A new world of emergency medicine
Holy Name Hospital’s new ER facility
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Holy Name Hospital’s George P. Pitkin M.D. Emergency Care Center, which opened in August 2008, was the focal point of Dr. Arie Eisenman’s April 27 visit to the hospital.
The $22 million facility has more than doubled the emergency-treatment capacity to 41 beds (compared with 18 in the old ER). In times of very high demand, rooms can be further expanded to accommodate 82 patients at once.
Jonathan Hirsch, director of guest services at Holy Name, explained that there are several pods with individual nursing stations, and as each pod fills up, personnel can open a new area. “The pods break up the size, and each [medical] team has a certain section,” he said. “Personnel have cell phones and internal phones to get assistance. In addition, we can page all the doctors in the ER at once.”
“Forty to sixty percent of our patients come through the ER,” said Hirsch. “We want them to have very good experiences. We want to triage everybody within about five minutes of arrival and then send them right to a room.”
When patients are moved into rooms quickly, it is much less stressful for them, he said. They have more privacy and, if they feel up to it, they can take advantage of the communication centers provided in the ER rooms. Those electronic stations provide access to phone, Internet, and television.
The emergency facilities were designed to have a calming atmosphere, said Hirsch. Earthtone colors were used, as well as recessed lighting, so that a patient on a gurney, looking up at the ceiling, won’t be disturbed by glaring lights.
Children who come in to the ER can stay in the private rooms with their parents. If a child is crying, the glass doors may be closed for more privacy, said Hirsch. “For children we have toys and games. Parents don’t have to worry.” There is also an emergency dental room in the ER for sports injuries, which occur more commonly in children.
In the event of infectious diseases like the swine flu H1N1 virus, the new facility has several rooms with negative air pressure. The ventilation of such rooms is designed so that air can only flow freely into the room. Air exiting the room, possibly harboring infectious agents, is pumped through filters that remove germs. This reduces the risk of the infection spreading to other patients and medical personnel.
The new ER is also equipped to handle chemical or radiologic emergencies. The decontamination area for chemical toxins has special shower facilities. In addition, there is a radiologic detector to screen patients who might have been exposed to radioactive substances.
The ER can be expanded in the event of a large catastrophe. The Marion Conference Center, located underground, one level below the ER, has been designed to serve as an emergency triage center. Rabbi Lawrence Zierler, who attended the event featuring Dr. Arie Eisenman, remarked that the design of emergency facilities is approached differently since 9/11. “The biggest spaces in Israeli institutions are also protected spaces,” he said. “We’re learning the same thing here [in the United States] — to design spaces for possible use in an emergency. We no longer think of them as single-use purposes.”
“We have to be prepared,” said Zierler. “Close your eyes and imagine it. God forbid, in a situation where there are massive casualties, a major accident, or another terrorism attack, that room would look very different.”
Holy Name also has a mobile command center with mobile intensive care unit available for emergency use. It was used recently, Hirsch reported. “We were down at the airline crash in the Hudson, treating patients,” he said.
More on: A new world of emergency medicine
Western Galilee’s emergency preparedness and underground hospital
Western Galilee Hospital has more than 700 beds and a staff of 330 physicians and 850 nurses, organized into 61 departments and units. “We are busier than Holy Name, with the same size staff,” said Dr. Arie Eisenman, head of the Medical Emergency Room at Western Galilee. Each year there are approximately 120,000 ER visits (compared with 44,000 at Holy Name), 60,000 hospitalizations (vs. 26,000 at Holy Name), 15,000 surgical procedures, 28,000 dialysis treatments, and 6,500 births per year (compared with about 1,200 per year at Holy Name).
Since it is a teaching hospital affiliated with Technion Medical School in Haifa, Western Galilee also trains medical students and residents. Eisenman reported that the hospital has an award-winning Continuous Quality Management program, which is involved with maintaining high standards in patient care and maintenance of facilities.
Israeli doctor shares his experiences at Western Galilee Hospital
At Western Galilee Hospital, six miles from the Lebanese border, emergency drills are commonly conducted to ensure that physicians, nurses, and emergency service personnel are ready to respond when disaster strikes. “On 16 July, 2006, it was no longer an exercise,” recalled Dr. Arie Eisenman, head of the Medical Emergency Room at that hospital, located in Nahariya, Israel. “Hostilities broke out with Hezbollah, due to the abduction of two Israeli soldiers.”
Last Monday, at Holy Name Hospital in Teaneck, Eisenman recreated the scene. During the Lebanon war in 2006, cities in the north of Israel were subjected to frequent rocket attacks. There were hundreds of soldier and civilian victims who needed medical attention. “All the patients were evacuated to the underground facility in less than an hour,” said Eisenman.
