Dr. Samir Sinha is a passionate and respected advocate for the needs of older adults. Dr. Sinha currently serves as the Director of Geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto and was recently appointed the Peter and Shelagh Godsoe Chair in Geriatrics at Mount Sinai Hospital. In 2012 he was appointed by the Government of Ontario to serve as the expert lead of Ontario's Seniors Strategy. He is also an Assistant Professor in the Departments of Medicine, Family and Community Medicine, and the Institute of Health Policy, Management and Evaluation at the University of Toronto and an Assistant Professor of Medicine at the Johns Hopkins University School of Medicine.
A Rhodes Scholar, after completing his undergraduate medical studies at the University of Western Ontario, he obtained a Masters in Medical History and a Doctorate in Sociology at the University of Oxford’s Institute of Ageing. After returning to pursue postgraduate training in Internal Medicine at the University of Toronto, Dr. Sinha went to the United States where he served as the inaugural Erickson/Reynolds Fellow in Clinical Geriatrics, Education and Leadership at the Johns Hopkins University School of Medicine.
Dr. Sinha's breadth of international training and expertise in health policy and the delivery of services related to the care of the elderly have made him a highly regarded expert in the care of older adults. He has consulted and advised hospitals and health authorities in Britain, Canada, the United States and China on the implementation and administration of unique, integrated and innovative models of geriatric care that reduce disease burden, improve access and capacity and ultimately promote health.
Areas of Expertise (5)
Quality of Care
Ageing in Place
Carers and Caregiving
Oxford University: Ph.D., Geriatrics
Oxford University: M.D., Medicine
- Mount Sinai and the University Health Network Hospitals : Director of Geriatrics
- Ontario’s Seniors Strategy : Provincial Lead
- University of Toronto : Assistant Professor of Medicine
- Johns Hopkins University School of Medicine : Assistant Professor of Medicine
Media Appearances (6)
Mt. Sinai Leads the Revolution in the Care of Seniors
Toronto Star Newspapers Ltd. print
Few people are as aware of that as Sinha, at 34 one of the youngest geriatricians in Canada and a man who is determined to help revolutionize the way in which we care for seniors.
Mount Sinai's aim is simple: To get vulnerable seniors, many of whom are so housebound they can't even get to a doctor's office, back on their feet and back into their homes, with the necessary supports, as quickly as possible.
The team approach is also intended to focus better care on the so-called “frequent-fliers” — the frail elderly with four or more chronic conditions that land them in the emergency department on a regular basis.
To better help them manage their illnesses, the hospital has partnered with House Calls, a multidisciplinary team headed by Dr. Mark Nowaczynski, as well as the province's Community Care Access Centre, to ensure they get both the medical care and support they need at
People to Watch: Dr. Samir Sinha
Toronto Star Newspapers Ltd. print
In the two years since he has taken on the job, Sinha has transformed the way health care is delivered to those aged 65 and up with the aim of helping them return home to live independently and with the highest quality of life possible.
His success has not gone unnoticed. This past spring, Ontario Health Minister Deb Matthews tapped him to lead the province’s “seniors care strategy.”
At only 36, this wunderkind has a daunting responsibility on his shoulders: to overhaul the way health care is delivered to Ontario’s 1.9 million seniors.
It’s easy to see why Matthews chose him. In addition to being an MD, the Winnipeg-born Sinha is a Rhodes Scholar with a master’s in medical history and a PhD in sociology, both from Oxford. He also did a fellowship in geriatrics at Johns Hopkins.
Sinha comes from a family of doctors. His older brother is a cardiologist at Johns Hopkins. His Indian-born parents reside in Winnipeg, where they both work as physicians. And his maternal great- grandfather was the surgeon-general in the Indian state of Uttar Pradesh.
His days are long, divided between meeting bureaucrats and seeing patients. He squeezes in exercise by using the city’s BIXI bike system, cycling between his condo at Queen and Spadina, the hospitals and Queen’s Park.
At Mount Sinai, Sinha has succeeded in significantly decreasing patients’ length of stay, urinary catheter use and hospital re-admission rates. And under his watch, the number of patients who end up returning to their own homes — rather than going to nursing homes or rehabilitation facilities — has dramatically increased.
The seniors strategy, which he delivered to Matthews before Christmas, is seen as key to the keeping the province’s health system sustainable.
“If we neglect their needs, then they are going to be bouncing in and out of hospitals,” he warns, “they are going to be using very expensive forms of health care, they will need institutional care, they won’t be happy and we won’t be happy because it is not recognizing an opportunity to do better and create a sustainable health care system.”
Don't Seniors Deserve Better?
Maclean's Magazine print
Then there’s Dr. Samir Sinha, the dynamic new director of geriatrics at Mount Sinai in Toronto,
who approaches eldercare with evangelical zeal. The hospital board gave him a mandate to do what’s best for its older patients, to make geriatrics a core priority,
to have an integrated team deal with every aspect of their hospital stay—and, where possible, to meet their needs as outpatients or at home. “Our goal,” says Sinha,
“is that people in the community never have
to come visit our hospital.
