Muhlenberg - Courier - Satellite ER planned

Published in the Courier News, Monday, April 21, 2008

Muhlenberg plans satellite emergency room

By CLEM FIORENTINO
STAFF WRITER

PLAINFIELD — The impending closure of Muhlenberg Regional Medical Center's acute-care facility will affect the lives of Plainfield-area residents in many ways — economically, socially, culturally and historically.

But what will it mean on the most visceral level, when an emergency hits home and someone needs to make a life-and-death decision?

No one can predict, but those planning and implementing the transition are working hard to make sure that disasters and personal tragedies can be averted.

Under the closure plan outlined by Solaris Health System, Muhlenberg's parent company, a "satellite emergency room" will remain on the Plainfield campus.

"Not only am I going to be there, but my entire staff is going to remain there," said Dr. Ken Herman, director of emergency services at Muhlenberg. "We will be there 24 hours a day, seven days a week and there will be backup coverage during the busiest times."

If a patient must go to an acute-care facility after being stabilized at the emergency room, he or she will be transferred to an acute-care facility, Herman said. "Patients won't sense any difference from beginning to end, except for admission to an inpatient setting, at which time, we will arrange for transportation."

Learning from experience

The situation will be very similar to what happened last year at Union Hospital in Union when, one day after its closure on Sept. 30, Atlantic Health's Overlook Hospital moved in and began operating a free-standing, 15-bed "emergency services deparment" with 75 staff members.

"We've been happy with how it's gone," said Alan Lieber, chief operating officer at Overlook's Summit facility. "We offer a very high level of care to the community."

Lieber points out that, unlike the Muhlenberg situation, a completely new unit had to be established at the Union site. Overlook EMTs and nurses spent time with area rescue squads, helping them make decisions in any given circumstance.

Squads from surrounding municipalities such as Elizabeth, Cranford, Roselle Park, Kenilworth, Springfield and Union itself were educated in procedures for determining where a patient should be taken. The more serious cases (those that will likely require hospitalization) often go directly to Overlook. The less serious still go to Union.

Once a patient is stabilized at the free-standing emergency facility, transportation can be arranged. Because Overlook operates its own ambulance service (with bases in Springfield and Union), staff members there are able to route and prioritize.

Lieber said Overlook decided to open and operate the Union facility "to avoid getting overwhelmed in Summit." Also, he said, "Those physicians closest to us indicated they were coming on our staff."

Now, Overlook is, once again, preparing for a similar scenario with Muhlenberg patients and staff.

"We're very concerned about this," Lieber said. "We are about to renovate our emergency department again, with 10 more bays starting next week. We are planning to increase our capacity."

The Union site will serve somewhat as the model for Muhlenberg's facility.

"A lot of this has been preregulated by the state as to what a satellite emergency room can provide," Herman said. "We consulted with the folks at Union. They have been very accommodating."

Herman said that anyone enroute to the Muhlenberg ER will not be told to go somewhere else.

"I want to assure the community and Solaris that they won't disappointed," Herman said. "If anyone has any questions or concerns, they can call me at (908) 668-2112."

Satellite services

Satellite emergency rooms are not new. They have been around since the 1970s in areas where full-service hospitals are no longer readily accessible.

The issue in Plainfield will revolve around how well the community accepts and adapts to the downsized facility. That is one of the myriad issues being discussed by a task force convened by Assemblyman Jerry Green, D-Union, task force, in the wake of the Solaris announcement in February.

"We have to have a coordinated effort," Green said. "We have to set up networks with all other hospitals. It's important that all hospitals are buying in to what we have to do. We need to be prepared."

For example, if catastrophe strikes, "Robert Wood (with its trauma center in New Brunswick) would be at the top of the list," Green said.

Other surrounding hospitals such as Saint Peter's University Hospital in New Brunswick, Robert Wood Johnson in Rahway, Solaris' JFK Medical Center in Edison and Somerset Medical Center in Somerville will be called on for support.

Green said the task force, which includes chief operating officers from all five surrounding hospitals, will have to determine which percentage of patients goes to each facility. "We have to know what hospitals we are sending them to," Green said. "Union has given us a lot of help in terms of where they could have done better and where they have been successful."

Green added: "We need state dollars for emergency rooms and state dollars for transportation. We need to get hospitals in position to take on added responsibility."

Question of time

For one area rescue squad, however, time might be more valuable than money.

