ECMC to expand emergency care

Responding to recent surge in trauma cases, hospital plans to build new $45 million department beside the existing ER at Grider Street campus

Seventy-eight percent of inpatients at Erie County Medical Center, the Buffalo Niagara region’s Level 1 adult trauma center, come in through the emergency room, and 16 percent rise in demand has prompted the need for a new building with greater capabilities. Sharon Cantillon/Buffalo News file photo

By Stephen T. Watson | News Staff Reporter | @buffaloscribe | Google+

Erie County Medical Center is planning to build a new $45 million emergency department as a recent surge in trauma cases shows no sign of letting up, CEO Thomas J. Quatroche Jr. told The Buffalo News on Wednesday.

The hospital is firming up plans for the expanded emergency department, which will be built to the side of the existing department on its Grider Street campus in Buffalo, and has sought input on the project from physicians, nurses and other hospital staff.

Quatroche said ECMC will launch a capital campaign later this year to raise money to help cover the cost of the new department and late this year or early next year will file detailed plans with the state Department of Health, which must approve the project.

“The emergency room is the front door of our hospital, so it’s very important,” he said.

ECMC is the Buffalo Niagara region’s Level 1 adult trauma center, handling patients with life-threatening wounds and injuries caused by gunshots, motor vehicle crashes and burns, along with other emergency cases. Seventy-eight percent of ECMC’s inpatients come in through the emergency room, according to the hospital, and demand is driving the need for the expanded department.

ECMC said emergency room visits rose by 16 percent between 2010 and 2015, from 58,090 to 67,296 over the five years.

June, July and August are typically the busiest months in the department, which has 34 beds and three overflow beds that can be added for low-acuity cases when needed, said Dr. Michael A. Manka Jr., chief of emergency medicine at ECMC.

During peak periods, every emergency room bed can be filled, a back hallway can be lined with patients on stretchers receiving care as they wait for a room to open, and the waiting room can be filled with 30 or so patients with less severe ailments, he said.

“We are currently undersized for the volume of patients that we see,” said Manka, who has practiced medicine in the department for 20 years, including his three-year residency.

ECMC has had its busiest January, February and March ever recorded in the emergency department this year, Manka said.

Quatroche, who was named permanent CEO in January, has overseen the planning for a new emergency department since his appointment as acting CEO in November.

He and other top ECMC administrators have sought input from trauma, surgery, radiology, orthopedic, behavioral health and nursing staff on what they’d like to see in the expanded emergency department.

“Everything we do from a capital perspective, but also from a strategic perspective, is physician- and nursing-led,” Quatroche said.

ECMC’s emergency department is located at the southwest end of its campus, near its new Regional Behavioral Health Center of Excellence. A ramp takes emergency vehicles and others dropping off patients up from the ground floor to the first-floor emergency department.

The existing 22,000-square-foot department last underwent a substantial renovation in the late 1990s, Manka said, although the hospital added eight exam rooms and a trauma treatment room in a $2.9 million renovation in 2010.

An emergency department has a life span of about 20 years, so it is time for an update, he said.

Hospital administrators and staff still are putting together specifics on the size of the new facility, the number of beds and the technology that will be included in the new department, Quatroche said.

But he and Manka were able to share some details. It will be a new building, constructed just to the side of the existing department, and it will be located on the ground floor of the hospital. Officials decided that trying to renovate the existing space would be too disruptive.

It will be larger than the current department, not just in the number of beds, Manka said, but because each room will be larger, allowing more space for high-tech equipment and for more providers to serve patients.

It will also allow the new department to function more efficiently, allowing for smoother patient flow through the department, and the planning for that process is continuing.

Hospital planners also are focusing on how the expanded emergency department will work in the Affordable Care Act era, as emergency rooms face competition from urgent care and telemedicine and as health insurance companies and the federal government seek to reduce spending on unnecessary procedures.

“The idea is to have fewer avoidable ER visits,” Quatroche said, such as for congestive heart failure, a chronic condition that can be monitored by the patient and managed with medication.

The effect on emergency room volume is considered impossible to predict. “Nobody has the crystal ball to tell us what’s going to happen,” Manka said.

Full details on the project will be revealed when ECMC files the required certificate of need with the state Health Department either late this year or early next year.

In about six to nine months, ECMC plans to publicly launch the capital campaign that will raise a portion of the estimated $45 million cost of the emergency department, officials said. The ECMC Foundation and the hospital are conducting a feasibility study in preparation for that campaign.

“We are going to go to the community for help,” Quatroche said.

email: swatson@buffnews.com