KPLU Local News
(2010-06-13)
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A trauma room at Highline Medical Center's new Emergency Department.
If you need to rush to a hospital Emergency Department in the near future, you may find a pleasant surprise. Cramped and over-crowded ER's are giving way to spacious modern facilities, with shorter wait-times. Some of these are even located miles away from the nearest hospital.
Not far from SeaTac airport, in Burien, Highline Hospital has a brand-new Emergency Department. It's spacious and open, and that leaves Dr. Greg Garcia beaming with pride. He's director of the ER and says having 32 rooms available, compared to 19 in the old facility, makes a huge difference. Before, you couldn't count on getting a private room.
"We would have to move patients all the time over there," says Garcia. "Here we aren't going to have to do that. So, when patients come and are in room 14, they're going to be in room 14 for the duration of their stay. You're not going to be moved."
Doctors and nurses are no longer tripping over each other. Equipment is easier to find. For emergency patients, having so many private rooms means families can stay together. And, the stereotyped 3-hour wait in an ER lobby is down to 20 minutes or less here, as it is at most newer ER's. Everything's just more efficient.
The hospital's "front door"
That makes the whole medical center more attractive, says Highline CEO Mark Benedum. While the older ER was truly out-of-date, having been designed 50 years ago, he admits competition also was a factor in the upgrade.
"Hospitals recognize you have to maintain the very best facilities and very best equipment, or patients are going to go elsewhere, because patients have a lot of choice in the Seattle area. There are a lot of good hospitals, including us," he says.
In the industry, the ER is known as "the front door to the hospital." That's where you have to make a good first-impression. If you want to keep your main hospital busy and profitable, a huge portion of your patients come first through the emergency department. At Highline, outside the maternity floor, more than half the patients come through the ER.
That's the business reason for a building boom. In the last five years, in the Seattle-Tacoma-Everett area, at least seven new Emergency Departments have opened -- and ten more are under design and construction. No one's been more aggressive than Swedish Medical Center, based in Seattle. They've pioneered the freestanding Emergency Department, which is not even part of a hospital. The first was in Issaquah.
Racing to the suburbs
"There are pockets of population, similar to Issaquah, where residents were having to drive 15-20 minutes to access emergency care. They want to have these services close to home," says Kevin Brown, the Chief Administrative Officer at Swedish.
His strategy is to build new Emergency Departments in fast-growing suburbs, instead of an expensive upgrade at his core hospital's downtown ER. He has a local map pinned to his wall, with existing hospitals marked in blue, and big red circles drawn around suburban areas without hospitals: Redmond, Mill Creek and Maple Valley.
"When you put it on a map, there are communities that just pop out," says Brown.
Competing hospitals are also eyeing those towns. In the Covington-Maple Valley area, three hospitals -- Swedish, Multicare, and Valley -- are racing to get their freestanding ER's built first. Based on the "front door" metaphor, it's easy to see why. If, someday, you need to see an expensive specialist, such as a cardiologist, you'll feel connected to that hospital with a nice ER down the street.
What about the cost?
Anthony Hemstad, of Kent, was bothered by this trend. He's an elected commissioner for Valley Medical Center's public hospital district. He voted against building a new ER in Covington, but lost the vote.
"Emergency [Departments] are great for actual emergencies, but we need a rational number of them," he says. "We are treating way too many non-emergency cases and it is not an efficient way to provide health care."
That argument has been repeated many times in the recent health-care debate. Emergency rooms charge more than walk-in clinics because they're staffed by highly trained doctors and nurses, around-the-clock. On the other hand, the evidence for over-use is mixed, and it's not clear they're any less efficient than the rest of the medical system.
In the near future, the new federal health law will probably boost ER use, as more people get insurance. That's happened in Massachusetts. And hospitals will gladly use their shiny new buildings to bring people into their networks.
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