Northeast Times

Expanding care

Aria Health debuts a $37.1 million emergency department and Level II trauma center this week at its Torresdale campus.

  • In case of emergency: Tom Kurtz, the new senior director of clinical operations for emergency medicine at Aria Health’s Torresdale campus, walks through the new emergency department and Level II trauma center. A ribbon-cutting ceremony was held on Monday. MARIA POUCHNIKOVA / TIMES PHOTOS

  • Well equipped: The new construction covers about 80,000 square feet of space over two floors. Treatment areas are arranged into three pods, each with about a dozen private rooms. All pod rooms are equipped with cardiac monitors, wall-mounted computers, flat-screen televisions and washing stations.

  • Well equipped: The new construction covers about 80,000 square feet of space over two floors. Treatment areas are arranged into three pods, each with about a dozen private rooms. All pod rooms are equipped with cardiac monitors, wall-mounted computers, flat-screen televisions and washing stations.

Look­ing for the epi­cen­ter of Amer­ica’s health care crisis? Look no fur­ther than hos­pit­al emer­gency rooms.

In April 2013, The At­lantic re­por­ted that an­nu­al emer­gency room vis­its soared from 88.5 mil­lion to 127.2 mil­lion na­tion­ally from 1991 to 2010, al­though 11 per­cent of the na­tion’s emer­gency de­part­ments closed dur­ing that two-dec­ade span. And between 1990 and 2005, 339 of the na­tion’s cer­ti­fied trauma cen­ters closed, leav­ing com­munit­ies with few­er and more-dis­tant op­tions in the most des­per­ate cir­cum­stances.

North­east Philly-based Aria Health is re­vers­ing that na­tion­al trend loc­ally with the de­but of a new, $37.1 mil­lion emer­gency de­part­ment and Level II trauma cen­ter this week at its Tor­res­dale cam­pus. Monday’s ce­re­mo­ni­al rib­bon-cut­ting oc­curred barely one year after Aria opened a new, $15 mil­lion emer­gency fa­cil­ity at its Frank­ford cam­pus.

At Tor­res­dale, ca­pa­city will in­crease from about 45,000 emer­gency vis­its a year to about 70,000, ac­cord­ing to Tom Kur­tz, the hos­pit­al’s new seni­or dir­ect­or of clin­ic­al op­er­a­tions for emer­gency medi­cine.

“Na­tion­ally, the num­ber of emer­gency de­part­ment vis­its is in­creas­ing, but the num­ber of emer­gency de­part­ments is de­clin­ing,” Kur­tz said. “We want to be the lead­er in this re­gion in provid­ing that ser­vice.”

“If you want to be a des­tin­a­tion for emer­gency care, you have to look the part and this looks the part,” said Dr. Ger­ald Wydro, Aria’s chair­man for emer­gency medi­cine.

Ac­cord­ing to The At­lantic art­icle, which cited data by the Amer­ic­an Hos­pit­al As­so­ci­ation as well as joint re­search by an emer­gency phys­i­cian and eco­nom­ist, op­er­a­tion­al costs are driv­ing many hos­pit­als away from emer­gency care while lack of per­son­al health in­sur­ance drives many pa­tients to use emer­gency rooms for their primary care. A down­ward spir­al en­sues as hos­pit­als end up eat­ing more of the costs of treat­ing un­der­insured or un­in­sured pa­tients.

This is not to say that most of Aria’s emer­gency vis­its could be handled more ef­fi­ciently by fam­ily doc­tors or ur­gent care cen­ters. In fact, 60 per­cent of all emer­gency de­part­ment vis­its at the sys­tem’s three cam­puses (Tor­res­dale, Frank­ford and Bucks County) are con­sidered at the middle or high end of a five-tier sever­ity scale, Kur­tz said dur­ing a re­cent tour of the new Tor­res­dale fa­cil­ity. 

Many severely in­jured pa­tients, such as car ac­ci­dent and gun­shot vic­tims, are routed to Tor­res­dale be­cause the next closest trauma cen­ters are in Cen­ter City, Abing­ton, Mont­gomery County, and New­town, Bucks County. Frank­ford takes about 55,000 emer­gency vis­its a year and Bucks about 25,000. Neither is a cer­ti­fied trauma cen­ter.

