce EMS physicians and professionals to the tenets of health care improvement science. He sits on the American Heart Association Coronary Artery Disease Advisory Group and serves as the New York City Regional Emergency Medical Advisory Committee as the chair of the Quality Improvement Committee as well as the Stroke Systems of Care group.    

Kevin Chason, DO
Medical Director for EMS/Transfer Services

Jeremy Rose, MD
Site Medical Director for EMS, Mount Sinai Beth Israel

Jared Kutzin, DNP, MS, MPH, RN
Director of Simulation
Dr.  Kutzin is Director of Emergency Medicine Simulation at The Mount Sinai Hospital. He is a registered nurse with advanced degrees in health policy and management, public health, leadership, and medical education. His advanced training includes completing the Clinical Quality Fellowship Program offered by the Greater New York Hospital Association and the United Hospital Fund, and the Comprehensive Patient Safety Leadership Fellowship offered by the National Patient Safety Foundation and American Hospital Association. Dr. Kutzin is certified in health care quality, patient safety, simulation operations, and as a Nurse Executive – Advanced. He sits on the New York State Board of Nursing and the New York State EMS Council and is the lead nursing representative. He is passionate about the use of simulation in EMS education and is helping to advance the profession of EMS at Mount Sinai and throughout the state.

Laura Iavicoli, MD
Director of EMS and Emergency Management, Elmhurst
Dr. Iavicoli is an emergency medicine physician with expertise in EMS/Emergency Management. She has been employed at Elmhurst Hospital Center, a teaching affiliate of Mount Sinai, for 20 years, training and teaching emergency and internal medicine residents and medical students in emergency medicine. Dr. Iavacoli serves on numerous hospital committees devoted to EMS and emergency management issues; attended more than 90 specialty seminars and training sessions in emergency preparedness over two decades; and has given more than 80 presentations to hospital staff on a variety of topics including disaster preparedness, terrorism, mass casualties, blast injuries, psychiatric effects, decontamination, and protective equipment. She has been a disaster relief team member for more than 10 years for New York City and Federal Emergency Management Agency.

George Loo, DrPH, MPH, MPA
Emergency Management Liaison, Statistician
Dr. Loo is an epidemiologist and an Assistant Professor of both Emergency Medicine and Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai. Prior to joining the faculty at the Icahn School of Medicine, he was on faculty at the State University of New York-Albany School of Public Health as an Assistant Professor of Epidemiology and Biostatistics, and was employed at the New York State Department of Health in the Office of Health Emergency Preparedness. Dr. Loo earned his Doctorate of Public Health in Epidemiology and Master of Public Health in General Public Health from the Columbia Mailman School of Public Health. He completed a Master of Public Administration from the City University of New York-John Jay College and a Bachelor of Arts from State University of New York-Stony Brook. Dr. Loo’s research interests are in emergency medicine/EMS, medical and public health emergency preparedness/response, disaster mental health, and injury epidemiology. He has published in the areas of motor vehicle biomechanics and injury, EMS, emergency medicine, first responder volunteerism/willingness, disaster preparedness, and mental health. Additionally, Dr. Loo concurrently serves on the U.S. Department of Health and Human Services–Office of the Assistant Secretary for Preparedness and Response as a federal emergency manager where he has deployed on response missions in various roles for the NY-2 Disaster Medical Assistance Team and currently for the Incident Management Team-Operations Section.

The Division has produced and contributed to a variety of research projects and publications, both peer-reviewed and not. Selected publications are listed below.

Peer-reviewed publications include:

Munjal KG, Shastry S, Chapin H, Tan N, Loo G, Chason K. Richardson R. Retrospective Cohort Study of Rates of Return ED Visits Among Patients Transported Home by Ambulance. Journal of Emergency Medicine.  2020 Jun 16;(20):30373-5. PMID 32561107.

Munjal KG, Margolis G, Kellermann A. Realignment of EMS Reimbursement Policy: New Hope for Patient-Centered Out-of-Hospital Care.  Journal of the American Medical Association. 2019 Jun 21; 322(4):302-304. PMID 31225862.

