Sampson Regional Medical Center’s emergency room, designed in the 1970s, has a bed capacity that can accommodate about 17,000 visits annually, but in recent years the volume of patients has been double that. A change was needed, and that change is now coming.
Renovations are underway within the hospital’s Emergency Department to meet the needs of local patients. The $500,000 project will increase bed capacity without new bricks and mortar, modifying the floor plan to downsize the current lobby and waiting area space so that it can become part of the Emergency Department treatment area.
In all, the hospital is increasing that emergency bed capacity by nine, from 14 to 23 beds, to help a patient volume that now hovers around 35,000 a year — roughly 100 patients each day.
“That’s continuing to grow. We’re trying to find a creative way to take care of that volume safely and make sure we have beds for them,” Sampson Regional CEO Dr. Shawn Howerton said. “We found a way to have less waiting room and more bed capacity. Shrinking our waiting room a bit allows us to expand our ER within the same footprint.”
There were multi-million dollar plans about a decade ago to rebuild the ER that never came to fruition. Putting $7-8 million in a sweeping renovation is not the best move with the “healthcare roller-coaster” that is being experienced these days, Howerton noted. Instead, the hospital was able to work with a local contractor to modify the floor plan.
Clinton-based HN Carr Inc., which recently renovated Ribeyes Steakhouse of Clinton, received the bid award for the hospital project through a requests for proposals process. Howerton lauded the contractor for working with the hospital to get the project down to a manageable half-million dollars from a previous range of $800,000-$1 million.
After years of talk about how to best expand the ER, hospital officials said, the time to do something had come.
“We often do not have enough beds open for the number of patients we have registered during peak times,” said Amber Cava, vice president of marketing and community relations at the hospital. “This leads to longer than desired waits in the waiting area and, at critical times, requires us to use ‘hall beds’ in the ED to manage patient volume. By increasing bed capacity, we can direct-bed more patients when they present to the ED.”
The ER’s medical director Dr. Steven Kelley said the benefit that comes with an ER expansion — it will be coupled with additional staffing — is “considerable.”
“Right now, we’re running with just one physician and, at optimal times, running with two PAs (physician assistants) and one physician,” Kelley said. “Hopefully, we will have another physician shift within the day.”
That is still being studied, but Kelley said the hope is to have three physicians total in a 24-hour period, with shifts overlapping throughout the day.
“I think it will take a lot of the load off, especially mid-day,” he remarked. “Starting at about 9 a.m. to 5 or 6 in the afternoon, it gets pretty busy in there.”
“We’re going to take each day as it comes and look at the volumes,” said Laurie Smith, director of Critical Care Services, which includes the ER and the Intensive Care Unit. “The nursing staffing will be adjusted based on the volumes.”
While there used to be about 62-65 chairs in the Emergency Department waiting area, the renovation will reduce that to about 40, a number that will be split into two separated waiting areas that allow for segregation of really sick patients and those who are not.
Kelley noted the door-to-doctor time is 12-13 minutes already. The only change will be getting out of the waiting area and into a room sooner.
“We will grow staff as we grow our beds,” Allison Taylor, chief nursing officer, pointed out. “The process in the back will not change, because staffing will change to match. So patients should not see a difference once they go to beds in the back. We just have more space to pull patients back quickly.”
Five Fast Track rooms that allow for patients with non-emergency conditions to be seen expeditiously will also remain. The ultimate goal of the ongoing project is to cut down on wait times in the lobby.
“Our goal is to reduce reliance on the lobby for those patients who are waiting for care,” Cava noted.
“What we’re hoping is that there will be much less movement for patients in the future,” added Smith, who noted that lab work and X-rays have traditionally required patients to go to and from the ER waiting room. “I think that’s the first difference patients who use our ER will notice.”
Phases 1 and 2 of the plan — changes to the private vehicle entrances and lobby area to allow for bed expansion, as well as expanding the trauma space from one room to two — are expected to be done by the first of the year.
That move is important, hospital officials said, because trauma rooms are often used during catastrophic events such as natural disasters or in cases of industrial accidents and car crashes, where more than one person is likely to require emergency care.
“For the longest time we’ve only had one and that becomes a problem,” said Kelley. “With this (second trauma room), if I have two patients or more that come in, we can have that collapsible wall in the middle that allows you to direct and manage care with PAs in the same room. That has been a long time coming. We have not had that.”
After the first of the year, phase 3 of the plan will be completed, including reducing one of the curtained rooms to allow for expansion of the remaining six, which will enhance privacy with new partitioned walls. That will start in March, following cold and flu season.
“To be able to offer that to patients is significant,” Cava noted.
Howerton said the renovation as a whole is a feasible way to extend improved care to patients, whose tally will only continue to grow. That is a continuing effort.
“It puts us in a good position for our current state,” the hospital’s CEO said. “As our volume grows, we’ll have to come up with Plan B and C over the next 10 years.”
Reach Managing Editor Chris Berendt at 910-249-4616. Follow the paper on twitter @SampsonInd and like us on Facebook.