Angel Medical Center
Angel Medical Center: Poised to Bring the Best in Advanced Care to Macon County Since 1923, Angel Medical Center has been a mainstay in Macon County. The Angel Hospital clinic in downtown Franklin, first established by Macon County native, Dr. Furman Angel, has grown tremendously over in the 20th century. With help from his brother, Dr. Edgar Angel, who joined the hospital in 1932, Angel Hospital became the Angel Brothers Hospital, and underwent massive expansion, redesign and relocation in subsequent decades. In 1967, the hospital became a nonprofit organization and was renamed Angel Community Hospital, followed by a renaming to Angel Medical Center (AMC) in 1996. Through it all, Angel Medical Center remained entirely focused on the health of the surrounding communities, and continues to deliver superior and compassionate patient care. Thanks to solid, ongoing community investment, AMC has built upon its impressive history, and even expanded services over the years. Angel Medical Center has received the prestigious Top 100 Critical Access Hospital Award two years’ running, most recently receiving recognition in 2017. Awardees were chosen by iVantage Health Analytics, the Chartis Center for Rural Health, and the National Rural Health Association’s Rural Health Policy Institute. This achievement reflects the hospital’s commitment to providing high-quality patient care for the community, while meeting the unique needs of rural Macon County. Despite community contributions, rural hospitals like Angel face significant challenges in funding, staffing and recruiting, Medicaid expansion, and program diversity and availability. Healthcare needs of the rural Franklin community are ever-growing, and AMC must adapt in order to address current and future issues. Patients aged 55 years and older are the fastest growing demographic in the area. To survive and succeed, Angel must meet the healthcare concerns of this aging population, and equip itself to handle the financial constraints that come with prevailing Medicaid, Medicare and self-pay approaches in the region. In assessing the region’s future healthcare needs, AMC President and Chief Nursing Officer Karen Gorby, along with the Hospital Board and Mission Health leadership, have set sights on three key issues, and seek support from the community for the following: 1. A replacement facility to serve the community with close-to-home care and access to Mission Hospital specialists in Asheville 2. A new, state-of-the-art Surgical Suite with new operating rooms, and modern technology and equipment 3. A new community Emergency Department focused on county needs, and offering a safe, efficient environment for patients, families and staff
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Needs and Challenges Building Infrastructure While AMC staff provide excellent care, the hospital building and structure are in dire need of restoration. AMC struggles with water damage resulting from roof problems, which means all windows need replacing; very small patient care areas are hard for staff and patients to navigate; and treatment spaces are poorly designed. These are in addition to the serious electrical, HVAC, and plumbing problems, strained generators, and technical challenges, the latter of which makes WiFi connectivity and accompanying technology hard to stabilize. The current facility was built in phases, creating a disjointed hospital layout that makes it hard for patients and their families to navigate. Illogical pathways lessen efficiency, creating confusion for patients and stress for staff. Beyond that, inpatient rooms are 40% smaller than standard hospital rooms, making it difficult for families to accompany and support patients, and consult with doctors about care. An October, 2016 study done on the building revealed that the extent of the structural problems and inefficiencies are major, and there are only three possible solutions to address them: 1. Keep the Angel Medical Center building “as-is� and perform band-aid repairs as needed (approx. $3-5 million/year) 2. Renovate the entire facility to fix all problems (approx. $52 million) 3. Build a replacement facility (approx. $43-46 million) When weighing costs, the best solution for patients and staff was overwhelmingly a brand-new hospital. This new Angel Medical Center will be approximately 80,000 square feet, and house 25 inpatient beds and five observation beds. Though smaller, the new facility will be more efficient, and greatly improve the delivery of care.
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The Emergency Department and Operating Rooms The current Emergency Department and operating rooms at AMC desperately need modernization and expansion. Current operating rooms make work difficult for surgeons and staff, primarily because of configuration and work flow inefficiencies. Worse, operating rooms are using outdated tools and lighting. Current operating room (OR) lights use halogen bulbs, which create immense heat. These bulbs also cast shadows, which makes a surgeon’s job harder. In the OR environment, outdated tools and lighting, coupled with an outdated electrical system, HVAC and generators, can create delays, hiccups or even, disaster. New OR lighting will offer greener technology, less heat and provide better lighting for surgeons. The new AMC building and OR areas will also be cordless, meaning safer environments and less risk of falls. To top it off, these areas will feature integrated technology that enables speedy communication among medical staff.
