An expansion and renovation of East Georgia Regional Medical Center’s emergency department, completed in December, added 10 treatment rooms plus a sub-waiting area designed for emergency patients with less urgent needs.
The emergency department project concluded a series of renovations representing a multimillion investment in the Statesboro hospital by its parent company, Community Health Systems, or CHS. Now the emergency department, often informally called an “E.R.,” has a total of 29 treatment rooms, up from 19 previously. EGRMC remains a 149-bed hospital in terms of inpatient rooms.
“In December 2017 we completed the project and we opened all 29 rooms,” the hospital’s CEO, Paul Theriot, said in an interview last week. “We also renovated the original rooms at the same time, and so it all has a consistent look.”
Adding treatment rooms was one way to address a bottleneck in patient arrivals the hospital had been experiencing, but Theriot said the rooms were not the whole solution.
“Pure and simple, you’re adding capacity,” he said. “Now, there are pros and cons when you do that. Obviously you have more rooms you can put more patients in, but you have a greater distance to do it with. So when you’re thinking in terms of time, it’s not just simply a matter of adding rooms. You have to have processes that can now apply to a much larger area when we added 5,000 square feet.”
Originally, the hospital announced plans to expand the emergency department by 12 treatment rooms. But Theriot asked the company’s internal consultants to look at how patient flow could be improved within the available space. This resulted in the change of plans to provide the sub-waiting area for low-acuity patients, in place of two of the rooms.
The primary waiting area hasn’t changed. The added area is where patients with less urgent medical needs wait for test results or further treatment after they have been checked in and gone through an initial screening exam. High-acuity patients, requiring urgent attention, are not sent through the sub-waiting area, which is furnished with recliners and a big TV.
“One of the big improvements we feel like we’ve made was the addition of the sub-waiting area,” Theriot said. “That allows patients who are there with a low-acuity condition to be seen, to get their labs and whatever tests done. They’re in a different flow and are much more comfortable. They’re not lying on a bed if they’re just there with a sore throat.”
With the expansion, more storage spaces were also added so that staff members do not have to walk so far to a single supply location in the expanded department, Theriot said.
EGRMC also brought some new management into the emergency department, hiring Melissa Edrington, RN, as its clinical, or nursing, director. She has 15 years experience in nursing and was previously emergency department nurse manager with Memorial Health in Savannah. Edrington’s Linkedin profile states that she has been with East Georgia since October 2016.
“She’s been a fantastic addition,” Theriot said. “She brought some of her experiences at Memorial and allowed us to incorporate some more best-practices.”
Since mid-2016, when EGRMC emergency department “door-to-doctor” times exceeded 90 minutes, wait times had been cut in half, Theriot was already reporting last February. Previously chief operating officer at a CHS-owned hospital in Alabama, he arrived as chief executive of the Statesboro hospital in April 2016, in time for the biggest renovations since its opened in 2000.
Now, with the renovations done, the average door-to-doctor wait has been brought much closer to the previously stated goal.
“We’re around 32 minutes, so much better than we used to be,” Theriot said last week. “Our goal is to be under 30 minutes, so we’ve got a little bit of work to do.”
Community Health Systems was slated to recognize EGRMC for its improved emergency room performance metrics with a company presentation last week, said Theriot and Erin Spillman, the hospital’s new director of marketing. Besides wait times, hospital officials look at LWOT percentages, reflecting the number of patients who “leave without treatment.”
“We’re getting them in the E.R.,” Theriot said. “They’re not coming in, getting checked in and saying, ‘Look, I don’t have time, I’m leaving.’ Wait times have gone down drastically.”
The hospital also renovated and relocated several other functional areas during 2016 and 2017, with the emergency department expansion being the final step.
The first step had been moving business and medical records offices out of the hospital into the neighboring medical office building. A cashier’s office where patients can pay bills remained in the main hospital.
Then the hospital pharmacy was moved into former business office space, and the inpatient endoscopy suite to where the pharmacy had been. The same-day surgery department moved last spring, at last freeing the space for the emergency department growth.
Each area underwent renovations as the dominoes fell.
“What’s even more impressive, I think, is the fact that we were able to see these patients and improve on our through-put and all that all during renovation,” Spillman said. “So we did not stop treating patients during the renovation progress.”
In October 2016, Statesboro Herald business columnist DeWayne Grice reported that the cost of the renovation and expansion, based on building permits, would exceed $2.5 million. For a February 2017 story, Theriot did not object to a description of the cost as several million dollars, and this week he said there been no change in the numbers.
For a while, patients and visitors also saw work underway on the exterior of the hospital. Every window was resealed, a process that required cutting bricks from around the windows, to fix what Theriot described as a design flaw in the original building. This was completed earlier in 2017.
Also last year, the company undertook improvements to Statesboro Imaging Center, which operates as a department of the hospital but is a across town on Lester Road. The waiting area and women’s center were renovated. The center’s MRI equipment and software, “everything but the magnet itself,” were upgraded, and some other equipment will be added or replaced this year, Theriot said.
Flu a challenge
Meanwhile, the expanded emergency suite does not solve every capacity problem, especially during a peak flu season. Theriot reported that the staff was having meetings on a regular basis earlier this week “just to manage the tremendous surge in volume.”
Not just influenza itself, but flu-related viruses and other respiratory illnesses have been filling EGRMC and other hospitals.
“We’re full today,” he said Tuesday. “It ebbs and flows. We hope to create some capacity between now and the weekend.”
Herald reporter Al Hackle may be reached at (912) 489-9458.