Age is an­oth­er factor con­trib­ut­ing to de­mand. As a whole, the pop­u­la­tion is get­ting older and in great­er need of emer­gency care, Kur­tz said. But de­mand wasn’t the lone factor in Aria’s de­cision to ex­pand emer­gency ser­vices. The new Tor­res­dale fa­cil­ity is also more ef­fi­cient and tech­no­lo­gic­ally ad­vanced than its pre­de­cessor. The staff seeks to re­duce or elim­in­ate wait­ing times and im­prove “pa­tient flow.”

“If a pa­tient comes in and has to wait to be seen, you haven’t ac­com­plished any­thing,” Kur­tz said.

The new con­struc­tion cov­ers about 80,000 square feet of space over two floors. Aria ob­tained $3 mil­lion in pub­lic grant money from Pennsylvania’s Re­devel­op­ment As­sist­ance Cap­it­al Pro­gram with help from state Sens. Mike Stack and Robert M. Tom­lin­son. Aria used its own fin­an­cial re­serves and fin­an­cing from M&T Bank to cov­er most of the con­struc­tion costs.

The cam­pus ad­ded about 50 new per­man­ent po­s­i­tions to its 2,000-mem­ber work­force, in ad­di­tion to between 80 and 100 tem­por­ary jobs re­lated to con­struc­tion.

The main floor is con­figured with sep­ar­ate en­trances for am­bu­lances and for those who ar­rive in private vehicles. A nurse will staff the re­gis­tra­tion desk at the walk-in en­trance to provide im­me­di­ate as­sess­ment of a pa­tient’s con­di­tion and call for emer­gency treat­ment as needed.

Treat­ment areas are ar­ranged in­to three pods, each with about a dozen private rooms. Pod 1 will re­main open around the clock and is de­signed to handle the most severe emer­gen­cies. Pod 2 will usu­ally open from around 9 a.m. to 2 a.m., de­pend­ing on de­mand, and is de­signed to ac­com­mod­ate middle- to high-sever­ity pa­tients. Pod 3 will open dur­ing peak hours, usu­ally from 11 a.m. through the af­ter­noon and in­to even­ing.

All pod rooms are equipped with car­di­ac mon­it­ors, wall-moun­ted com­puters for real-time chart­ing, flat-screen tele­vi­sions and wash­ing sta­tions. 

An ad­di­tion­al five rooms have been des­ig­nated as “fasttrack” rooms for pa­tients with non-severe ail­ments such as minor sprains and cuts. These rooms will have a faster turn­around. There are two ad­di­tion­al isol­a­tion rooms for pa­tients with con­ta­gious con­di­tions, such as in­flu­enza or tuber­cu­los­is. They have private bath­rooms and are next door to a de­con­tam­in­a­tion room with private showers.

Uniquely, the new emer­gency de­part­ment has a ded­ic­ated CT scan room so pa­tients don’t have to be taken to an­oth­er part of the hos­pit­al for ad­vanced dia­gnostics. X-ray ser­vices are also in­side the emer­gency de­part­ment.

The trauma room is one of the greatest im­prove­ments over the former Tor­res­dale emer­gency fa­cil­ity. At about 1,000 square feet, it has three per­man­ent re­sus­cit­a­tion bays and room for sev­er­al more “lit­ters” in case of large-scale dis­asters.

“With trauma ac­tiv­a­tion, you have a multi-dis­cip­lin­ary team — doc­tors, as­sist­ants, nurses, X-ray tech­ni­cians, an­es­thesi­olo­gists,” Kur­tz said. “You could have eight to ten people by a bed­side. To have enough room for these folks is key.”

The trauma room is a straight line from the am­bu­lance en­trance, al­low­ing med­ics and staff to take gurneys dir­ectly from the door in­to the treat­ment area. An el­ev­at­or lead­ing to the up­per-floor op­er­at­ing room is just across the hall.

The new con­struc­tion also in­cludes pa­tient wait­ing areas, ad­min­is­trat­ive of­fices, a con­fer­ence room, a cof­fee shop and a court­yard. Fur­ther, the hos­pit­al re­con­figured its cam­pus to ex­pand park­ing and fa­cil­it­ate vehicle flow.

“It’s a game-changer, es­pe­cially com­ing from an en­vir­on­ment that’s been cramped and un­der­sized,” Wydro said.

“It’s a mor­ale boost­er for sure, a palp­able boost,” Kur­tz said.

Vis­it www.ariahealth.org for more in­form­a­tion about Aria Health. ••

You can reach at wkenny@bsmphilly.com.

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