Since the current Emergency Department has only one bathroom and no shower facilities, upgrades are planned to provide optimal, patient-centered hygiene areas. Instead of patient spaces divided by curtains, new pre- and post-op areas will feature three walls and a glass panel. This will provide more space and privacy, along with better visual access for staff. With these enhancements, physicians can consult with patients, families, and staff without risking patient privacy. A separate waiting area for families will also be built to make visitors more comfortable while patients are in surgery. In addition, new and improved signage will help patients and families navigate the new AMC easily. Ample parking will be built into the new design to erase parking struggles commonly faced by visitors. A centrally located cafeteria and multi-purpose conference space is also planned.
The new AMC will be equipped with three operating rooms, an endoscopy suite, and a much-needed new Sterile Processing Department for cleaning surgical instruments and medical equipment.
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Improving AMC Services and Access to Benefit the Community Better Behavioral Health Services The demand for behavioral health services to help patients facing mental illness, crisis and trauma-induced disorders has grown nationwide over the past decade. The demand is no different for residents of Macon County. Unfortunately, there is a shortage of behavioral health services in the Franklin area; the new Emergency Department at the AMC aims to address that gap. Flexible, special care “safe rooms” will be included in the new Emergency Department design. Safe rooms are designed to protect patients from distress, self-harm and violence against others. Lighting will also be adjustable to create a calmer environment for patients.
Enhanced Specialty Services and Care Access The compassionate and superior care the community has depended on for decades will remain a constant at AMC. Building on that, patients will now benefit from convenient access to services, better communication with network physicians, and expedient transportation to Mission Hospital, when necessary. While these treatment possibilities grow, patients will still enjoy community care at their hometown, AMC hospital. Such enhancements include: • Virtual care and telemedicine will give Angel Medical Center patients access to specialty care in Asheville, along with virtual care services to connect physicians with Mission Hospital clinicians (or any other network hospital) remotely. Additional plans are underway to increase care access by relocating the MAMA (Mountain Area Medical Airlift) landing pad to a location above the fog line. This will lower aircraft flight risks and cancellations during rescue flights. • Imaging services will be relocated and unified; these include, radiology, echocardiography, breast imaging, MRI, CT scans, nuclear medicine, ultrasound services, and bone density testing. • The AMC Intensive Care Unit (ICU) will be redesigned, but continue to provide community care for stroke patients and other intensive care conditions. The new layout will feature 30 continuous unit beds, with five beds reserved for critical care. This will not only improve patient care, but resolve problems related to a disjointed building arrangement. • A centrally-located, open nursing station will create a better workflow for medical staff, facilitate better patient care and enhance safety, no matter the level of care required. • Current cardiology services are tightly compacted in one narrow hallway. In the new AMC facility, heart patients will enjoy non-interventional diagnostic cardiology services in a more efficiently designed, space. • With Joint Commission accreditation as a certified stroke care center, AMC can now care for acute stroke patients in revolutionary ways. For example, time between diagnosis and life-saving drug administration to dissolve the blood clot and restore brain blood flow was recently delivered to a stroke patient in an impressive 23 minutes. Angel Medical Center
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New MRI Machine Offers Transformational Benefits and Sustainable Care to Community Cutting-edge technology and medicine are more closely intertwined than ever, especially when it comes to Magnetic Resonance Imaging (MRI) machines. These machines are some of the most frequently used screening tools, as this noninvasive technique is an excellent way to examine the body’s soft tissues. This indispensable technology helps physicians diagnose, analyze and treat critical health conditions, including cardiac, orthopedic, and cancer-related issues. However, like all technology, MRI machines are constantly being updated and improved. And while these machines provide advanced, targeted medical care, they have finite lifespans. The current MRI machine at AMC is due for replacement. Not only is the machine old, but technology has advanced considerably over the last decade. New, upgraded MRI technology offers many benefits; procedures can now be completed in less time, and made available to more patients. All in all, replacing the MRI machine will measurably improve the patient experience and patient outcomes. AMC has identified an MRI machine with unparalleled technical capabilities called the Signa™Artist model. This wider bore MRI machine is equipped with the latest, most advanced features that provide more comprehensive imaging delivery in less time. This model will allow technologists to quickly secure a greater number of clearer images, enable clinicians to make diagnoses with increased accuracy, and provide patients with a more comfortable MRI screening experience. The most revolutionary advantage of the Signa™Artist machine is a technical feature dubbed MAGiC. This feature allows technologists to produce multiple and clearer image contrasts within a single scan. Image contrast, defined by differences reflected in signal intensity, can even be adjusted after imaging to provide a more complete and detailed view. For example, during existing imaging procedures, patients must remain still while the MRI unit scans their brain numerous times. With the MAGiC feature, one scan can quickly capture data, and be processed in various ways post-procedure. This feature eliminates repeat scans, translating into more efficiency in the care setting, shorter scan times and better patient experiences.
