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Facing a space crunch and more patients, Methodist plans $25 million ER expansion

August 21, 2018

Facing a space crunch and a more than 20 percent increase in patient volume over the past five years, Methodist Hospital has launched plans to remodel and double the size of its emergency department.

The emergency room at 83rd and Dodge Streets saw almost 28,600 patients in 2017, up from just under 23,400 in 2013, said Dr. Joseph McCaslin, the emergency department’s medical director.

The $25 million expansion will increase patient rooms from 12 to 24. Officials say it is being designed to meet space and functional needs for the next 25 years.

“We really do view the emergency department as a valuable resource for the community,” said Tracy Madden-McMahon, president and CEO of the Methodist Hospital Foundation.

So far, the foundation has raised $12.6 million for the project from different sources, including donors and foundation and hospital sources. Public fundraising will coincide with Methodist’s annual internal campaign, which starts Thursday.

The Nebraska Medical Center and Creighton University Medical Center-Bergan Mercy handle trauma in the metro area. Both recently completed their own emergency room expansions.

Methodist, located in a more elderly part of the city and near a number of nursing homes, sees a lot of older patients. With the number of baby boomers in Douglas County projected to increase by some 40 percent in the next decade, the hospital is expecting even more older patients, McCaslin said. Many of those patients want to stay close to home if hospitalized.

The hospital, with specialties that include cancer care and high-risk surgery, also has a high rate of admissions — 34 percent — from the emergency room. Nationally, the average is 9 percent, according to the federal Centers for Disease Control and Prevention. Those patients tend to be sicker and take time to evaluate and treat.

Methodist’s emergency room has closed to all ambulances a handful of times, McCaslin said, and the hospital occasionally has to divert private ambulances, which bring a lot of nursing home patients.

Construction is expected to begin in 2019. Madden-McMahon said the foundation typically prefers to meet 70 percent or more of its fundraising goal before breaking ground. The project is to be done in six phases and is expected to take about three years.

McCaslin said the hospital expects to keep 13 rooms open at all times through construction. To double the size of the department from 11,500 square feet to 24,500 square feet, the hospital will build out toward Dodge Street and borrow space from the North Tower waiting area, security and radiology.

Older patients often are accompanied by family members. That and the extra equipment needed to care for very ill patients translates to a need for larger rooms.

The emergency room already has a geriatric resource nurse, emergency room nurses who know the resources available in the community and can help make follow-up appointments and make sure patients’ medications are available, on duty six days a week. That frees up medical staff to focus on the medical side of care.

To better accommodate patients with behavioral health problems, the new space will include two rooms designed to more safely house patients who may be entertaining thoughts of harming themselves. Currently, the staff has to clear a room and assign a person to watch such patients until a treatment bed can be found in the community.

The hospital also is creating a new enhanced and more private space for victims of sexual assault, domestic violence and human trafficking and three rooms with lifts in the ceiling to transfer obese patients in a way that’s safer for them and for staff.

A couple of rooms will be large enough to allow for future technology, including telemedicine. The addition will offer improved ambulance access separate from that used by patients and two fast-track triage rooms where advanced practice staff can see patients with sore throats and ankle sprains without going through the emergency room.

“Everything along the line has been done with patient care in mind,” McCaslin said.

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