If you think your 2020 plans went out the window with COVID-19, spare a thought for a hospital trying to revamp its emergency department as part of a larger $700 million project.
“We thought we had it figured out,” said Richard Herring, consultant with the architecture firm, Perkins+Will. “Then, the pandemic hit … and we had to rethink everything. We’ve been doing hospital design in emergency departments for a long time, and this really did cause us to pause and think about everything.”
Northeast Georgia Health System announced in December its intention to build a new patient tower that would be operational by 2024.
In a Feb. 22 letter of intent concerning a certificate of need application, the health system said its $700 million, 11-story tower project would include relocating and expanding its emergency department and constructing a rooftop helipad. NGHS spokesman Sean Couch said the existing emergency department is 31,000 square feet, and the plan for the new department would more than double that to 78,500 square feet.
NGHS officials said the lessons learned from the past year in the pandemic are being folded into the plans for the revamped emergency department.
‘Organizing the chaos’
NGHS hit its peak of COVID-19 patients Jan. 8 when the health system recorded 355 patients being treated for confirmed cases of the disease. Less than three weeks later, the hospital was also coping with a mass casualty event in the Foundation Food Group liquid nitrogen leak.
Six people died and 12 total people were hospitalized after the Jan. 28 leak at the Gainesville poultry processing plant.
Angela Gary, executive director of emergency and trauma services, said there has been heavy discussion of handling mass casualty and mass injury events with the new emergency department plan.
Working in emergency medicine is about “organizing the chaos,” she said.
“That is another thing that we learned through the pandemic is that we know how to mobilize alternate treatment spaces very quickly,”
Dr. Mohak Davé, NGHS’ chief of emergency medicine, said some of the greatest lessons learned during the pandemic were about adaptation and perseverance.
“We had to adapt to changing almost by the day recommendations on (personal protective equipment), recommendations on treatment, on screening, on testing (and) being able to adapt to changing patient volumes,” Davé said.
The lasting memory Davé has of 2020 was highlighted in December ambulances were lined up for hundreds of yards outside the Gainesville emergency department.
“I never thought I would see that day where our staff were going out to ambulances that were waiting to drop patients off,” he said.
Each one of the EDs — Gainesville, Braselton, Barrow and Lumpkin — has designed a plan to identify additional spaces that they could go into in case of emergency.
“When we’re in this business, we have to plan for the worst,” Gary said. “… Going through this process in the pandemic, it forced us to relook at those plans and dive into them a little bit more carefully and then bring all of those lessons learned into these architectural design meetings.”
Gary said they have discussed having negative pressure throughout the emergency department. Negative pressure prevents airborne contaminants from spreading into other areas of the emergency room.
“(Herring) knows I am constantly stating, ‘How are we going to implement better ideas and more innovative ideas to prepare for any pandemic in the future space?’”
Better flow, better space
Herring said some of the ideas include better managing the flow of people entering the facility and potentially windows to vet people before coming into the emergency room. This rethinking continues down to some of the more minute details, such as storing large supplies of personal protective equipment in an area that won’t block hallways.
Gary said she is particularly excited about having greater operational flow and more space from what can now sometimes be a disconnected and crowded emergency department.
“A lot of people realize that this emergency department we’re currently in is really fragmented, and it feels a little disconnected, even though we staff it appropriately so the patients don’t feel disconnected,” she said. “What we’re so excited about is it’s all going to be in one space. We have a huge trauma bay, huge resuscitation rooms.”
There has also been discussion around designated areas for pediatric patients and behavioral health patients.
Even in the current emergency department, Davé said they have been trying to make a distinct area for behavioral health patients that would keep them away from the “standard noise, distractions and environment that can be taxing as a behavioral health patient.”
With eyes on the new tower project, Davé said they are looking at ways to create ways to treat both adult and adolescent behavioral health patients.
“One thing that Richard and his team have challenged us on is it’s not just about being new. It’s not just about being bigger,” Davé said. “It’s also about being more efficient and using technology — leveraging what’s available now and even what will be available in the future — in how we are going to deliver care.”