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Features of the Signa™Artist MRI machine also include: • Superior image quality and finer image definition • Technical advantages, such as multi-dimensional images, less noise, and more rapid image production • Highly customizable images to address different screenings, such as neurological, orthopedic, cancer-specific, cardiac-focused, etc. • Motion correction capabilities to compensate for movement during the procedure – especially important for patients with MS or Parkinson’s Disease • Sharper identification and differentiation of body metal, otherwise known as “image artifacts” (metal pins from past surgeries, artificial knees, metal mesh, etc.), which otherwise muddy images • Larger machine bore (the opening for patients) to ease patient stress and accommodate patients of all sizes • Shorter breath “holds” (when a patient holds his breath) for certain procedures to improve the screening experience and patient comfort • Soft lighting, a memory foam surface for the patient, and lower orientation to the ground so patients can easily get in/out of the machine and rest more comfortably, and technologists can easily position patients • Intercom and microphone systems to allow technologists to communicate with patients • Logistical and efficiency enhancements for the hospital resulting from reduced patient scan times • Customizable and adaptable menu of features adjusted to hospital’s current and future needs • Implementation of a unified MRI protocol across the entire health system
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Current MRI Challenges If the MRI machine at AMC malfunctions, the current contingency plan outlines that the hospital must reschedule patients until the unit is repaired, or send patients to another facility for imaging. With an aging MRI machine, the department currently experiences delays and frequent downtime during these repairs. To make matters worse, MRI usage projections indicate that Angel’s patient population is expected to grow significantly in the upcoming eight years, at a rate of approximately 2-5% per year. To continue providing Franklin residents with timely and advanced imaging care, Mission Health needs to construct a purchase plan, timetable and strategy for acquisition of a new MRI machine at AMC within the next year. AMC needs community support to help purchase a new MRI machine that will offer patients a better imaging experience, and access to the most advanced care in the region. A new MRI will provide more detailed imaging to aid in physician diagnosis, and create a more streamlined work flow for technologists. Investing in the Signa™Artist machine funds a community healthcare solution that is deeper than surface-level; an investment in this machine will provide innovative and necessary care for Franklin residents for decades to come.
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The Bright Future of Healthcare for Franklin and Macon County Changes planned for AMC are exciting, and represent an intentional and future-focused partnership between Angel Medical Center and Mission Health. The new facility will provide an improved and safer hospital experience for patients and families, offer clinical professionals and hospital staff the latest tools, and incorporate a building layout that helps staff work more quickly and efficiently. As you can imagine, every second counts when providing life-saving care, and a smart design will save valuable minutes.
Consistent support from our community over the decades has always been – and continues to be – essential to the success of Angel Medical Center. Without this crucial support, weathering numerous healthcare challenges would be difficult, and growth impossible.
Those who give to this new facility can be assured they are guaranteeing a bright future for Angel Medical Center and all our neighbors.
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