CEO Blog: NHRMC ED - North: Expanding Emergency Services to Meet Patients' Needs

April 14, 2015

By NHRMC President and CEO, Jack Barto

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As we announced some time ago, New Hanover Regional Medical Center is building a standalone emergency department to serve the rapidly growing areas of northern New Hanover County and eastern Pender County. NHRMC Emergency Department - North will open on May 20 and will no doubt provide a much-needed service to that area.

But I want the community to understand that the modern Emergency Department is evolving to meet patient need. The new ED - North will address current expectations of today's patients and families. In much the same way, the upcoming renovation of our ED at the NHRMC campus on 17th Street will meet the unique needs of that population, even offering a "value office" to facilitate follow-up care for patients and their referral to community resources.

The role of the community emergency department is changing right before our eyes. We have to challenge ourselves to re-think the term "emergency medicine," who seeks it and why. When patients today seek emergency care, they have a choice on where to go and expect value and an excellent experience when they get there.

This is why we used Lean methodology for construction and design plans, as we have done with the renovation at the 17th Street campus and as we do now do with all major business decisions. With Lean, the goal is to focus on how to gain the most quality for the patient while eliminating waste and duplication. We asked our ED leadership as well as construction leadership to serve on these teams. But also playing large roles are frontline ED nurses and other caregivers who provide care every day, and the most important constituency: Patients.

We have patients helping us design facilities to treat patients. This is Lean at its best, and this is how hospitals will have to think to meet today's challenges, when patients and their employers are holding us all to higher standards of quality and value than ever before.

The resulting designs look at every square foot of space, every service and function, from the patient's point of view.

Arriving patients at NHRMC ED - North will immediately find that they are not directed to waiting rooms as they have known them. Instead, the ED is designed so that patients are checked in and screened right away, and if X-rays, lab tests or pharmacy are needed, then those services are on site for patients. We're also moving our nearby Health & Diagnostics site to the new ED for enhanced patient convenience.

Many patients will seek the kind of care that many of us might have sought from our family doctor. There are multiple reasons for this - it may be after hours, or the patient may not have access to go anywhere else - but this is reality in today's emergency department.

Instead of a traditional bed, patients with less emergent needs may be placed in a "vertical bed," which is another word for a treatment chair. This is a better use of space, it's more comfortable for the patients, and it better matches our care to the patients' needs.

The treatment rooms themselves have been the subject of much discussion and planning from the patient's point of view. As the process moved forward, two questions came up that had to be resolved: Where to put the caregiver's sink, and where to put seating for the family?

Surprisingly, we found little research had been done on how to optimize standalone emergency departments for patients and caregivers. So we did a little of our own. The result? Placing the family at the patient's head allows for better face-to-face communication with the provider, and placing the sink at the front of the room - before reaching the patient - allows staff to use hand-sanitizing gel and wash their hands more easily prior to engaging with the patient.

Simple steps, right? Well, by smartly designing the 10 exam rooms and one critical care room in the new ED, we were able to reduce the square-feet per room by 10 percent - a large contributor to overall savings of $596,000 that came from finding efficiencies like these. That's money we can invest in patient care and in the community.

The NHRMC ED - North will be a one-of-a-kind place to get emergency care, but not the last of its kind. The expansion and upgrade of our ED on the 17th Street campus will use many of the same design features. The healthcare design of the future will meet patients where they are and build to their needs, their comfort and their safety. When it opens May 20, the NHRMC ED -North will be a shining example of how design can be tailored to the needs of the patient.

The general public is invited to a community event for NHRMC Emergency Department - North from 2 to 4 p.m. on Saturday, May 16. The address is 151 Scotts Hill Medical Drive.