The Nov. 4, hospital workshop focused on infrastructure and service updates, with Tom Johnson of Tom Johnson Architecture presenting his company’s analysis of current building deficiencies and resulting flow issues.
Key problems include the basement, where water lines are laid over electric service, an undersized water heater is housed along with too-small medical gas tanks, and the fact that meal and laundry deliveries must go outside the building. The walk-in kitchen freezer breaks down, and food is sometimes stored offsite.
First floor issues include departments being functionally undersized, the front entrance not being handicapped accessible, and few patient rooms with medical gases capability. The imaging department is spread across several locations resulting in long travel for staff.
There are no changing rooms in procedure rooms, and there’s inadequate power for the Emergency Room, and blood draw is separated from the laboratory. Traffic flow issues include pharmacy delivery through the Emergency Department, crossing hospital and public waiting areas, as well as ED transfers having to go through public halls to reach the helipad. The door for emergency evacuation is not as wide as a hospital bed.
Access to the second floor is by stairs only, with no handicapped provisions, and there are no conference rooms. Radiology and ED directors are separated from their departments and must go downstairs in emergencies.
The helipad is on the side opposite the ED and used for staff parking. Other exterior deficiencies include main entrance parking being inadequate, and there is no loading dock, so small deliveries must use a ramp, and large trucks cannot be used.
“We can’t just move the building because we’d lose critical access designation since it would be too close to Berryville. We have to make part of this building functional,” Johnson said.
Respiratory Therapist Greg Barrios noted his area is small and requires physical expansion. Barrios also noted that oxygen tanks are dangerous, and that newer hospitals have ports for pumping oxygen directly into patient rooms. Johnson agreed that this, too, was likely needed to conform to new codes.
Structural changes considered
Four proposed alternatives were presented, and each discussed with staff and the board. Current cost estimates are outdated and will need revision.
A behavioral unit is under consideration, although there was discussion about its size. Commissioner Ty Burden noted that behavioral health includes alcohol and substance de-toxification, something the hospital is seeing more of. Burden did agree, however, that 10 beds might be difficult to fill.
Burden cautioned that any new building plans must be made with proposed CMS legislation in mind that seeks to limit future critical access facilities to be emergency treatment only, with inpatient care accomplished by transporting patients to larger hospitals.
Other structural issues involve the need for a much larger generator with SWEPCO providing dual power lines to ensure power in the event of an outage. Any movement of the helipad would require FAA glide path analysis and approval.
Possible new services
Suggestions for added services are also being considered. These include a chest-pain and cardiac care unit which would include stress testing and nuclear medicine. A new cardiologist is onboard who might be interested in this type of clinic and/or critical care unit, Dr. Radhir Tandon. Local physicians have requested an MRI since it’s difficult to schedule this imaging and can be challenging in terms of travel for some patients. MRIs are expensive, but it was agreed that including proper housing and power for such a device in any new building or remodeling might be appropriate for possible future acquisition.
Commissioner April Griffith remarked that there are no facilities for delivering a baby in Carroll County and that she knows of women who have gone without prenatal care for unreasonable lengths of time; consideration will be given to having an obstetrician available for consultation at the clinic and possibly other OBGYN services.
The next meeting is Monday, Dec. 20, at the Aud, 6 p.m.