ED milestone underscores importance of expansion project

On Friday, September 29, 2017, Brigham and Women’s Faulkner Hospital’s Emergency Department achieved a major milestone: They saw patient number 30,000 for the fiscal year.

Each year, the ED sees more and more patients. In fact, since 2013 the number of patients seen has grown 18 percent (4 percent per year on average). This year’s number, 30,126 cases to be exact, is a new record. All the while, staff have been functioning within the same area of the hospital. Luckily, plans are underway to expand the ED to better accommodate the growing number of patients seeking care each year and redesign the care model to be more efficient and more comfortable for patients and their families.

Luis Lobón, MD, MS, Chief of Emergency Medicine at BWFH, has been working with hospital administration on the project. After Special Testing and the Outpatient Lab move to the third floor in the spring/summer of 2018, the ED can take over that space and break ground on their expansion project. “We’re gaining about 3,000 square feet. We currently have just over 8,000 square feet, so we are increasing our space by 40 percent,” says Dr. Lobón.

He explains, “What is really significant about the expansion is not so much the additional square footage, but the care model redesign that we are doing along with it.” 

In the new ED, which is expected to be complete by the end of 2019, ambulances will arrive at the existing ambulance bay. But patients who walk into the reception area will have a whole new experience. The new design features a Care Initiation Area. The space will feature five patient rooms, a nurse’s station where an attending physician, a nurse and an ED tech are assigned, plus a Results Pending Area and a consultation room.

“Thirty to thirty-five percent of our patients will never go past this area. They will come in, be assessed and go to the Results Pending Area. In the meantime, the attending physician can be taking care of the next patient behind them in line in one of the rooms. We can turn over patients quickly,” explains Dr. Lobón. “When their results are ready, the attending physician will take them to the adjacent consultation room to discuss assessment and discharge planning and subsequently the nurse will discharge them.”

For patients with higher acuity, the new setup allows the attending physician to start their care in the Care Initiation Area while waiting for another room in the acute ED pods to become available.

The new space will also feature two behavioral health rooms with garage doors that keep equipment within easy reach but can be locked to keep the patient safe when it’s not in use. These rooms will also have a shared vestibule where one sitter can watch two patients at once. This new ED pod will also include two new multipurpose rooms that are separate from the rest of the new ED pod making them ideal for pediatric patients. This area of the ED will be open 24 hours a day, 7 days a week.

The area that houses the existing ED will continue to offer acute care to patients arriving by ambulance or through the reception area. This area will be open from 11 am to 11 pm each day.

Finally, when the Outpatient Infusion Center moves to the third floor, the ED will take over their space on the fifth floor for observation patients. They will begin with six beds and eventually expand to 12.

“I think the expansion of the ED will bring an incredible amount of quality and satisfaction to our patients,” says Dr. Lobón. “The staff will fully embrace the new care model in the space built for that purpose. It will allow us to continue growing with some flexibility with the space that we have.”

In the meantime, the staff is being trained on the new care model and taking time to celebrate their recent milestone. “We all anticipated the 30,000th patient on Friday, September 29,” says Nurse Director Robin Powell, RN. “There were a few of us that thought confetti would fall from the ceiling and lights and bells would ring, but that didn’t happen. The staff just kept on working as hard as ever, taking excellent care of number 30,000 with the same enthusiasm and compassion as the 29,999 patients beforehand. The ED doors are always open and we never know who will come through those doors, but when they do, we are ready to help them. That is what we do.”