Suddenly, hospitals throughout Baltimore are putting up big money to heal an old wound: Their antiquated and in some cases, hopelessly cramped, emergency rooms.
And Gloria Barlow, clinical manager for Maryland General Hospital's emergency department, couldn't be happier.
The ER in which she has worked for 29 years is a throwback to another time.
To get to her cubbyhole of an office in the ER, Barlow must pass through another tiny office where emergency room patients are evaluated. Outside, patients lie on gurneys in a hallway. The nurses' station is near an examining area with a dingy curtain for privacy.
"There have been times when a doctor has asked one patient a question, and a patient waiting on the other side of the curtain has answered," Barlow said.
Such circumstances may be fodder for television dramas about life in the ER, but they get low ratings from hospital staff and patients.
Maryland General's remedy was to spend $6.8 million to build a new ER, including the latest in medical equipment.
Tomorrow, the state-of-the-art facility opens with hope of better accommodating the flood of patients and radically altering the way the hospital delivers emergency medicine.
In opening the new facility, Maryland General is leading a trend in Baltimore -- new emergency rooms equipped with high-technology diagnostic devices and computer systems, designed to ensure patients are attended to quickly and in a setting that affords privacy.
Several other hospitals in Baltimore are working on or planning expanded and improved emergency rooms:
Union Memorial Hospital, which sees 40,000 people annually in its ER, recently launched a $2.5 million renovation of its emergency room to provide more privacy for patients and their families, speed up medical attention, and improve efficiency.
The University of Maryland Hospital is planning and designing an entirely new emergency department as part of its multi-million-dollar construction program.
Sinai Hospital plans next month to break ground on a new, $12 million emergency room that will double the current facility's size to 35,000 square feet. The new ER, which officials plan to open in the fall, will allow the staff to keep patients needing specialized care such as pediatrics and psychiatry separate -- rather than having everyone mixed together.
More patients are using Sinai's ER than ever before, said Dr. David Meyers, the hospital's chief of emergency medicine. The hospital estimates that 10,000 more patients visited the ER last year than in 1978, when it opened.
One reason for the growth in patient visits to emergency rooms is that many people who do not have family or primary-care doctors use the emergency room for even the most minor of ailments, experts say.
But competition also is driving Sinai and other hospitals to
budget big money for new ERs.
Said Meyers, "Patients, especially those with insurance, can go anywhere they want for treatment. We want to appeal to the sense of the high-tech and signal that we are at the forefront of emergency medicine."
Maryland General's new ER has some of the latest technology and design themes, including a central nurses' station that serves as communications hub and is quickly accessible to all parts of the emergency room.
Other elements at Maryland General's new facility include an isolation room to prevent the spread of tuberculosis and other disease, sound-proof rooms for monitoring and caring for patients complaining of chest pains, private examining rooms, a quiet, comfortable waiting room and a separate room for counseling grieving or distressed family members.
The design also features examining rooms to expedite nonemergency cases as part of a "fast track" program, as the hospital has dubbed it, that is expected to save time in treating ailments such as sprained ankles and sore throats.
"There were a lot of issues we wanted to address with this new facility, but to me the priorities were patient privacy and the waiting," said Barlow, who already has the key to her new office.
"The new ER," she said, "will change everything -- radically -- for the staff and the patients we serve in this community."
There are many reasons for the trend toward the new, high-technology ER, said Dr. Brian Browne, director for emergency medicine and a professor at the University of Maryland Hospital.
Among the key ones, he said, is that emergency medicine has blossomed in the last decade as a medical specialty demanding new equipment and more space.
Historically, emergency rooms were not always given enough space and the location within the hospital often was not the best. Many emergency rooms have suffered from crowding for decades. Some have been overwhelmed by the volume and intensity of the workload of the 1990s.
But the emergence of the ER as the point of diagnosis at many hospital and the dazzling advancements in medical equipment and computers have made it possible to equip and design emergency rooms that operate with speed and efficiency and offer staff and patients a high degree of security, privacy and access to specialists.
"One of the most important trends in emergency rooms is that they are becoming the diagnostic centers of the hospital. They are the silent partners in everyone else's admissions," Browne said.
Pub Date: 8/14/96