The growing importance of freestanding EDs

Freestanding emergency departments, though not yet approved in all states, are a growing way for hospitals and medical groups to extend emergency services beyond the traditional hospital setting, says Kevin M. King, ACHA, ACHE, associate AIA, senior design manager for architecture firm Earl Swensson Associates Inc., Nashville, Tenn.

Davis Hospital and Medical Center, Layton, Utah, which is part of the Franklin, Tenn.-based IASIS Healthcare system, recently opened a freestanding ED on the medical center’s Weber campus in Roy, Utah, eight miles from the main hospital campus.

Leslie A. Christiansen, R.N., CEN, Davis Hospital emergency department director, IASIS Healthcare, says the area is experiencing a lot of growth, and while the community didn’t need another acute care hospital or urgent care center, it was lacking in emergency services. Hill Air Force Base, located across the freeway from the Weber campus, has a clinic but does not provide emergency care. And the 15-minute drive from the Weber campus to the hospital can take much longer when the road is blocked, as often happens, by freight train traffic. The freestanding ED was seen as a way to deliver centralized emergency medicine to the region and to stabilize and transport patients who need more specialized treatment to the appropriate setting, such as a stroke or trauma center. The hospital reports that recently an injured child’s life was saved because emergency medical service providers were able to quickly access the freestanding ED facility.

The 16,000-sq. ft. ED has 14 treatment rooms, eight of which are arranged in two pods of four rooms. Each pod has a central work area and its own bathroom, a layout Christiansen describes as convenient for patients and staff. There is also a trauma bay, a main orthopedic room, a negative-pressure isolation room (which also has its own bathroom) and two overflow rooms that the ED shares with a radiology department.

The ED offers full-service laboratory, mammography, respiratory and radiology services, including X-ray and computed tomography. The hospital plans to add portable magnetic resonance imaging soon.

In the two years the freestanding ED has been open, its patient volume has more than doubled, from 300 to 400 patient visits a month up to 1,000. The average length of stay is one hour and 38 minutes.

“Our turnaround times are so short that it’s actually becoming quite a popular place,” Christiansen notes. “I want the public to say, ‘They’re really good. The doctors are really good, the nurses are all [certified emergency nurses]. They’re awesome!’ But what really gets them is the hour and 38 minutes,” she laughs. — Amy Eagle