Source: UT-San Diego
By: Michelle Breier
Posted: Wednesday, June 27, 2012
In less than two months, patients seeking emergency care in inland North County will be treated at a new state-of-the-art hospital on the western edge of Escondido instead of the decades-old medical center in the city’s downtown.
At 7 a.m. Aug. 19, the emergency room at the old downtown hospital will close and reopen at the $956 million Palomar Medical Center on Citracado Parkway.
The Palomar Health hospital district is conducting an extensive outreach campaign to make the public aware of the move. The busy downtown emergency department treats about 70,000 patients a year, officials said. Palomar Medical Center operates the only trauma center in North County.
For a photo gallery of the new and old emergency departments by U-T photographer Charlie Neuman, go to utsandiego.com/emergencydept.
If you have an emergency
The Emergency Room will open at the new Palomar Medical Center, 2185 W. Citracado Parkway, at 7 a.m. Aug. 19.
No emergency services will be available at the downtown hospital, 555 E. Valley Parkway, after 7 a.m. Aug. 19.
Labor and delivery services will stay at the downtown facility, to be renamed “Women’s and Children’s Hospital at Palomar Health Downtown Campus.” Women in labor, with nonemergency conditions, should go to the downtown campus.
The downtown campus’ emergency room will reopen as a 24-hour urgent care center for treatment of minor illnesses and injuries.
The downtown hospital will remain open as Palomar Health Downtown Campus, providing an urgent care center; a women’s and children’s center, including labor and delivery; cardiac rehabilitation care; and mental health services. Construction on the new hospital began in late 2007, using funds from a $496 million bond approved by voters in 2004. The Palomar Health hospital district covers 850 square miles in inland North County.
With a cramped waiting area that’s frequently standing-room-only and patients sometimes awaiting examinations in hallways, Palomar’s emergency department had long outgrown the downtown hospital.
Physicians and nurses typically see about 200 patients daily in the downtown emergency department, which was designed for about 125, said Catherine Prante, director of emergency services.
“We are as efficient and as lean as we could be,” Prante said. “At the end of the day, we just need space. We’ve taken up every nook and cranny.”
The downtown hospital has no private treatment rooms in the emergency department, and the hallway houses some of its 29 emergency beds, said Dr. Jaime Rivas, the emergency department medical director who is overseeing the department’s move with Prante.
The narrow hallways of the downtown emergency department were buzzing and crowded on a recent weekday afternoon. A nurse sat at a portable computer station in a hallway because the nurses’ station near the entrance is too small for all the staff. Nearby, an elderly woman waited on a gurney in the hallway.
Treatment beds in the exam rooms are separated by curtains, and several of the rooms themselves are divided by accordion walls.
Over in west Escondido near the crossroads of Interstate 15 and state Route 78, the new emergency department is a study in contrasts, starting with the wide, bright-with-natural-light walk-in entrance. Ambulances will pull into a wide, secluded ambulance bay on the hospital’s far west side, rather than share an entrance and parking area with private vehicles like they do downtown.
The emergency department “reception area” — it won’t be called a “waiting room” — has a low, open check-in desk. The triage rooms are private. Downtown, the registration windows and triage desk are squeezed in to the already tight waiting room.
The reception area includes upholstered booths, chairs and love seats, tables, and children’s-size seating. Floor-to-ceiling windows facing a landscaped courtyard provide an abundance of natural light.
Beyond extra-wide double doors are more than four dozen treatment rooms with adjacent work space for medical staff that will improve treatment, officials said.
“When people ask me about it, the message I give them is, this is what the community deserves. You’re going to be seen faster, (there’s) more space, (for) better healing,” Rivas said.
The emergency department now has private rooms, better visibility between the nurses’ station and patients, and its own CT scanner — the most significant differences between the old and new, Rivas said.
Having radiology equipment such as a CT scanner right in the emergency department is a common feature in modern, efficient emergency departments, he said. A pharmacist also will be based in the department.
Other efficiencies include a private, direct elevator from the department to the surgery floor above and a trauma elevator from the 11th-floor helipad.
With the changes, the new Palomar emergency department will have the capability to handle 100,000 patients a year, officials said.
In addition to 44 spacious private treatment rooms, the department has four fast-track beds and two large trauma and cardiac resuscitation rooms that can hold up to five patients in a mass-casualty situation.
Training is under way for the department’s staff — more than 300 nurses, 30 doctors, 10 physician assistants, and 40 technicians and interpreters. Preparation for the Aug. 19 transition includes dozens of hours of education for each employee and a mock moving day.
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