Kutzin, J. (2019). Escape the Room: Innovative Approach to Medical Education. Journal of Nursing Education. 58(8). 474-480.

Cicero MX, Whitfill T, Walsh B, Diaz MCG, Arteaga GM, Scherzer DJ, Goldberg SA, Madhok M, Bowen A, Paesano G, Redlener M, Munjal K, Auerbach M. Correlation Between Paramedic Disaster Triage Accuracy in Screen-Based Simulations and Immersive Simulations. Prehospital Emergency Care. 2018 Aug 21:1-7. PMID 30130424.

Cicero M, Whitfill T, Walsh B, Diaz MC, Arteaga G, Scherzer D, Goldberg S, Madhok M, Bowen A,  Paesano G, Redlener M, Munjal K, Kessler D, Auerbach M. 60 Seconds to Survival: A Multi-Site Study of a Screen-based Simulation To Improve Prehospital Providers Disaster Triage Skills."  Academic Emergency Medicine: Education and Training. 2018 Jan 31;2(2):100-106. PMID 30051076

Redlener M, Olivieri P, Loo G, Munjal KG, Hilton MT, Potkin K, Levy MK, Rabrich J, Gunderson M,  Braithwaite S, “National Assessment of Quality Programs in EMS Prehosp Emerg Care. May/June 2018. Vol 22/3: 370-378.

Cicero MX, Whitfill T, Munjal K, Madhok M, Diaz MCG, Schwerzer D, Walsh B, Bowen A, Redlener M, Goldberg S, Symons N, Santos J, Kessler D, Barnicle R, Paesano G, Auerbach M. 60 Seconds to Survival: A Pilot Study of a Disaster Triage Video Game For Prehospital Care Providers.  American Journal of Disaster Medicine. 2017 Spring;12(2):75-83. PMID 29136270.

Goldberg S, Porat A, Lim N, Sanchez G, Wijeratne S, Strother C, Munjal KG. Quantitative Analysis of the Content of EMS Handoff of Critically Ill and Injured Patients to the Emergency Department. Prehospital Emergency Care.  2017 Jan-Feb;21(1):14-17. PMID 27420753.

Non-peer reviewed publications include:

Munjal KG. “Is Emergency Triage, Treat, and Transport the Future of EMS?” Emergency Physicians Monthly, March 3, 2020. Available at: https://epmonthly.com/article/is-emergency-triage-treat-and-transport-the-future-of-ems/

Dorsett M, Redlener M, Braithwaite S (2019). Quality in EMS, Past, Present, and Future, Journal of Emergency Medical Services, March 29, 2019. https://www.jems.com/articles/2019/03/quality-in-ems-past-present-and-future.html

Yu Y, Rodriguez E, Munjal KG. “Journey to 2050: Creating a Culture of Innovation.” EMS World, Nov 27, 2019.  Available at: https://www.emsworld.com/article/1223571/journey-2050-creating-culture-innovation.

Health Care Innovation Awards – Emergency Medical Services Learning Collaborative. HCIA: Emergency Medical Services Report. HCIA Connect. January 2019.  

Zavadsky M, Munjal KG. “Promoting Innovation in EMS Column” EMS World, Aug-Nov 2018. 

  • “What We’ve Learned.” November 29, 2018
  • “Business Acumen - Putting It All Together” Oct 26th, 2018.
  • “The Cost of Innovation.” September 27,, 2018.
  • “Revenue Analysis.” August 29, 2018.
  • “Get to Know Value and Cost.” August 1, 2018.

Munjal KG. “Value Them Like Firefighters.” The Chief Leader, March 12, 2018.

In addition, our Division staff serves on the National Association of EMTs – EMS 3.0 Committee. The Mobile Integrated Healthcare and Community Paramedicine Second National Survey. Clinton, MS. National Association of EMTs. April 2018. (Member of EMS Pictures: https://www.dropbox.com/sh/5kvugxrinvx447q/AADpA31nbM6CXUQ9B9BP9f_Sa?dl=3.0 Committee.