"Until it closes, nothing changes much," said Doug Krisburg, captain of the North Plainfield Volunteer Rescue Squad. "When it does close, the impact will be troublesome. If we have to go to Overlook, the travel time will be a lot greater."

To avoid being caught short-handed, Krisburg said he will establish a "scramble crew" to back up the crew on duty.

"If the primary truck is out, the scramble crew will react," Krisburg said. "We'll do what we have to do."

The volunteer crews will not have time to wait for a patient to be stabilized at a satellite facility. If a patient needs to be transferred, that duty will fall to transport companies.

"Transport companies get paid to do that," Krisburg said, who said that sometimes his crew will help out North Plainfield residents, if at all possible. "We'll do what we have to do," Krisburg said.

Also affected on the transportation front will be the American Red Cross' Tri-County Chapter, which accommodates patients who need rides to scheduled doctors' apppointments and services like dialysis and chemotherapy.

"There is going to be a greater need," said Nathan Rudy, CEO of the Red Cross chapter. "Our program is fairly unique. We don't base it on the location of the hospital. We go to Robert Wood or to Jersey City. We take them where they need to be."

The Red Cross has two vehicles and two paid drivers and "we're always looking for volunteers," Rudy said. "I expect an increase. We will have to ramp up our service."

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StoryChat

It was reported by the paper that Union has their own transport company located in Union and Springfield that enables a fast response time to the facility for emergent transports to an acute care facility. This is simply not true. The company that is contracted to do these transports is owned by the same company that owns Union ER, yet the main hub is in Livingston. There is not a dedicated transport crew just for Union. The response times have been paltry at best. The same will happen at Muhlenberg, however, Solaris does not have a transport team of their own. They will have to contract an outside company, usually the lowest bidder, which most likely will not be in the geographical area due to the lack of available paid resources. The process of requesting the transport can be time consuming. Factors include calling the hospitals for bed availablity, availablity of a transport team, time of day(most beds become available after 10pm), finding a doctor to accept the patient. And guess who gets to pay for the transports? You got it.

Posted: Tue Apr 22, 2008 3:49 am

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Jerseyred,

Just a short note: there are 3 other acute care facilities within a few miles of Muhlenberg. Now within a few miles?

That's all I have to say.

Have a good night!

Posted: Mon Apr 21, 2008 11:37 pm

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The only "argument" the narrow band of Muhlenberg advocates have been able to concoct over the least few weeks has been that people will die in emergency situations, even thought there is no evidence of that and there are 3 other acute care facilities within a few miles of Muhlenberg. I have mentioned, in addition to other facts, that Solairs had committed to maintaining emergency services on the Muhlenberg campus. Nothing matters. There are people who demand that a hospital which is financially unsustainable in an over-served area nevertheless remain open. But there has been not a single good, rational reason offered. I strongly suspect the certificate of need to close Muhlenberg is all but a foregone conclusion. It's hard to imagine a stronger case for closure than the one Muhlenberg has been victim of.

Posted: Mon Apr 21, 2008 7:30 pm

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Ive said it before ! If we dont put a stop to it, they will over run this country in 10 years !!!! Evil or Very Mad

Posted: Mon Apr 21, 2008 5:54 pm

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if you are not smart enough to see what is going on....well that is 3/4's the problem. of course charity care cases are what drove the hospital under. now most illegals have jobs, but they all work under the table where no insurance is offered. now instead of being charity cases they could purchase ins. instead they go for charity care. this is happening all over california , and the south west boarder states where hospitals are closing due to illegals. why they do this are they being cheap or are they affraid of trying to purchases ins. well one or the other its both their fault if they were not illegal they would have nothing to worry about, or shame on anyone who can afford ins. and doesn't get it to save themselves some money and put the burden on the taxpayers. now if you ask any hospital staff which i am not, but i have an illness that brings me to the er and for inpatient care often and i see this first hand. the er isn't filled with americans it is filled with illegals, that is just the way it is. the same thing is going on in schools, the taxpayers have to pay for these little anchor babies to get an education, when all they do is bring down the quality of service everywhere they go and raise the taxes. that is what is going to happen to somerset medical center now. the er will now be worse then it is packed with illegals looking for healthcare. who is going to suffer? the ins. holder the taxpayer who needs prompt and good care won't get it because the hospital is cutting back to pay for all the illegal charity cases. say well their are non illegals with charity care.. well we should take care of our own citizens who are down and out with an illness or on hard times. this is a house of cards and muhlenberg is just the begining of the fallout.....

Posted: Mon Apr 21, 2008 1:50 pm

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