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Coming soon to Santa Fe: ER options

September 19, 2018

Emergency medicine is about to get more interesting in Santa Fe.

Two new emergency departments are coming on line within the month. Christus St. Vincent opens its new emergency department at its Entrada Contenta clinic on Cerrillos Road in another week. Presbyterian Healthcare Services debuts a combined emergency and urgent care services department when its Santa Fe medical center opens Oct. 1.

The two are located close together but have slightly different approaches to emergency medicine.

The Christus facility, a freestanding operation adjacent to but separate from the Entrada Contenta clinic, 5501 Herrera Drive, will provide residents of southwest Santa Fe a place for emergency treatment, said Shannon Barton, director of Christus St. Vincent’s south-side operations.

“This is something that has been in the works quite a few years,” she said Friday. “There is a growing population and young families on that side of town that is able to facilitate this and get it up and running.”

The Christus emergency department, on which construction started in March, has an entrance apart from the adjacent clinic. Patients who arrive at the emergency department will be assessed by emergency care providers but may be referred elsewhere, including urgent care at the clinic, said Mary Bednar, Christus St. Vincent director of emergency services.

The Presbyterian emergency department at 4801 Beckner Road employs a different approach. Patients will be examined first in a triage area and directed either to the emergency department or the urgent care department across the hallway.

“We’re essentially trying to take away and relieve some of the stress of deciding where you need to go for care quickly,” said Dr. Darren Shafer, Presbyterian program medical director for urgent and emergency services. “There is efficiency in not only the quality of care but the timing of how quickly the care is delivered.”

Emergency medical service providers at the city and county fire departments said two new emergency rooms are a boon, but also said they’re still learning about the capabilities and protocols at both.

“The health care landscape in Santa Fe is becoming richer and more complex. That presents both opportunities and challenges,” said Greg Cliburn, medical officer for the Santa Fe Fire Department.

Where a patient will go in an emergency depends on location and, to some extent, capabilities, he said. Insurance coverage or ability to pay isn’t a factor.

“We don’t base the decision on finances,” Cliburn said. “Our obligation is to take them to the closest facility. That’s the fundamental decision point.”

The current emergency department in Santa Fe, at Christus St. Vincent Regional Medical Center on St. Michael’s Drive, will remain the highest-rated department in the area. It’s a Level 3 trauma center, based on a five-tier system with Level 1 the most advanced.

Christus St. Vincent is one of the busiest emergency departments in the state with more than 50,000 visits a year, said hospital spokesman Arturo Delgado. The Entrada Contenta clinic, by contrast, sees about 20,000 visits annually for services ranging from lab work and primary care to urgent care and X-rays.

“Some of our most popular pediatricians are based there,” Delgado said.

One area in emergency services that needs improvement is behavioral health — patients with a substance abuse or mental health emergency, said Andres Mercado, Santa Fe Fire Department’s mobile integrated health officer.

Behavioral issues make up a fourth of all medical emergencies, which constitute about 90 percent all fire department calls, he said. Yet a stigma sometimes attaches to those patients that’s hard to shake, Mercado said, and outcomes for them are not as high a priority as they should be.

“Instead of thinking of behavioral health as a separate thing, the truth is the entire system needs to be retooled,” he said. “Every nurse and physician, every EMT, every police officer should have that tool in their tool belt.”

Bednar said Christus St. Vincent is reviewing its options for treating behavioral health emergencies and is working with local organizations that provide support for those patients after their hospital visits.

Dr. Anne Foster, Presbyterian Santa Fe’s chief medical officer, said behavioral health professionals at the medical center will meet with patients after they’ve been medically cleared to improve their treatment during and after their hospital visit.

Foster said she has worked with the mobile integrated health program, which focuses on following up with patients after they’ve been seen by emergency medical providers.

“It’s really important to have that in an emergency room setting because that’s where many people come in times of crisis,” she said.

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