By Ken Leiser
St. Louis Post-Dispatch (Missouri)
Copyright 2006 St. Louis Post-Dispatch, Inc.
All Rights Reserved
EMERGENCY ROUTES: Hospitals are concerned that Highway 40 construction will delay ambulances.
FINDING A SOLUTION: The state has asked Gateway Contractors to account for emergency traffic.
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It’s the closest thing St. Louis has to a hospital highway.
That’s why hospital administrators, fire departments and ambulance companies already are working to prevent critical transportation delays when stretches of Highway 40 (Interstate 64) are closed for the biggest highway construction project in state history.
Final details are still being ironed out for the Missouri Department of Transportation’s $535 million plan to rebuild the 10.5-mile stretch of highway, all the bridges and 12 interchanges from suburban Frontenac to a point just east of Kingshighway in St. Louis. But the state has asked Gateway Contractors to account for emergency traffic and other flows during the work scheduled from next spring through October 2010.
Along Highway 40, described by one ambulance firm official as a “sort-of hospital row in the St. Louis area,” there are at least nine medical centers from St. Luke’s in Chesterfield to Cardinal Glennon Children’s Medical Center on Grand Boulevard in St. Louis.
Emergency responders and health-care officials said last week that their early concerns revolved around:
- Patients spending more time in the back of ambulances, and less in an emergency room, in the event of traffic-related delays.
- Emergency vehicles encountering backups on nearby surface streets, such as Forest Park Parkway and Clayton Road, that will become popular alternatives during the highway face-lift.
- Getting from one side of the highway to the other while the north-south bridges and interchanges are being rebuilt. That’s particularly true in communities such as Ladue and Richmond Heights, where firefighters are based on one side of the highway and often respond to calls on the other.
“Every minute counts in a medical emergency,” said Jeff Roorda, the director of human resources for Gateway Ambulance, and a state representative from Jefferson County. “We are working with MoDOT and other health-care providers to mitigate the disruptions of service that will result from the protracted highway improvements.”
The project begins next spring with reconstruction of the Interstate 170 interchange in Richmond Heights. The most disruptive phases begin in 2008, when the western half is rebuilt. The following year, the western half reopens and the eastern half will be overhauled.
There are several concerns, Roorda said. Chief among them is that construction-related delays will lead to ambulance crews’ administering more hospital-type care in the back of ambulances.
He said ambulance firms would meet soon with transportation officials to discuss how the final construction plan revealed earlier this month would affect their ability to transport patients. Hospital officials met with highway engineers last week.
“The emergency issue is probably going to be the most difficult issue and the biggest challenge for all of us to try to navigate through,” said Steve Hoven, vice president of public affairs at SSM Health Care, whose hospitals in the Highway 40 corridor include Cardinal Glennon Children’s Medical Center in St. Louis and St. Mary’s Health Center in Richmond Heights.
Hoven said the construction would have ripple effects for hospitals outside the immediate work zone.
He expects traffic to worsen on Interstate 270 as motorists flock to Interstates 44 and 70 to bypass the orange construction barrels. For that reason, he thinks the project’s effects could be felt at DePaul Health Center in Bridgeton, another SSM property.
June Fowler, vice president of corporate and public communications for BJC HealthCare, said that the state’s plan to alternately close two sections of highway to east-west traffic for roughly a year at a time came as a surprise, and that the hospital system would have preferred that some lanes stayed open.
But she credited the Transportation Department with reducing the overall project timetable and giving hospital officials up to a year to familiarize themselves with the plan. Fowler also applauded the decision to keep some key interchanges open to north-south traffic while they are being rebuilt, including the one at Kingshighway near Barnes-Jewish and Children’s hospitals.
BJC also operates Missouri Baptist Medical Center near Interstate 270, which is beyond the project’s western boundary at Spoede Road. All are expected to feel some effects of the work.
Department of Transportation spokeswoman Linda Wilson said the state had talked to police, fire and emergency medical providers in the past year about the importance of mutual-aid agreements with neighboring communities to provide backup during construction.
Wilson said the project bidders were required to address traffic flow, including emergency vehicles, during construction. More details, including work schedules, will emerge as final contract language is hammered out with the construction team that was selected for the project.
Wilson and others agree that there will be a premium on communications with emergency responders during construction. Traffic delays will prove unavoidable in some instances.
“It depends on where you are and which hospital you are trying to get to,” Wilson said. “Absolutely, we are trying to be sensitive to that, and knowing the community has to function while rebuilding the road.”
Clayton Fire Chief Mark Thorp, co-chairman of the St. Louis Ambulance Transport Commission, said the group would meet sometime after the holidays to go over potential changes to ambulance transport policies during construction.
Because some hospitals have different specialties, including trauma and pediatrics, coordinating patient transport will be important, said Thorp, whose department runs two ambulances and answers several thousand calls a year.
“Yeah, this is going to have a significant impact to us directly,” he said.
Delays on the ground could put more demand on helicopters to provide emergency transport.
Matt Kasten, program director at ARCH Air Medical Service in St. Louis, said the air-transport company was prepared for any increase in call volume, although he doesn’t anticipate a huge spike in business. ARCH maintains 11 helicopters and staffs them each with a flight paramedic, flight nurse and pilot.
“The way it impacts us is if agencies have difficulty getting to where they need to be,” he said. But because ARCH serves critically ill patients, don’t expect to see “overutilization of helicopters if it is not warranted.”