Friday Health Focus: Partially Completed NARH ER Opens

By Susan Bush
12:00AM / Thursday, February 23, 2006

NARH Medical Director of Emergency Services Dr. Paul Donovan

North Adams - The North Adams Regional Hospital has opened seven new Emergency Department patient treatment rooms as a part of a mostly completed first phase of emergency room renovations. Two rooms that were part of the former ER are also being utilized, meaning that the emergency room has a total of nine rooms currently open for patient care.

There are some temporary arrangements in place, such as a temporary nurses' station.

Changes In Place

Patients will notice a change in ER registration. Registration is likely to occur at patient bedside in an effort to streamline the admission process, said Medical Director of Emergency Services Dr. Paul Donovan and Nurse Director of Emergency Services Joyce Mickanin.

"We are changing to a rapid registration," said Mickanin during a Feb. 23 interview. "We're moving registration from out front to bedside registration. The plan is to put people into rooms as quickly as we possibly can."

Because construction is ongoing, patients may notice certain things that seem unusual, such as construction workers and tools. There may be some construction-associated noise.

But medical care will not be compromised, said Mickanin and Donovan.

Nurse Director of Emergency Services Joyce Mickanin and several Emergency Department staff began working in a new ER space on Feb. 23.

"Everything that needs to be working is working," Mickanin said. "We are telling people what's going on; we did tell our first patient of the day that they were the first patient in the new space. And we had someone who came in last night return today, and they said 'what a difference a few hours makes.'"

"The care the patients receive will be excellent as always," Donovan said.

He did offer a cautionary note about the space available as the construction continues. Emergency department construction is expected to continue for the next eight months, Donovan said.

"We are using some temporary, decreased space and it can be challenging to be in decreased space," he said. "We will have certain constraints."

Those coming to the Emergency Department should use the existing entrance. Temporary signage is in place to direct people to triage areas. Nurses, physicians, physician assistants and other staff are acclimating well to the new space, Mickanin said.

"Staff is functioning as though they've been working here and I'm really proud," she said. "Everyone here has been waiting for this for so long, and now we are seeing it."

Privacy, Comfort, Convenience, and Efficiency

Many improvements are in place and more will be evident once the work is fully completed, said project manager John Smith. The temporary nurses' station will be eliminated and a temporary dictation area [space where patient specifics are documented by medical staff] will eventually become a permanent staff lounge and locker room.

A permanent nurses' station will be constructed as the center point of a large, horse-shoe shaped unit that will host 13 patient rooms as well as a renovated decontamination room and an isolation room.

The nurses' station will be designed with larger work spaces and three dictation areas that will be protected from distractions, said Smith.

The isolation room will be used for people who may be affected with serious, contagious illness and will function with an independent ventilation system.

A seclusion room will be used for patients who may be suffering from psychological symptoms, and an adjacent ante room will allow patient supervision, Smith said.

Decontamination room renovations include erecting an exterior door, so that anyone who needs the area doesn't have to pass through the emergency room to access the treatment space, Smith said. A new independent holding tank will contain any contaminated water from the room.

Patients are treated in individual rooms, as opposed to the former ward-style, multi-bed emergency treatment area. Some rooms are protected by heavy curtains while other rooms are outfitted with both curtains and a door with a window.

A new ER patient care room at the North Adams Regional Hospital.

The obstetrical/gynecological care room was designed with an entrance that does not face the hallway for added privacy, and was also built directly across the hall from a bathroom for patient convenience, Smith said.

All patient care rooms are equipped with overhead examination lights and handwashing sinks.

The finished ER will host a patient nourishment area, an improved waiting room, children's play area and family room as well as new bathroom facilities. A tremendous amount of attention to patient care and comfort as well as efficiency was part of the planning process, Smith said.

"There were about 40 hours spent with staff about this design," Smith said.

Providing medical care in the new space bodes well for the finished ER, Donovan said.

"We've moved into a partial portion of the new space and if this is an indication of the finished space, it's very impressive," he said. "The flow of the patients and the time spent in the ER should improve as well. I think the environment under which care is delivered will be more appealing to patients and families."

Funding Boost Needed for X-Ray Equipment

Plans for the completed ER

A new X-ray room will be part of the finished ER, but funds are not in place to outfit the room with the needed radiology equipment, Donovan said. The ER treats about 20,000 people yearly and orders about 12,000 x-rays on a yearly basis, he said. The goal is to offer x-ray services without having to transport patients away from the ER and through public accessways to the radiology department. The costs of equipping an ER radiology space are at about $250,000 - $300,000 at present, and those costs may increase as time passes, Donovan said.

Project Progress

The Emergency Department renovation/expansion project is part of an about $23 million hospital improvement that includes the medical/surgical unit, the critical care unit, the lobby, and the maternity section. About $10 million in project funds have been generated by a CARE Campaign and about $13 million in revenue came from bonds.

The medical/surgical and critical care units opened to patients earlier this year, and work is progressing at the maternity unit.

The new lobby was expected to open this month but lobby construction was slowed in order to enhance construction efforts at other parts of the project, according to Paul Hopkins, Community Relations Director for the hospital's parent company Northern Berkshire Healthcare.

Former ER treatment area is emptied of beds and equipment.

The lobby may open during late April, Hopkins said.

Susan Bush may be reached via e-mail at suebush@iberkshires.com or at 802-823-9367.