The University Record, February 25, 1998
By Jane R. Elgass
With 36 percent of all hospital admissions coming from the emergency room (ER) at University Hospital, "emergency medicine has evolved from a low-volume, limited access service on the fourth floor of 'Old Main' to the 'front door' to the Health System," the Regents were told last week.
In making the case for a renovation of the area expected to cost $19 million, Gilbert S. Omenn, executive vice president for medical affairs, said a renovated emergency unit and addition of a clinical decision unit "will add value to the Health System, especially in the managed care environment."
Patients coming to the ER "will be sicker, with the percentage of patients admitted to the Hospitals continuing to increase. Currently, 25 percent of patients seen in the ER are admitted to the Hospitals.
"The ER," Omenn explained, "is the front door to most tertiary inpatient services. Patients are frequently screened in primary care settings and sent to the ER for more definitive diagnosis and treatment. Thus, construction of a consolidated adult and children's emergency service area, along with the clinical decision unit, positions us to occupy a crucial niche in the managed care environment."
The renovation/construction project will include:
Integration of children's emergency, urgent care and ER operations and relocation of the Employee Health Service from Med Inn.
Creation of an on-site pathology laboratory to manage high-volume lab tests within the area.
Addition of a two-room radiology suite and relocation of a CT scanner to provide easier and safer access for ER patients. The current lack of these services presents a patient safety issue and slows patient movement through the area.
Other issues affecting efficient and safe patient care and medical student education that will be addressed by the project:
During 16 of 24 hours each day there are not enough beds in the main ER area. Staffing inefficiencies and physically separate locations of the adult, children's and urgent care areas make it difficult to move patients from over-utilized areas to under-utilized areas.
The addition of a 17-bed clinical decision/observation unit will make it possible to observe patients at a lower cost than would be incurred by hospital admission. Diagnostic testing also can be consolidated, affording multiple consultations and testing.
Consolidation of the areas will enable tightened security without limiting access to health care.
Medical students pursuing residencies that require emergency medicine experience will receive a more coordinated educational experience.
Work on the project, which was approved by the Regents, is expected to begin within a year of approval of a Certificate of Need.