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Memorial Focuses on Technology; Falls Hospital's Emergency Room, Heart Center Moving into Spacious New Quarters

Posted on: Tuesday, 24 January 2006, 09:00 CST

By Gail Norheim

Patients at Niagara Falls Memorial Medical Center will soon get a better taste of the latest advances in emergency medicine and cardiac care.

Next month, the hospital will open a $20 million addition that moves its emergency room and Heart Center of Niagara across the street, into larger spaces with new equipment and more workers.

"Many of us have been down here for quite a while, and seen [several] plans for new emergency rooms, and we had become cautious as to believing anything would come true," said Susan Little, a registered nurse who's worked in the Falls emergency room for 25 years. "The [addition] is going to be beneficial to us as workers and us as the community. The space, the newness, is a positive sign that Memorial has started to invest in the community."

Patients in the first-floor emergency room can expect shorter waits to see a doctor, and closer monitoring. And those who show up with heart-related problems will have the comfort of knowing that help may be as close as the Heart Center upstairs.

"We're not pretending to be a level one trauma center," Memorial CEO and President Joseph Ruffolo said during a recent interview, "but we'll be treating more patients and referring less out [to Erie County Medical Center]."

The Heart Center of Niagara/ER1 will open Feb. 1 at Walnut Avenue and 10th Street. A dedication ceremony is planned for Thursday.

Heart Center staff will gradually move into their new quarters during February.

The emergency room will open at the start of the month -- and visitors will immediately notice a difference.

A big difference.

At 22,000 square feet, it is nearly three times the size of the current emergency room.

More space, more technology and greater proximity to the Heart Center of Niagara will be key to providing better emergency care to patients, Ruffolo said. In addition, he said, 20 new nurses, technicians and other employees have been hired during the last six months as the hospital has geared up for expanded operations of the emergency room.

The new operation also has a new name: ER1.

"The joke is, we'll all be wearing roller skates," Little said. "With the expansion, there are more of us, meaning a faster time as far as minor emergencies."

Even the nursing station in the new emergency room is much larger than in the current ER, about 1,500 square feet, compared with 200 square feet.

Ruffolo said he began pushing for a new, larger emergency room when the state announced early this decade that the Senecas would build a casino and hotels downtown, projects that already have affected the number of emergency visits.

"The first thing that came to my mind was that there would be an increase of about 15,000 to 25,000 visits per day to an area two blocks from Niagara Falls Memorial Medical Center," Ruffolo said. "When they need health care, they'll go first to the emergency room."

Another feature of the new building is an expanded waiting area that will be able to serve as "surge capacity" in the event of a large emergency.

The current emergency room offers up to 11 patient areas -- divided by curtains -- with two hallway beds. The new building has 17 separate rooms with the ability to create 21 patient areas, and no hallway beds.

Registered nurse Norma Kudela said that may seem like a small thing, but it is the item she is most excited about.

"I'm counting on better patient confidentiality with the single rooms," said the 30-year nurse. "It's hard to interview patients when there's someone on the other side of a curtain."

The new emergency room is so large that it includes an indoor decontamination unit with its own entrance. The unit consists of three fully contained showers to clean hazardous material from a person who has been exposed. The water will drain into its own underground tank and be pumped out by special hazmat trucks.

Ruffolo said the hospital's proximity to three international bridges prompted him to include that extra item.

Technology, from flat screen plasma televisions in each patient room to a paperless patient tracking system, also will make people more comfortable and well-looked after, Ruffolo said.

>Training and technology

Included in the recent hires is a group of board-certified emergency-trained doctors, which Ruffolo said is a big commitment by the hospital and an added feature for patients. As the hospital moves toward requiring all its emergency room physicians to have had residency training in a trauma setting, Ruffolo believes Memorial will be the first in the area to do so.

One of those physicians, Dr. Steve Lopez, said it's a good thing for everybody that Niagara Falls' emergency room is now void of clipboards and paper records of patient histories.

Lopez said the paperless tracking system includes a computer in each patient room, where a doctor can look at lab results and patient background. It also includes a computer in the nursing station that alerts doctors and nurses to a patient who has been waiting longer than 15 minutes for care. Each patient's name is color coded according to the severity of the nature of the visit. This will help doctors sort out priority.

"There are at least three visual prompts to ensure a patient is seen timely," Lopez said last week. "It's just another form of checks and balances. It's a more orderly, more logical progression of record management."

The system even alerts doctors to instances where two patients have the same or similar names, something that happens often and causes confusion in many emergency rooms, Lopez said.

Since the new building is across the street from the hospital, connected by an elevated, enclosed walkway above Walnut Avenue, Ruffolo said blood samples will be sent to the hospital's laboratory through a pneumatic tube instead of using human carriers.

At 30 feet per second, the speed of those lab samples its just another example of how Memorial will use technology to hasten the care it gives.

However great the technology in the emergency room, many patients will likely use sophisticated equipment on the second floor, home to the Heart Center of Niagara. That's important, because one in three patients in an emergency room has some form of respiratory distress ailment, which signals a heart problem, Ruffolo said.