The program was in its infancy in mid-September when Mr. W arrived in the ER. He was screened as all patients 65 and older now are to determine his capabilities and risk factors. On Monday, a geriatric emergency nurse alerted Sinha to Mr. W’s fragile state. Where do you want to go from here, Sinha asked during his bedside consultation. “I want to go home,” said Mr. W. Out went the catheter and intravenous, in came physio and occupational therapists. Some two weeks later, Mr. W pushed his walker out the hospital door. Nowaczynski read Sinha’s discharge notes, and thought: “Finally, somebody who gets it.” He and Sinha have since formed a collaborative, interdisciplinary team.
They believe they have seen the future, and a part of it is reminiscent of the past: a time when the knock on a patient’s door made a world of difference. The two doctors recently paid a visit to the home of a rejuvenated Mr.W. As his 101st birthday approaches, he is busy writing his memoirs.
Zoomer Magazine print
Sinha is not only a renowned geriatrician but one who had written a blueprint for a comprehensive circle of care for elders that both starts and ends in the community and includes the emergency department, out-patient clinics and in-patient care. This encounter with Mr. W. linked him to Nowaczynski’s House Calls unit – and Sinha quickly recognized it as the perfect vehicle for providing the care beyond the hospital.
NOWACZYNSKI HAS HIGH PRAISE FOR SINHA.
“He completely gets it. We need to ramp up the expertise of the doctors providing care to seniors, especially with the population aging,” he says.
Sinha believes every hospital in Canada should be a geriatric-centred one. “We’re increasingly learning that
bed rest can be the demise of older people,” he notes. Managing geriatric issues and helping these people live
at home makes good economic sense as well. “Every patient you prevent from going to a nursing home, just on a yearly basis, saves the system about $70,000,” he says.
Sinha is both a gerontologist – an expert in the psychological and social aspects of aging – and a geriatrician– an internal medicine specialist trained to diagnose and treat older adults. Typically, older patients have complex medical issues that often require multifaceted care. “Geriatrics is a team sport,” Sinha is fond of saying.
This past April, Mount Sinai Hospital opened a 28-bed Acute Care for Elders (ACE) medical unit, with its own
team: a nurse practitioner, occupational therapist and social worker. Nurses and other staff on the unit receive
19 hours of advanced training to raise awareness of various geriatric syndromes. Subtle changes like non-glare floors and outlining patients’ room doors in contrasting paint make the ACE unit less difficult for the physically or cognitively impaired.
At the weekly “rounds,” I join Sinha as he meets with his team – which also includes a resident in internal
medicine, a pharmacist and the House Calls nurse practitioner – to assess each patient’s progress. It’s where I first heard Heather Taylor mention Syd F. She’d sent him to hospital on New Year’s Eve, delirious as a result of a kidney infection. For years, he’d been the primary caregiver.
Building a Health System that Meets the Needs of an Aging Population
Hospital News print
Dr. Samir Sinha, expert lead of Ontario’s Seniors Care Strategy, Director of Geriatrics at Toronto’s Mount Sinai Hospital and passionate advocate for the health care needs of seniors, suggests that if we miss the subtleties of the current state of healthcare, seniors may be blamed for Canada’s health care crisis, instead of placing the responsibility where it belongs – within the system itself.
Insisting aging is not a disease but that it is a triumph, Sinha suggests, “We seem to be blaming older adults for causing inefficiencies in our health care system when perhaps, it is a lack of planning and as such, it is our responsibility to build a system that is more responsive to their needs.”
In Ontario, older adults represent only 14.6 per cent of the population and yet, due to complex health issues, they account for nearly half of all health care spending in Ontario. Still, it’s not their fault the system isn’t prepared to meet their needs.
In recognition of the need to revisit traditional approaches to care, Toronto’s Mount Sinai Hospital designated geriatrics as a core strategic priority in 2010, making it the first hospital in Canada to do so. As part of an ambitious plan, dedicated teams of health professionals screen every older adult who visit the hospital’s emergency department to identify their unique level of risk and programs that can help prevent emergency room visits
As a result of this innovative approach, older adults are returning home faster and more often following hospitalization. Ultimately, as a result of the risk assessment and risk mitigation, they also have a lower chance of readmission which reduces overall costs to the health care system. “It’s truly a win-win situation,” says Sinha.
In the Ontario Seniors Strategy, authored by Sinha and published in 2012, he put forth recommendations for elder-friendly hospitals, based on the success realized at Mount Sinai. The recommendations and Mount Sinai’s approach is attracting interest from Ontario hospitals, Local Health Integration Networks (LHINs), out-of-province Ministries of Health and beyond.
The innovative approach challenges deeply ingrained models of care delivery in favour of an elder-friendly, integrated approach.
Could providing hospital care for the elderly bankrupt Britain?
