modular emergency room emergency department example LGH

This is an example of a modular emergency department manufactured by Johnson Portables of Michigan. Penn Medicine Lancaster General Health said the company will build one for Lancaster General Hospital, to help its emergency department deal with increasing demand. It is expected to open in July 2019. 

As UPMC Pinnacle prepares to close its Lancaster city hospital’s doors for good on Feb. 28, one key question is how the only other hospital in the immediate area will handle more patients.

On Tuesday, Penn Medicine Lancaster General Health announced plans to expand the capacity of Lancaster General Hospital’s emergency room with a temporary 2,500-square-foot modular building to open in July.

Lancaster General spokesman John Lines said the $3 million addition “is among the approaches both under way and under consideration to address the projected growth in demand for emergency care.”

It will, he said, “afford us the necessary time to address the financial and patient care and workforce impacts a more permanent expansion would require.”

LGH is just over a mile from the hospital that’s closing. The latest state records are from 2017 and show LGH had 533 beds, 31,941 admissions and 115,990 emergency department visits, while UPMC Pinnacle Lancaster had 136 beds, 3,513 admissions and 23,360 emergency department visits.

LNP reported in January 2018 that the LGH was considering a similar modular project then.

Expanding the hospital would require review and approval from the system’s board of trustees, Lines said, “and that has not occurred.”

Already busy

According to Lancaster General, its current department has 54 bays, or beds. It was last expanded in 2000-01 and was designed to handle 90,000 visits a year. It saw about 117,000 in the 2018 fiscal year, which ended in June.

“Regrettably, there are at times extended wait times,” Lines said.

But, he noted, the current flu season has been much less severe than last year’s, and so far overall emergency department visits are down about 3 percent year over year, with 67,280 from July through January, compared to 69,130 last year.

There were 9,689 visits in December and 9,832 in January, he said.

Meanwhile, Lines said, urgent care visits are up about 7 percent year over year, at 65,800 compared to 61,270, and the system continues to urge patients to get treated in places other than the emergency room when appropriate.

An internal Lancaster General newsletter posted online in November said a study of patients at some Lancaster General offices found that about 15 percent of those who visited the emergency department “had conditions that could have been properly cared for in a primary- or urgent-care practice.”

Some patients chose the emergency department “due to convenience,” the newsletter said, others because they perceived their situations as emergencies, and some who had Medicaid chose it “to avoid a co-pay.”

Researchers worked to educate patients in those practices, the newsletter said, and in the end reported a 23 percent decrease in emergency visits that could be treated at an urgent care or primary care practice.

Plan details

According to Lancaster General, the modular facility manufactured by Johnson Portables of Michigan will include a nurse’s station, restroom facilities and nine treatment bays, and the system’s permit allows it to be used for up to three years.

“The building will deliver the same patient experience and quality provided in the existing Emergency Department,” a news release said.

It also noted that the department’s main patient entrance will not change, but that “ambulances that use the Duke Street ramp will need to turn around on the ramp, and exit from it.”

Other numbers

The latest state records are from 2017. They show that UPMC Pinnacle Lancaster had 136 beds set up and staffed, with 3,513 admissions and 23,360 emergency department visits.

Here’s what records show for the other local hospitals in 2017.

— Lancaster General Hospital: just over a mile away; 533 beds; 31,941 admissions; and 115,990 emergency department visits.

— UPMC Pinnacle Lititz (where inpatient services will be consolidated, formerly known as Heart of Lancaster Regional Medical Center): 7 miles away; 102 beds; 2,465 admissions; and 13,091 emergency department visits.

—WellSpan Ephrata Community Hospital: 16 miles away; 141 beds; 6,294 admissions; and 29,375 emergency department visits.

— Penn State Health Milton S. Hershey Medical Center: 28 miles away; 523 beds; 27,488 admissions; and 74,526 emergency department visits.

Complete coverage: UPMC Pinnacle Lancaster hospital closure

UPMC Pinnacle closed the former St. Joseph Hospital at the end of February 2019.