BRUNSWICK, Maine — A dramatic increase in the number of psychiatric patients treated at Mid Coast Hospital’s emergency department and the increased length of those stays has prompted the hospital to undertake a $740,000 expansion designed to more quickly and effectively meet the needs of its patients.
The average number of visits of behavioral health patients to the hospital’s emergency department has more than doubled since 2010 from 64 a month to 158 a month in 2014, Lori Allen, nurse director of Mid Coast’s emergency room, said Monday.
The average length of stay for those patients also has increased, from 7.7 hours in 2011 to 11 hours in 2014.
In order to better serve those patients, Mid Coast will create a new emergency department behavioral observation unit, a secure area with three single rooms, a common area and a kitchen area. The new space — in the former diagnostic imaging department holding area — is designed to more effectively care for behavioral health patients while freeing up beds in the ER.
“The patients are often left with lengths of stays that are not beneficial to their treatment and well-being,” Mid Coast Hospital spokesman Steve Trockman said. “Mid Coast’s goal is to turn these lengths of stay into opportunities for therapy to begin as soon as possible in the most supportive and therapeutic environment available.”
The lengthy stays for psychiatric patients in the emergency department result from myriad factors, including a shortage of inpatient psychiatric beds in the state.
When a behavioral health patient arrives at the emergency room, the patient is cleared by medical staff. Then the patient is evaluated by a Sweetser crisis worker, who then works with emergency department staff to determine whether the patient’s condition warrants admission to an inpatient facility. The crisis worker than calls hospitals around the state seeking an inpatient bed.
The wait can sometimes last eight days, according to Allen.
“This past year, we have averaged 17 patients per month with a length of stay in the ED greater than 24 hours,” she said.
Mid Coast consulted with the National Alliance on Mental Illness and Sweetser when designing the new space.
“The area will definitely be more therapeutic,” said Leslie Mulhearn, Sweetser’s senior director of crisis, clinic and community-based services. “People aren’t confined. When they’re in the ER, they’re really confined to their room. This area will have a living room and places to get up, so if you do have to wait, you can get up and move around,” Mulhearn said.
In conjunction with the new behavioral health unit, Mid Coast already has begun another expansion, adding three “quick care” spaces outfitted with treatment chairs instead of stretchers for patients who don’t need full treatment rooms. This area should be completed by the end of November, Trockman said.
According to Trockman, the past year has seen periodic “surges” in the overall number of patients in the emergency department, sometimes resulting in an increase in the number of patients in the waiting room.
While Trockman said Mid Coast already offers the shortest wait time in the state — “an average of nine minutes, door to doc” — the new “quick care” chair will make the wait even shorter “because they will get people into a room even faster.”
The project is just one of several in the past five years designed to ease the burden on Mid Coast’s busy emergency department.
In 2009, the hospital opened a $21.3 million, 35,000-square-foot expansion, including a new emergency department and 18 new private beds on the floor above the new ER. Among the goals of the project, which doubled the size of the emergency department, was eliminating long wait times.
Two years later, Mid Coast opened a 10,000-square-foot non-emergency primary care and walk-in clinic in downtown Brunswick.
That clinic was designed to treat patients who might otherwise have gone to the emergency room for treatment, but at a lower cost.
Trockman said the current project was financed entirely by Mid Coast Hospital, with no state or federal funding.
Jay Mullen, medical director of the Department of Emergency Medicine at Mid Coast Hospital, said the new space will “dramatically improve” the environment for patients and staff.
“It will also allow for a more therapeutic environment in which mental health professionals can start the healing process,” he said.