PORT ANGELES — Even as Olympic Medical Center officials warn of a cutback in capital spending in 2008, they are considering tripling the hospital emergency room.
Cost of the three- to five-year project has not been projected
Hospital commissioners received the preliminary proposal Wednesday from Lorraine Wall, chief nursing officer.
Moments later, they got a gloomy third-quarter financial report from Julie Rukstad, chief financial officer.
The emergency room plan emerged from a four-day visit by consulting company Freeman White of North Carolina.
What emerged from the study were changes not just in the emergency room but in the quickness and quality of care it provides.
“It was amazing that we ever got a patient through our process, it was so complicated,” Wall said.
Big boost in patients
Last remodeled in 1992, the emergency room at 939 Caroline St. has experienced a 9 percent increase in patients this year and a 35 percent hike in trauma cases.
Emergency room traffic has increased 83 percent in the past 10 years, according to Wall, presently serving more than 26,000 patients annually.
That sometimes means “boarding” patients — the widely criticized practice of putting patients in beds in the emergency room hall.
“Ours is certainly not the worst,” Wall said, “but it’s not optimal.”
The facility currently has 11 beds, and OMC would enlarge it to 33, first by expanding into the present billing department annex west of the main hospital.
OMC also would provide “urgent care” service in Sequim.
Reduce waiting time
Plans call for drastically reducing the time patients wait to be treated.
The goals:
ä Door to emergency room: Currently 30 minutes, the interim goal is 15 minutes with a best-practice goal of 10 minutes.
ä Door to doctor: Cut from current 58 minutes to 30 minutes, then to 14 minutes.
ä Discharge from emergency room: Quicken from present 165 minutes to 135 minutes with a goal of 81 minutes.
ä Admission to hospital: Trim from present 4.6 hours to three hours, then to two hours.
Other practices would make better use of existing staff, such as teaming a nurse and technician to treat each patient, and taking laboratory samples immediately instead of waiting for a lab tech to do it.
“This is sort of a paradigm shift from doing things the old way,” said Commissioner Cindy Witham.
“This is really exciting.”
Income below budget
Not so exciting but perhaps more crucial is the hospital’s financial condition.
Third-quarter operating expenses were up by $865,000, but operating income was more than $1.5 million below budget, Rukstad said.
Net revenue undershot the budget by almost $1.67 million and by than $1.34 million for all 2007.
OMC’s operating margin — which generates funds to build facilities and buy equipment — was a negative 4.7 percent for the quarter.
Eric Lewis, CEO, blamed the “huge fixed cost” of inpatient treatment that was chased by charity care and bad debt that could total $7.2 million for 2007.
That figure includes OMC’s contributions to the new Port Angeles VA Clinic, the Volunteers in Medicine of the Olympics Clinic in Port Angeles and the Dungeness Health and Wellness Clinic in Sequim.
The last two clinics serve uninsured or underinsured patients.
More capital requests
Lewis said the hospital must curtail its capital spending, which recently included buying and upgrading the former Virginia Mason Clinic in Port Angeles, building a new medical services building in Sequim, expanding the Sequim cancer center and expanding the Caroline Street hospital.
“We have to reduce capital spending to reflect the bad income that we’ve had,” Lewis said.
Nonetheless — besides the emergency room expansion — commissioners Wednesday received requests for a $407,184 cardiology upgrade, an orthopedic clinic X-ray machine costing $107,000, and $1.72 worth of new computers and software.
On a brighter note, they learned that the recent Harvest of Hope fundraiser brought in more than $100,000.
The money will buy new radiation software and support the patient navigator program at the cancer center by paying for patients’ uninsured out-of-pocket costs.
Surgery open house
OLYMPIC MEDICAL CENTER’S surgical services department will hold an open house from 10 a.m. to 3 p.m. Nov. 3.
The event will allow visitors to meet surgeons and receive an overview of the department in the hospital at 939 Caroline St.
They will be able to watch demonstrations and learn about surgical specialties, including orthopedic surgery, joint replacement technology, incontinence surgery, colonoscopy and gastroscopy procedures, seed implants for prostate cancer, pre-menopausal ablation procedures.
Hospital officials say the open house is especially recommended for people older than 45 who may find themselves needing such services.
Learning about the overall surgical process can help reduce the stress and anxiety of surgical procedures, they said.
The department also will offer a drawing for three $25 gift cards to Seasons Café that is located near the east entrance of OMC. Refreshments will be provided for guests.
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Reporter Jim Casey can be reached at 360-417-3538 or at jim.casey@peninsuladailynews.com.
