St. Joseph's Hospital in Syracuse opens new, larger emergency department

Syracuse, NY -- It would be easy to mistake the entrance to the new emergency department at St. Joseph’s Hospital Health Center for the hospital’s front door. Visitors pass by a hotel-like reception desk into a spacious waiting area equipped with flat-screen TVs and a bank of large windows that let in lots of natural light.

The department is laid out so that each patient exam room is visible from a nursing station. It is organized into three areas: a “speed zone” for patients with minor problems that can be treated in 30 minutes or less; an intermediate zone for patients with problems that will require more than 30 minutes, but not hospitalization; and an acute zone for the sickest patients who might need life-saving measures.

The emergency department, which opened at 3 a.m. Wednesday, is more than three times bigger than the hospital’s old one. Its size and design recognize that the department really is the hospital’s front door for a growing number of patients. More than half of the people admitted to St. Joe’s come through the emergency department, said Mark Murphy, a St. Joe’s senior vice president.

St. Joe’s old emergency department was designed for 30,000 patient visits annually, but it has been handling nearly 56,000 visits in recent years. Upstate University Hospital has the busiest emergency department in Syracuse, but St. Joe’s has the largest amount of ambulance traffic, according to the Hospital Executive Council, a Syracuse hospital planning agency.

“We have been undersized for years, and this is an attempt to match our capacity with community demand for emergency services at St. Joe’s,” Murphy said.

It is the first new emergency department among Syracuse’s major hospitals since Upstate opened its emergency department in 1996. The Syracuse VA Medical Center built a new emergency department in 2003.

The new department at St. Joe’s takes up the majority of an $80 million, three-story emergency services building that also houses a separate psychiatric emergency department, a 15-bed observation unit and a computer data center. The building is part of a $220 million hospital expansion that will include a tower with private patient rooms, new operating rooms, intensive care unit and other clinical areas.

The main entrance to the emergency department is on Townsend Street, near Butternut Street. The old emergency department occupied cramped, windowless basement space on the north side of the hospital. The department was often so crowded that patients on stretchers had to be cared for in narrow hallways. Walk-in patients and patients arriving via ambulance all came through the same door into a congested reception area. Because there were only three parking spaces for them, arriving ambulances sometimes had to wait in line before their crews could unload patients.

What’s new

• Three times bigger.

• More parking for ambulances, patients.

• Quieter. No overhead pagers, call bells. Call system buzzes nurses on cellphones.

• Separate entrances for ambulance patients, other patients.

• Skylights, windows let in more light.

• Cafe overlooking a park.

The difference between the old and new is striking.

The new emergency department has separate entrances for walk-in patients and those transported by ambulance. There are 13 covered parking spaces for ambulances. There are more than 50 parking spaces for patients and visitors, more than double the number of spaces at the old emergency department. There are 54 patient exam rooms, 10 more than in the old emergency department. There are many skylights and windows throughout the emergency services building.

“When you are working in the other ED, you can’t tell if we’re having a hailstorm or a snowstorm outside,” said Jessica Caruso, the department’s nurse manager. “We always hoped we would have windows.”

Windows are just one element incorporated into the design after Caruso and other St. Joe’s employees visited other modern emergency departments in the Northeast. In addition to being good for staff, natural light promotes patient healing and helps create a more soothing environment, hospital officials said.

The new department is designed to be quiet. There will be no overhead pager announcements or call bells ringing. A call system will buzz nurses directly on their cellphones. “The environment can be busy, but it won’t be perceived as being chaotic for the patient,” Murphy said. “Too much stimulation, like bells going off, is distracting, especially for elderly patients when they are compromised.”

In the new emergency department, supplies such as syringes and gauze are stored near patient beds. Supplies are tracked by an automated system. Nurses will spend less time running to get supplies and more time with patients, Murphy said.

By the numbers

Emergency department visits at Syracuse hospitals:

Crouse

2010: 38,137

2011: 40,222

Change: +5.5 percent

St. Joseph's

2010: 53,604

2011: 56,398

Change: +5.2 percent

Upstate University Hospital

2010: 58,293

2011: 62,997

Change: +8.1 percent

Upstate Community General

2010: 25,331

2011: 24,953

Change: -1.5 percent

Source: Hospital Executive Council

“One of the biggest complaints we hear is, ‘I came to the emergency department and I didn’t see anyone for a long time,’” Murphy said. “We are trying to design the physical space so practitioners can stay with patients.”

In the back of the building there is a cafe, overlooking a park, for visitors and staff.

St. Joe’s psychiatric emergency department, known as the Comprehensive Psychiatric Emergency Program — CPEP for short — was previously housed in a small building on the north side of the campus, far from the regular emergency department. The unit, which handles about 7,000 patient visits annually, is the only psychiatric emergency department serving Onondaga and Madison counties. It was so small that there was not enough room to segregate children and adults, or to separate violent adult patients who have been brought in involuntarily from patients who come voluntarily.

The new CPEP on the second floor of the emergency services building is three times larger and has enough room to keep those populations separate. There are 18 bedrooms, nine more than the old CPEP. Mary Bishop, executive director of CPEP, said the larger space will dramatically improve safety.

There is a separate entrance for CPEP next to the emergency department entrance. It leads to an elevator that takes patients and their families to CPEP on the second floor.

The second floor also has a 15-bed observation unit. This is designed for patients with chest pains and other problems who need to be watched for up to 48 hours but are not sick enough to be admitted to the hospital. The new unit will help prevent backups in the emergency department and will free beds elsewhere in the hospital needed for sicker patients, hospital officials said.

Contact James T. Mulder at 470-2245 or jmulder@syracuse.com.

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