NMC Commentary

Is NMC Planning to Renovate its Emergency Department?

Yes. NMC has applied for a Certificate of Need (CON) to the Green Mountain Care Board (GMCB) for the modernization of our Emergency Department (ED). This is the next priority within NMC’s master campus plan, following our investment in private rooms for our inpatients and efficient space for Primary Care, Urgent Care, Orthopaedics, and Specialty Clinics at the front of campus. After 30 years of service, the NMC ED’s physical space is undersized and its design is out-of-date. Given that emergency medical services are a core function of a community hospital and the renovations bring increased safety and privacy, we have formally requested ‘expedited review’ by the GMCB.

The modernization of our ED brings significant improvements in patient and staff safety relating to the care of patients with mental health concerns; treatment area capacity; additional safety concerns relating to airborne infections and physical safety; and patient privacy. For the care of patients suffering from severe mental health issues or suicidal ideations, the new design features a flexible layout with two dedicated private Safe Holding Rooms and two flexible treatment rooms which can be converted to Safe Holding Rooms. This area can be secured as a two-room unit or as a four-room unit, with its own nurses’ station and bathroom. The ED’s new design transforms the curtained treatment bays in the center of the ED into private treatment rooms. This much-needed improvement in patient privacy also enhances communications, education, and restfulness. The design provides for two airborne infectious isolation rooms for patients with conditions such as Tuberculosis, Measles, Chicken Pox, etc. This is a step-up in quality from the portable air filtration approach we currently use. The new layout brings our registration personnel and our Security Station into the secure perimeter of the ED, enhancing safety for our staff. As we improve safety and privacy, we are also right-sizing the ED to meet community need now and in the future. Even with reductions in non-emergent use of the ED through expansion of access to Primary Care and Urgent Care, we treat 25,000 patients per year in the ED. We will now have 20 ED beds, which aligns with national and Vermont benchmarks for our patient volumes. In addition, the renovations improve staff visibility of patient care areas; storage capacity; energy efficiency; heating, ventilation, and air conditioning (HVAC) improvements; and workflow efficiency. It is a once-in-a-generation project and we are very excited at the prospect of these improvements in the patient-centered environment.

The project is estimated at a cost of $7.6 million. Even with the financial challenges of healthcare reform, we must invest in our core services. The NMC Board of Directors anticipated the need for a project of this nature and has positioned NMC’s cash reserves to allow us to do this project without the added expense of additional debt. As a result our community will not see additional ED charges to directly cover the cost of this upgrade. With timely approval from the GMCB, we anticipate construction starting in the Spring of 2020 with completion in the Spring of 2021. Throughout the renovations, emergency medical services will continue uninterrupted, as we will retrofit the nearby former Intensive Care Unit as a fully functional temporary ED.

I am proud of the care provided by the NMC Emergency Department team. Over three decades, the design of their unit has grown inadequate for the provision of exceptional care. The critical need for this project was highlighted during the 2018 survey by the Centers for Medicare & Medicaid (CMS). It is time for NMC to invest in this vital community resource to improve quality, safety, and privacy for patients and staff. I am happy to discuss these plans or any questions you may have. Call me at 524-1054.

— Jill Berry Bowen, RN, NMC’s Chief Executive Officer