The Highlander: Hospital Starts ER Renovation

Renovations to the Highlands-Cashiers Hospital emergency room got underway as members of the hospital’s board and Mission Health staff met to break ground on the project at an April 26 ceremony.

“I think the community will start to see the steel go up this summer, and that’ll be huge,” said HCH President and Chief Nursing Officer Jackie Ring. “I think we’re going to have a lot of excitement about that and around this groundbreaking. I’m excited to get this project rolling and do it well.”

The project, slated to cost $6.7 million, is expected to be complete by summer of 2017. Ring said the improvements will address several key issues with the current emergency department, particularly dealing with privacy concerns.

“Privacy is a huge issue with the emergency department,” she said. “When they walk up, they stand at the window and they tell what’s wrong with them. That’s not really private. In this new setup, we have them coming in to a registration area so they walk up to this desk and they will sit down with a nurse. It’s enclosed, so there’s privacy.”

This approach will also help streamline care and assist critical issues more efficiently, Ring said. Working with a nurse upon arrival helps staff know which patients need treatment most urgently without jeopardizing their privacy.

“It’s a ‘nurse first’ kind of concept, and then if they really need vital signs and all those sorts of things, they can take them to a triage room,” Ring said. “But this gets them the initial ‘how fast does this patient need to move to the back’ without anybody else having to hear it.”

The emergency department was created as part of the hospital’s operations when HCH was built in 1993. The work taking place over the next year will be the first major improvements to the emergency facilities.

The new facility will also provide additional lobby seating and improve the quality and privacy of patient rooms in the ER. Currently, rooms are shared and divided with curtains. The new facility will have four separate exam rooms, a triage room, one isolation room, a trauma room and a decontamination room all divided with walls for privacy and security. Ring said the department’s capacity will remain the same, however, because state regulations dictate how many exam rooms are necessary.

“Based on our volume, because it’s so seasonal, they level it out over the year so we don’t qualify for any more rooms,” she said.

The ambulance entrance will also be moved across the building, to provide separate entrances for ambulances and foot traffic.

“The ambulance entrance will move around to the side for safety,” Ring said. “There are huge safety issues with running an ambulance where people are walking in.”

Kathy Guyette, Mission’s senior vice president of regional member hospitals, told the crowd assembled at the groundbreaking ceremony that the changes to HCH’s emergency department reflect ongoing changes to the way Mission handles community health.

“The current system of, what I’ll put in quotes, ‘sick’ and emergency care provided by health care organizations across the country does a poor job of giving people what they need,” Guyette said. “As we prepare to manage population health care and the way we provide services to the community, we will look very, very different. The ultimate goal of Mission Health and Highlands-Cashiers Hospital is to have a healthy community.”

Guyette said the improvements at HCH will help to further that goal.

“The new Highlands-Cashiers Hospital emergency department will continue to reinforce this objective through preventive and emergency-based care,” she said. “Our aim is to create convenient access to care while providing access to urgent care and emergency care.”

Several other representatives from HCH and Mission Health addressed the crowd during the ceremony, including members of the hospital’s board and the foundation board tasked with raising funds for projects at the facility.

Thomas Duncan, a primary care physician at the hospital who spent years working in the emergency department, spoke to the crowd about the necessity of having an effective, emergency care facility even in a remote location such as Highlands.

“You see it all, small town or big town. You see trauma, you see cardiac events, you see life-threatening allergic reactions,” he said. “It’s actually where you see the most sad and the most triumphant things in human life, and it’s all done, basically, taking care of your neighbors and friends.”

Duncan said this project will tie HCH to the community even more, by improving the level of care for locals and visitors without having to reach out to other facilities as often.

“Medical problems tend to reduce us all to the common denominator of needing help, and this is the way our community is basically reaching out, endeavoring to care for the community,” he said. “This facility will allow for better care, improved privacy, protection of dignity, improved working environments and will help the caregivers do their work.”

The project was funded largely by philanthropic donations to the hospital’s foundation, with a $1 million infusion from Mission.

“Mission donated a million, and that was part of the original agreement when they did the affiliation — they committed a million dollars to it,” Ring said, referring to HCH’s merger with Mission two years ago. “Philanthropy has raised the rest, and we’re very close to being fully funded. We had one very, very generous donor that funded quite a bit of it.”

The project is still a little over a year from completion, and Ring said the current facility will suffice until the improvements are completed.

“The ED will remain where it is until we can completely open that up,” she said. “The only exception to that is the ambulance entrance. As soon as they finish that, we will change that because it’s a safety issue and, if we can use that entrance, we’d like to.”

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