>Heart Center's role

The Heart Center, which has seen success in its initiatives to prevent and reverse heart disease, uses a combination of lifestyle changes and non-invasive diagnostic equipment to detect coronary issues early and show whether medications are working. The center is currently serving patients from the eight Western New York counties and beyond, Ruffolo said, and some of its work will be featured between 8 and 8:30 a.m. Monday on the "Today Show" on NBC.

The center's new location will include eight private practice cardiology patient exam rooms and two testing suites. Nuclear medicine, echocardiography, nuclear imaging, stress testing and cardiac rehabilitation -- including a fitness center for patients -- will all be on the second floor as well.

Dr. Michael E. Merhige, Heart Center director, said one of the center's most-used features since 2003 has been the positron emission tomography, or PET, scanner, a non-invasive machine that takes 45 minutes to measure coronary blood flow and spot blockages. Next month, the center will install an additional $2 million non- invasive detection tool, which also will be available to patients coming into the emergency room with chest pains or coronary issues.

The computed tomography angiogram, or CTA, was purchased with help from GE Healthcare, the machine's manufacturer, and $1 million in federal money secured by U.S. Sen. Hillary Rodham Clinton, D- N.Y.

GE's machine, the LightSpeed VCT, is a 64-slice scanner that uses a high-speed camera and 64 detectors to capture three pictures per second of any organ. In about 10 seconds, it can form a high- resolution image of the heart, and scan the entire body in 30 seconds, to detect blockages or other problems.

Merhige said he believes that when the PET and new CTA scanner are used together at Memorial, cardiologists there will not only be able to tell which areas of the heart have blockage, but which blockage in particular is causing the trouble.

"The Heart Center's non-invasive approach . . . is less risky for the patient, more inexpensive than current modalities and more timely," Ruffolo said. "Now these services will be available on an emergency basis, 24-7."

Dr. Susan Graham, a congestive heart failure and women's cardiac care specialist, is one of the three physicians who practices out of the Heart Center. She said she believes the importance of opening up the center's technology to emergency patients can't be understated.

"One of the biggest frustrations in emergency medicine perceived by physicians and patients is they say, 'When I'm sick I need to be taken care of, and I need answers fast.' That has led to crowding in the ER," Graham said. "Having diagnostic capabilities will make it hopefully easy for emergency room physicians to do a better job as well."

>Technology maximized

Graham said patients in the emergency room who use the detection equipment are getting above-average care from a community hospital because PET scans are usually only found in a university setting. She said the only other two facilities in the region with a PET are the Veterans Affairs Medical Center and Buffalo General Hospital's cardiology department. The 64-slice scanner is also at Buffalo General Hospital, Mercy Hospital and Roswell Park Cancer Institute.

There is still a great necessity for surgeries, Graham said, although the testing gives primary care doctors better information for treatment options and cardiologists a better idea of the best patients to undergo surgery.

Graham also said research will be undertaken in Memorial's new building. Research has become a top priority at the Heart Center of Niagara since the Buffalo Niagara region has been identified as an area with one of the highest rates of heart disease in the nation.

"It will be very nice to have all of the people and staff close together," Graham said. "In the current setup, we're everywhere. In the basement, . . . on different floors. There is certainly greater collegiality and exchange of ideas and interaction with various staff members when you're geographically closer together."

Memorial has partnered with Niagara University, University at Buffalo, a state research group, and GE for several new research initiatives.

Ruffolo envisions the improved emergency care coupled with that research as the beginning of a medical corridor that could spring up in Niagara Falls. He has committed to hiring a full-time research coordinator to help that work, and said work will soon begin to restore the historic Schoellkopf Park on Portage Road at the edge of the hospital grounds. That project is meant to improve the appearance of Memorial's neighborhood.

"I think this $20 million project is the economic catalyst that will begin the next chapter of the growth of the Niagara region, which will have a major focus on health care and job creation," Ruffolo predicted.

Meanwhile, visitors to Niagara Falls Memorial's emergency room can take heart that their wait times will likely be shorter.

e-mail: gnorheim@buffnews.com

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Healthy improvements in the Falls

The new Heart Center of Niagara and ER1 emergency room at Niagara Falls Memorial Medical Center is scheduled to open soon.

Location: Walnut Avenue and Tenth Street, Niagara Falls

Cost: $20 million

Size: 56,400 square feet, including an elevated walkway to the main building.

Construction: 75 to 100 workers have been on site each day since construction began last spring. Savarino Construction Services of Amherst is the general contractor.

Workers: 150 employees will staff new addition.

Patients: The new emergency room can accomodate 25 at a time.

Heart Center: The second-floor center will include eight private patient exam rooms and two testing suites, along with non-invasive testing equipment.

Opening: The emergency room will open Feb. 1, while the Heart Center will move into its space throughout February. U.S. Sen. Hillary Rodham Clinton, D-N.Y., is among those expected to attend a dedication ceremony at 3 p.m. Thursday.

Source: Buffalo News

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