Fla. Hospital Revamps ED for $26M

Fla. Hospital Revamps ED for $26M

News Jan 23, 2018

Ocala Star-Banner, Fla.

Jan. 23—The $26 million expansion of the Munroe Regional Medical Center emergency department will now begin in earnest as hospital executives on Monday launched construction of the state-of-the-art project.

The hope for the 421-bed facility is that the expansion will shrink ED patient wait times and increase efficiencies at the Southwest First Avenue campus as the number of patients coming to the hospital for emergency help continues to grow.

Some preparation site work already has been done, such as boarding up part of the ED exterior walls, placing large metal construction debris containers outside and putting men wearing hardhats to work in areas into which the ED will expand.

Munroe currently has 36 ED examination rooms: the new design will have 40. Munroe is expanding its use of fast-track observation cubicles that include recliner chairs and basic monitoring equipment rather than fully functioning treatment rooms. These cubicles are used to observe patients who do not need immediate treatment. The venue currently has one such fast-track station: the new ED will have six.

While four additional ED exam rooms and six fast-track observation cubicles may not seem like a big improvement, Munroe's director of medical services said the ED reorganization will make a night and day difference.

The ED reached its current size and design not by planning years ago, but by expanding whenever it could get the additional space, said Dr. Frank Fraunfelter. The problem was that each time the ED expanded, it could help more people but lost efficiencies.

"Over the years, it grabbed a little more space and a little more space and a little more space," he said. "So now it moves in a lot of different directions to get the job done."

The newly designed rooms within the ED facility will be equipped with machines to allow emergency doctors to treat patients suffering from a wide array of possible afflictions such as heart attacks, sepsis or when a patient stops breathing, Fraunfelter said.

In addition, patients will be treated in a new, organized and planned-out facility as opposed to a 40-year-old ED that was assembled piecemeal, he said.

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The project will include building out part of the ED onto Southwest Third Avenue. The avenue will be closed north of Southwest 14th Street to Southwest 12th Street.

Vacant land across from the ED and on the other side of Third Avenue will become a parking lot for ED patients. Because the ED is on a higher elevation than the parking area, Munroe will install an elevator and build a covered walkway from the new parking lot to the ED to make the walk easier. Most patients come to the ED in their own vehicles or are driven by a friend or family member as opposed by ambulance.

Munroe treats about 75,000 ED patients annually.

Munroe CEO Jim O'Loughlin said that while construction is exciting, part of his job will be to make sure that construction does not interfere with current ED services. The construction is expected to take two years.

"This is a major project for the hospital," O'Loughlin said Monday, following an outdoor ceremony highlighting the construction.

ED patients account for 60 percent of hospital admissions so it is important the current ED still operates as best as it can while construction continues, he said.

O'Loughlin said he also will implement better ways to improve efficiencies to help staff provide services faster and better, all in hopes of a better patient experience.

To do that, staff will be encouraged to take stock of how long each procedure takes and how that impacts the patient's stay and view of the hospital as a whole.

To better understand how the new ED is succeeding and where it is not, staff will measure and document the time it takes to provide services, such as getting blood drawn and getting lab results, getting patients to imaging centers, and getting patients admitted and into a room if they need it, he said.

A lot of those measurements will come down to how long a patient waits for services after they walk through the front door and are released or given a room to stay for more treatment.

One goal is to get ED wait times for patients who eventually get admitted down to 240 minutes, O'Loughlin said.

Munroe's current ED median wait time for those patients is 369 minutes, according to Medicare.gov, the federal government's internet site for Medicare. In comparison, Ocala Regional Medical Center and West Marion Community Hospital had a combined median wait time of 303 minutes.

The median among Florida hospitals is 315 minutes. The national average is 334 minutes.

O'Loughlin said he also wants to cut wait times for ED patients who are not admitted and ensure they stay no longer than three hours unless there are unforeseen complications that warrant more medical treatment.

His goal is reach those marks within 12 months after the new ED is operational.

As the ED is built out toward Southwest Third Avenue, the ambulance entrance will be redesigned and moved to improve the flow of patients into and out of the ED.

James Banta, Marion County Fire Rescue chief, said the move will not create any problems for ambulances or how emergency workers bring patients into the ED.

Ocala Mayor Kent Guinn said the project is not one only of brick and mortar. The hospital and the expanding ED is "part of the fabric of our community," he said.

The expansion will encourage other new growth in the area, he said, such as new medical offices along Pine Avenue.

The new ED and its staff will instill faith in patients, "because you want to know that you're getting the best care" you can get, he said.

Fred Hiers
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