By Catherine Trevison
The Oregonian
Copyright 2007 The Oregonian
All Rights Reserved
MOUNT HOOD, Ore. — Eye-squinting sun glare mixed with patches of road ice make for a busy February morning in the emergency department at Legacy Mount Hood Medical Center.
Several bays are filled with patients carried in from car accidents. A stack of empty backboards lines one wall by the ambulance entrance. A special alert — meant to keep the department from having to send ambulances elsewhere — has the floor buzzing with extra workers, rushing equipment and patients to their destinations.
This isn’t unusual. On Feb. 13 the hospital’s emergency department treated an all-time-high 159 patients. That record didn’t last even a week. On Feb. 17, a Sunday, 170 patients came in. The escalating numbers have made Legacy Mount Hood’s emergency room the eighth-busiest in the state, said Bryce Helgerson, Legacy Mount Hood Medical Center administrator.
“It basically means patients wait because we don’t have a room to put them in,” said emergency physician Joel Brenner, who has worked at the hospital since 1976 and directed the emergency department for 20 years, until January. “The first thing I do when I go in when they’ve been waiting a long time is to apologize. Waiting in the waiting room when you’re doubled over in belly pain is miserable.”
Administrators intend to slash those waits this year, with a $9 million expansion that will break ground this summer. Fifteen emergency bays will become 30. An expanded walk-in area will treat colds and minor injuries more quickly. And a separate children’s area will pair a toy-filled waiting room with staff that has advanced pediatric training.
Right now, “You could have a kid in Room 10 with an earache next door to Room 11 with a screaming psychiatric patient,” Brenner said. “It’s good to have a pediatric-friendly part of the emergency department.”
The expansion is just one of several scheduled improvements.
Throughout the hospital, workers are pulling threadbare 20-year-old carpet from hallways and stripping outdated wallpaper and tiles from patient rooms. They’re adding brighter paint and floors that look like wood, but with a textured surface to help prevent falls. To keep the hospital running, workers block off eight rooms at a time to complete the improvements, surrounding themselves with zipper doors and sticky mats to avoid bothering patients.
Helgerson passes a janitor, who tells him the new floors will be easier to clean.
“I’m so pleased with how this looks,” the administrator said. “It will be beautiful when it’s done.”
Another initiative involves a healing garden, which will be built if the hospital’s foundation can raise about $250,000. A drawing by the Legacy Health System’s therapeutic horticulturist shows fountains, benches and plants arranged to create intimacy and harmony.
“The whole goal is to warm things up,” Helgerson said. “You want to come to a place that doesn’t feel like the hospital.”
The emergency department expansion is necessary partly because the area’s population has grown, Helgerson said; the hospital’s average daily census is up 11 percent over last year.
But it’s also part of a wider national problem, he said; many people do not have health insurance and end up using the emergency department as their only source of medical care.
Legacy Mount Hood used to divert ambulances to other hospitals about 40 hours a month, Helgerson said. Recently, administrators managed to bring that down to eight to 10 hours a month by issuing hospital-wide alerts when the emergency department’s five critical-care bays are filled. Those alerts scramble workers from all parts of the hospital, bringing them to the emergency department to help push patients through faster.
Emergency departments function as gateways that drive business into the rest of the hospital, Helgerson said.
“This is the main route in,” added cardiologist Robert Litt, who is called to help examine patients with problems such as chest pain or rapid heartbeats. “You have to open up this bottleneck to expand the rest of the hospital. East county is growing --we need more medical services out here.”
However, emergency departments aren’t seen as good sources of revenue, the way a day surgery center or a new scanning machine might be.
“We have to balance the business decisions and the mission,” Helgerson said. “One of our values is social responsibility . . . There’s a need for it. That’s the issue. And with a number of physicians in the community who are not willing to take care of the uninsured, the emergency department is just going to keep growing.”
Helgerson started working in Gresham about 18 months ago, with a goal of making the 115-bed Legacy Mount Hood preferred by east Multnomah County residents. Historically, that’s been a struggle, in part because the region’s largest hospitals are just a short drive away. Each year, the hospital has pushed to improve, from adding better surgical suites for doctors to improving its imaging equipment to expanding its popular Family Birth Center.
“We’re trying to make Mount Hood the hospital of choice for residents of east county,” Helgerson said. “To do that, we realize we need to make some upgrades.”