E.D. to focus on service, but can help in a crisis quickly provide data on drug interactions and the like, the doctor added.
HEALTHPLEX E.D., continued from p. 1
E.D. ON SEVENTH AVE. The emergency department’s main entrance will be on Seventh Ave. If a walkin patient has a serious condition, he or she will walk straight through to the main emergency center. For less-serious problems — if, for instance, only some sutures are needed — walk-ins will go to the left or right, where there are waiting areas and exam rooms where they’ll receive treatment. The E.D. will feature 26, private, stateof-the-art, critical-care rooms. “They have every piece of technology you’d see in an E.R.,” stated Cruzen, who is friendly and smiles readily. There will also be “telemedicine” devices in each room, he added, which will allow the staff to “beam specialists in” to help treat patients. Although the rooms are intended for one patient each, they are fitted with two medical-gas outlets, so they can each be doubled-up with two patients in the event of a disaster. “We want to be prepared,” he said.
BEYOND URGENT CARE More than a few local residents, still anguished about the loss of St. Vincent’s, have dismissed the HealthPlex emergency department as just an “urgent-care center on steroids.” After all, people who are suffering heart attacks, need cardiac cath-
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March 27, 2014
AMBULANCES ON W. 12TH
PHOTO BY LINCOLN ANDERSON
trical saws, chipping off excess concrete with a long pole. Construction dust from all the work filled the air. Everyone on the tour donned neongreen safety vests, hard hats and protective plastic glasses. The visit started with an elevator ride to the top and worked its way down the stairs. As Gupta explained, while standing on the roof, the building, constructed in 1964 by the National Maritime Union, was designed by architect Albert Ledner to resemble a ship. Thus, the round top of the shaft for a former elevator that serviced the union conference room on the setback sixth floor, sticks up on the roof to resemble a ship smokestack. The building widens as it rises, again, like a ship does. The glass-block wall that rings the first floor is supposed to evoke water upon which “the ship” is floating. Also adding to the structure’s nautical motif are the distinctive, scalloped, porthole-style windows higher up on the facade. However, while the tour went from top to bottom, it makes sense to skip floors six through two, for now, and jump down to the first floor. That’s because the emergency department will be located there, and that's where most of the action will be occurring.
Dr. Eric Cruzen, left, and Executive Director John Gupta with a $1 million, low-dose, CAT-scan machine in the Lenox Hill HealthPlex E.D. “It can scan your entire body in two breaths,” Cruzen noted.
eterization or bypass surgery or neurosurgery or have open fractures or major head trauma — not to mention gunshot wounds — won’t be dropped off here by paramedics and E.M.T.’s, but rather will be taken to an emergency room connected to a fullservice hospital. However, the HealthPlex E.D. will offer advanced life-support services, so that patients with acute conditions — suffering heart attacks or strokes or with major trauma — if needed, can be treated and stabilized here and then transported. It’s expected the E.D. will see 45,000 patients annually. The range of illnesses and injuries it is prepared to treat includes, but is not limited to, chest pain and other cardiac symptoms, early-onset stroke, shortness of breath, respiratory illnesses (asthma, pneumonia, chronic bronchitis and emphysema), concussions, fractures and joint injuries, motor vehicle injuries, severe cuts and burns, abdominal pain, allergic reactions, gastrointestinal illnesses, influenza (flu), occupational injuries, sports injuries and behavioral health issues.
‘INFINITELY DIFFERENT’ In short, Cruzen said, this E.D. will be “infinitely different than an urgent care.” For example, it will offer board-certified emergency physicians and nurses, plus a “128-slice” CAT scan, X-rays and ultrasound. It will be open 24/7 and staffed by 100 people — with 30 to 60 staff on duty depending on the time of day. The E.D. will be a receiver for the city’s 911 system. And it will be certified by the New York State Department of Health as an emergency center. Meanwhile, most urgent-care centers
might have only four treatment rooms maximum, he added. They also aren’t required to treat people without insurance, while the HealthPlex is required to do so. “We’re not just another City MD,” Cruzen stressed, referring to one of the current urgent-care operations out there. “We’re doing a whole different service.” For example, the high-tech, CAT scan machine costs $1 million, Cruzen said, and could be used to assess stroke patients. “It’s so advanced,” he said, “it can scan your entire body in two breaths.” They are applying for the E.D. to be a certified stroke center.
‘MORE LIKE A SPA’ Beyond its capabilities, a major theme of the new emergency center will be customer service. For example, staff soon will be trained on interacting with patients on the CAT scan by first using a robotic talking mannequin on it. “It’s an idea to totally redo customer service that’s more like a spa than an E.R. — like the Ritz-Carlton,” Cruzen explained with a smile. “We’re re-envisioning the way people are treated in an emergency department.” In a traditional E.R. layout, the nurses’ station is in the middle of the room. Here, the patients will be in the center, in 12 cubicles which will sport La-Z-Boy-style recliners and TV screens. “We want it to be like a spa,” Cruzen reiterated. “We didn’t want it to be focused on the doctors and nurses. The center of the room is now centered on the patients.” There will be “bedside” computer monitors, and all information will be taken down electronically on them, which will
The building’s W. 12th St. side is dominated by the E.D. ambulance bay, which has two special “resuscitation rooms” attached to it. Medical equipment and large movable lights in these two rooms will hang down from the ceiling, and they will be like any top-notch emergency operating room. Two HealthPlex ambulances will be based here to transport any patients to hospitals who require more intensive care or a hospital stay. In general, paramedics and E.M.T.’s have protocols for where to take various types of patients, so they won’t be dropping people off at the HealthPlex in the first place if they need a higher level of care, Cruzen noted.
MOSTLY TREAT-AND-RELEASE In fact, they expect that more than 90 percent of the patients they treat will be released without needing hospitalization. “There are 400 of these around the country, and they’ve been around for 20 years,” Cruzen said of the stand-alone E.D.’s. Studies have shown that only about 6 to 8 percent of patients at this sort of facility will need to be admitted to a hospital.
DISASTER RESPONSE A doorway at the ambulance bay’s west end leads to a full decontamination center, which Cruzen noted, could come into use during a mass casualty, if people are exposed to chemicals, radiation or “any toxin.” It has a giant shower that can be used by one or two people at a time. In addition, they will have large tents that can be set up outside where more people could be decontaminated. Although not designated as a trauma center, Cruzen said the HealthPlex will be prepared do whatever it can in the event of a major catastrophe — which, again, sets it apart from an urgent-care center. In terms of how many patients the firstfloor E.D. could handle at one time during a crisis, he stated, “I would say 75 to 100 would be our surge capacity. If another 9/11 happened, we’d have people in the halls — whatever we needed to do. In an emergency, we could shut down the rest of the building — the comprehensive care center — and use it for crisis.” Two emergency generators have now been installed for the building and there is a connection to allow a third to be hooked HEALTHPLEX E.D., continued on p. 24
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