It Takes a Village!

For half a century, a giant structure, reminiscent of a ship complete with portholes, has stood at the corner of 13th Street and 7th Avenue. Originally home to the National Maritime Union, the building is perhaps best known as the Medical Services Building of St. Vincent’s Hospital. Since the hospital’s closing in 2010, the building has moved onto its third reincarnation.  One part this reincarnation includes Manhattan’s first freestanding emergency department that resides in the facility’s first floor.

For more than a hundred years, St. Vincent’s cared for over 60,000 patients each year in its emergency room alone. Its closure not only left 3,500 employees jobless, but it also created a void in care for nearly 200,000 New Yorkers in Greenwich Village and adjacent neighborhoods. The new freestanding E.D., that resides within the Lenox Health Greenwich Village (LHGV) facility, is part of Northwell Health. Its goal is to address both the surrounding community’s needs, as well as help decompress overcrowding in the city’s other emergency rooms while shortening wait times and improving patient experience LHGV’s unique Emergency Department program design and community integration plan was spearheaded by Dr. Eric Cruzen, Chairman of Community and Acute Care Services (the Lenox Hill Hospital Department which oversees LHGV’s Emergency Center).  The healthcare facility emphasizes efficiency, innovation, and, above all, comfort. The receiving area for patients, for example, is called the patient lounge instead of a waiting room. Wait times often average no more than a few minutes. The welcome desk is manned by a nurse who typically assesses the patient’s needs the minute they arrive at the E.D. Patients are then promptly seen by a health care provider.

The state-of-the-art emergency department is essentially designed like a racetrack. Patient rooms line the outside of the track, and are designed to fit one patient each. They feature a range of amenities to ensure optimal comfort and privacy. The health care team works in the center of the track alongside private cubicles with reclining chairs for patients with non-emergent issues, such as ear infections. Beyond the patient floor are a series of suites designed to address specific patient’s needs. For example, LHGV has been named a Sexual Assault Forensic Examiner (SAFE) Center of Excellence. The specialized suite improves the standard of care for survivors of sexual violence. Rather than entering through the main patient entrance, survivors enter directly into the suite through a discrete unmarked entrance and are then treated in a private area separate from the remainder of the department. This can help the assault survivor to be as comfortable as possible during a very traumatic time.
 
Beyond this suite lay two resuscitation rooms, which are modeled after modern operating rooms. These can be used to treat patients in need of emergent care, such as those experiencing a heart attack or stroke.  New York City EMS Protocols dictate that patients with severe traumatic injuries be taken directly to a trauma center such as Bellevue. However, LHGV is equipped to stabilize and treat patients with any level of illness or injury and then transfer them to the hospital of their choice should an inpatient stay be required for their recovery. The resuscitation rooms are wired for telemedicine, meaning doctors can be beamed in from other facilities to collaborate in the patient’s care. High definition cameras allow remote doctors to see and assess the patient’s needs as if they were in the room. This is yet another example demonstrating LHGV’s place at the forefront of healthcare innovation.

LHGV also seeks to contribute to the mental health care within the Greenwich Village community with the addition of two behavioral health rooms. These rooms contain several features designed to protect patients who may be a danger to themselves or others. First, the rooms are barricade-proof, meaning they cannot be locked or fortified from the inside. The grates covering the vents in the room are so narrow that something as small as a shoelace could not fit into them.

Approximately 94% of LHGV’s patients are able to be treated and released back to the community.  In some cases where a patient might need more care than an ER visit but not as much as a hospitalization, LHGV offers observation services which allow a patient to receive up to 24 hours of treatment at the facility.  This helps to avoid costly (and sometimes dangerous) hospital admissions and allows the patient to get back home sooner.

Perhaps the most striking difference between LHGV and other hospital E.R.s is its laboratory. The full lab can run the entire battery of common Emergency Department tests with an average turnaround time of just twenty-two minutes.  This is just another benefit of the freestanding E.D. model and helps to shorten wait times, and improve the patient experience.

While the E.D. is already improving the health care of the community, the second construction phase on the building’s upper floors will expand LHGV’s ability to address patients’ needs. LHGV is already increasing its breadth, by serving both neighborhood residents and patients who travel to the stand-alone E.D. for the short wait times and top-notch care. The upper floors will feature an outpatient imaging center, which will open later this year. Among other services, this center will include an MRI, mammography, ultrasound and CT scan. The other phase of construction includes an ambulatory surgery center, which will open in 2017.  The center will also include physician offices as well as community meeting space.

“A lot of people think that LHGV Emergency Department is just another urgent care center. What they don’t know is that we can take care of everything and anything here – 24/7 --, but in a newer, faster, more efficient, and more comfortable setting” said Chairman of Community and Acute Care Services at LHGV, Dr. Eric Cruzen. Though the E.D. has only been open just under 2 years, it has already helped to fill the void left by St. Vincent’s and has staked its claim as a center of innovation. While LHGV has a positive impact on its patients, the ripple effect of the freestanding E.D. model is much greater. LHGV not only improves access to care for Greenwich Village residents, but will serve to help transform the healthcare landscape of New York City in the years to come.