The Guardian online
We are increasingly coming to understand how traditional models of care also put many older patients at risk for adverse complications such as falls, delirium, drug-interactions, functional decline and death. What is most worrying is that few have come to appreciate that many of these adverse outcomes are preventable.
Even if we acknowledge the need for reforms in primary and community care, older adults will still require to be taken into hospital. Studies have also demonstrated that focused models of care that consider the unique needs of older hospital patients in emergency, inpatient, outpatient, community and home care settings can improve overall outcomes while at the same time reducing lengths of stay, admissions, readmissions, and inappropriate resource utilisation – thereby improving the overall capacity and efficiency of the system.
However, implementing innovative models that challenge deeply ingrained traditional ways of providing care has proved to be a significant challenge. Nevertheless, there has never been such an urgent imperative to develop comprehensive, evidence-based care strategies to improve the care of older adults.
As Canada is facing these exact same issues, it may also hold solutions for the NHS to consider as well. For example, Mount Sinai Hospital in Toronto became the first acute care hospital in Canada to make geriatrics a core strategic priority for the entire institution. It developed a new model of comprehensive acute care for elders focused on always delivering older patients the right care, in the right place at the right time. .
What is impressive is that this model, which seeks to identify and deal with issues early, has achieved impressive results quickly. The hospital's overall quality of care has improved; it has reduced the need for and lengths of admissions, decreased readmissions, while increasing overall patient and staff satisfaction. In short, patients are returning home in better health and staying there longer. Other hospitals in Canada are following suit given that 60% of hospital expenditures there are directed at the older population.
Could the elderly bankrupt Britain? Absolutely. However, by viewing challenges as opportunities to transform our dated models of caring for older adults, we can help ensure that the greater efficiency and capacity that will be needed can be sustained within the existing public system.
Featured Articles (6)
This book chapter provides guidance to hospitals on how to use Mount Sinai’s ACE Strategy concept, that has now demonstrated significant improvements in patient and system outcomes, to drive a broader quality of care improvement agenda across an entire hospital that help to deliver better patient and system outcomes as well.
While aging is inevitable, the proportion of Ontario’s population living longer and living well into their later years has never been greater. Our province is also aging faster than ever before. In 2011, there were 1,878,325 Ontarians aged 65 years and older, representing 14.6 per cent of the province’s overall population. However, as the boomers started turning 65 last year, this demographic imperative will continue well into the future. In fact, the number of older Ontarians, defined in this report as those 65 years and older, is expected to double over the next two decades.
Canada's aging population poses a significant challenge for the existing healthcare system. While individuals 65 and older accounted for 13.7% of the population in 2005, they accounted for 60% of all acute care service spending. This paper further illustrates how the heterogeneity of the older population and its impact on patterns of healthcare use demonstrate the failings of our current care systems. Our outdated acute care models frequently disadvantage the system's highest users, who are often characterized by factors such as poly-morbidity, functional impairment and social frailty. Understanding how implementing innovative models that challenge deeply ingrained ways of providing care has proven to be a significant challenge, this paper highlights one hospital's mission to transform current traditional paradigms of care by developing and implementing an elder-friendly hospital integrated service delivery model. This hospital aims to demonstrate wide-ranging benefits of this model that can contribute toward optimizing the outcomes of hospitalization for older adults and the system as a whole. The establishment of a national agency that could support the development of a national aging strategy to promote best practice dissemination and implementation could also ensure that the significant health, social and economic benefits that better care models can realize could be more easily achieved.
This systematic review is now Dr. Sinha’s 4th publication related to the provision of Home-Based Primary Care. He has currently received close to 1M in grants through the Ministry of Health and Long-Term Care in Ontario to study and build the evidence for this model of primary care for older adults. Through Dr. Sinha’s work with the province – more Ontarians are now receiving house calls than ever before.
In 2014, the Minister of Health Appointed 6 individuals to form an Expert Group on Home and Community Care. Our group was tasked with conducting a province-wide consultation and then the development of a comprehensive report with 16 recommendations to support the Ontario governments planned home and community care reforms. Our report ‘Bringing Care Home’ received wide attention after its release in 2015 and helped shape the immediate response of the Minister who agreed to implement all of our recommendations. Most recently, the government has credited our report in helping to influence its overall decision to proceed with the first overall restructuring of the home and community care system in 20 years with the elimination of the CCACs and the better integration of primary and community care over the coming year.
In 2015, the IRPP appointed 5 individuals to form a Task Force on Ageing. Our group was tasked with conducting a nation-wide consultation and then the development of a comprehensive report with 37 recommendations to inform the development of a National Seniors Strategy. Our report ‘Designing a National Seniors Strategy for Canada’ received wide attention after its release prior to the 2015 federal election. The framework used was based on Dr. Sinha’s prior CIHR-funded work on this same issue. Overall the report was endorsed by Canada’s national professional associations like the Canadian Medical Association as well as newspapers like the Globe and Mail etc. The most recent federal election was the most active one to date around seniors issues and we are hoping this resource will continue to influence policy discussion in the years to come.