WakeMed stresses calm, quiet in trying to feel less like an emergency room

Published 12:00 am Wednesday, December 2, 2009

By Kathy Chaffin
Salisbury Post
RALEIGH ó The waiting room at WakeMed North Healthplex is quiet and relaxed, not what you might expect in a freestanding emergency department.
That’s what WakeMed Health & Hospitals officials intended when they added the department to the front of a three-story physicians office building in July 2005.
“The idea was to make it feel less like a hospital emergency department,” says Heather Monackey, WakeMed senior public relations specialist.
On this particular day, the idea is working well. There’s only a handful of people in the waiting room, and they appear quite calm.
While they’re waiting, they can take advantage of a coffee bar and a station where patients and family members can log onto a wireless Internet connection.
People going to the WakeMed North Healthplex ó open 24 hours a day seven days a week?ó can cut their wait by calling ahead or going online to provide information to get their charts started.
The freestanding emergency department was the first one in North Carolina until this month, when WakeMed opened a second one in Apex on Feb. 4.
The N.C. Division of Health Service Regulation has approved a certificate of need application for a WakeMed East Healthplex, and applications are pending for two other WakeMed freestanding emergency departments.
WakeMed North Healthplex has given many tours like this one. Oral Wise, director of ambulatory services for the freestanding emergency department, says a group from Carolinas Medical Center-NorthEast in Concord toured before asking the state for approval to build a freestanding emergency department at Interstate 85 and Lane Street in Kannapolis.
WakeMed North, a 104,000-square-foot facility, has 14 treatment rooms, with five more being added this month and two triage rooms.
The tour continues beyond the doors of the waiting room into the actual treatment area, where the calm atmosphere remains even though all the treatment rooms are full.
Officials plan to move 20 beds from the Raleigh WakeMed campus to the North Healthplex, which will make it a full-fledged community hospital.
The facility was constructed at 10000 Falls of Neuse Road because of the booming residential development in the area.
A WakeMed Critical Care truck waits on site at all times to take patients who need more specialized care, and a helicopter has flown patients in the past, Wise said. It can land in the parking lot if necessary.
The new Apex freestanding emergency department includes a helipad, according to Carolyn Knaup, WakeMed’s vice president of ambulatory services.
Officials don’t plan to turn the Apex emergency center into a community hospital because it is only six miles from WakeMed Cary Hospital.
The WakeMed North Healthplex is 12 miles from the WakeMed Raleigh Campus, but even in the busiest traffic, it’s only seven minutes away, Knaup said.
Back to the tour.
On the far left of the Emergency Department is a door for patients arriving by ambulance. Just inside the door, a resuscitation room sits ready to the immediate left.
Only 20 percent of the patients seen in the North Healthplex arrive by ambulance, Knaup says. The other 80 percent walk in.
Eight percent of patients seen in the Emergency Department end up being transferred and admitted to a hospital, she says.
“It’s not really time lost,” she says, as there are protocols in place for such serious emergencies as heart attacks.
Wise says the North Healthplex is prepared to resuscitate and/or stabilize patients needing surgery or more specialized care.
Patients who are transferred are already in the WakeMed computer system, which eliminates registration time at the Raleigh Campus.
Peak hours in the emergency department are 1 to 10 p.m.
Inside the hub of the North Healthplex, treatment rooms feature glass doors and inside curtains which remain closed to give patients more privacy. There are hangers for clothes and televisions with DVD players, and specialized equipment is discreetly tucked away behind attractive cabinetry.
The setup contributes to the calmness, while the glass doors keep the noise level at a minimum.
Lee Stikeleather, a staff nurse at the North Healthplex, says the noise level is much lower than the Raleigh Campus. “What a big difference,” she says.
The treatment areas for children feature brightly colored cabinets and small toilets.
Children coming into the emergency room get a stuffed version of WakeMed’s mascot for pediatric patients, Twinkle the Star.
Books, stuffed animals and children’s quilts donated by volunteers also keep the children entertained, Knaup says.
In the main emergency department area, low lighting contributes to the calm. “It’s a very nonchaotic emergency department,” Wise says.
The nurses’ station is located on the right side of the main emergency area. The physicians work at a station to their left.
WakeMed Health & Hospitals contracts with a group of 66 emergency department physicians to staff those various facilities, Knaup says, and they rotate working at all them.
In the first year of operation, she says the freestanding emergency department saw 23,000 patients. The second year, that number went up to 28,000. One-fourth were children.
The majority of residents around the North Healthplex are young families with children. “We are known for being a pediatric emergency department,” Knaup says. “I think there is a comfort level there.”
The North Healthplex offers a wide range of diagnostic imaging, including CT scans, ultrasounds, digital screening mammography, bone densitometry for osteoporosis and tomography.
The laboratory features a full range of diagnostic and pathologic testing, as well as frozen sections, a specific type of biopsy developed for rapid diagnosis of tissue.
In addition to emergency department services, the North Healthplex includes four outpatient operating rooms and outpatient rehabilitation.
The freestanding emergency department received a five-star rating for patient satisfaction from a survey service that rates facilities across the country.
“We were very proud of that,” Knaup says. “We work hard because we want it to be a positive experience, but we recognize also that it’s a stressful time.”
Contact Kathy Chaffin at 704-797-4249 or kchaffin@salisbury post.com.