Final case for support mcdowell hospital

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CASE FOR SUPPORT A NEW MCDOWELL HOSPITAL

CASE FOR SUPPORT – A NEW MCDOWELL HOSPITAL When McDowell Hospital was built in 1983, it was a state-of-the-art facility, serving a community that had plentiful jobs and a thriving family environment. That cluster of buildings has seen a lot of people and trends come and go. Today, the manufacturing jobs that sustained the local economy are gone, and the face of McDowell County has changed.

The county currently has 18.5% of residents over age 65, and 22% living below the federal poverty line.

During that same period, healthcare also saw monumental change in how people interacted with the system, and how technologies transformed processes and procedures. While the community’s need for quality healthcare close to home grew more pronounced, the modular hospital building that had served families so well for over 30 years became too small, and needed too many complex updates to merely renovate. McDowell County’s fastest-growing demographic consists of people aged 50 to 65, and the new hospital needs to take into consideration the needs of an aging population.

In the past year, McDowell Hospital administrators have recruited new physicians in primary care, OB/GYN, general surgery, orthopedics, and urology. The new hospital and medical office building are being designed to maximize the impact that these new physicians - and their long-serving local colleagues - can have on improving the community’s health and well-being.

Last fall, ground was broken for a new McDowell Hospital, on the same grounds as the current facility. We are purposefully looking into the future health of this community, and excited about bringing innovations in healthcare to the people we serve.

RIGHT SIZED FOR AN AMBULATORY CARE ENVIRONMENT When the McDowell Hospital opened its doors, it was licensed for 65 beds. Individuals who checked into the hospital for a birth or operation were there for a relatively long time. Today, medical innovation has made many procedures ambulatory, with a patient walking into and out of the hospital on the same day. The new hospital will reflect this reality, with a total of 30 inpatient beds, with five of those being dedicated state-of-the-art labor, delivery, recovery, and post partum (LDRP) suites, including a dedicated C-section suite. With a current demand of 19 patients per day, this gives McDowell Hospital ample room to meet community inpatient needs.

INSIDE THE NEW MCDOWELL HOSPITAL THE BUSIEST DOOR

ACCESSING EXPERTISE

EXPANDING OPERATING ROOMS

IMPROVED IMAGING

CENTRALIZING THE IMAGING CENTER

ROOM(S) TO GROW

MEDICAL OFFICE BUILDING

THE BUSIEST DOOR $1,000,000 In a community of 45,000 people, it is notable that McDowell Hospital’s Emergency Department sees 22,000 patients annually. The hospital’s location near Interstate 40 and Old Fort Mountain make it convenient to many who are just passing through when they need assistance. Emergency Services is also an expensive entrance to the healthcare system for families who don’t have primary care.

The ER rooms are small by today’s standards, and the whole unit is under-sized for the number of people being served.

Our most pressing issue is the need to provide an appropriate level of care for individuals with behavioral health issues. Because mental health crises happen 24 hours a day, the ER is frequently the only healthcare option for someone who is struggling. Throughout the region, healthcare facilities are seeing a growing numbers of individuals with mental illness, and the lack of adequate long-term facilities to shelter them. The hospital is sometimes asked to hold a behavioral health patient for more than 30 days, and a traditional ER is too fast-paced, noisy, and full of hazards for someone in emotional pain.

McDowell Hospital’s emergency room will grow from 11 rooms to 15, with three designated behavioral health safe rooms that are devoid of of strangulation hazards, equipped with seamless doors, rounded corners, and sand furnishings. Two additional rooms will be dedicated to trauma cases. Because many different kinds of patients come into the ER, there will be separate ambulance and walk-in entrances.

ACCESSING EXPERTISE The new unit will make room for McDowell Hospital’s expanding telehealth function. Currently, departments make connections to stroke, psychiatric, neurology, and wound management expertise at Mission Hospital in Asheville.

Telehealth gives McDowell Hospital patients the assurance that they have access to the highest quality care while staying in their own community, and addresses the transportation barriers that some patients face.

EXPANDING OPERATING ROOMS There are few spaces in modern hospitals that have changed more than operating suites. Today’s surgeons are in rooms that are far too small, and that requires equipment to be stored in other rooms and moved when needed. In a busy surgical department, this means a longer wait time for patients. Currently, McDowell has fewer pre- and post-surgical rooms than it needs, which also creates a challenge to efficient scheduling. In an aging building with aging technology, it requires more effort in maintenance and additional costs to maintain the required equipment such as the operating lights. More importantly, without upgraded lighting technology, the surgeons can create shadows over the operating field, and heavy electrical cords for the required equipment can create trip hazards.

In the new building, surgical services will have three large, spacious, operating rooms that are up to current standards, able to accommodate a team of physicians and the tools and technologies they need to provide state-of-the-art care. A dedicated endoscopy suite will include an endoscopy stack, video equipment, and monitoring equipment. In summary, McDowell will maximize patient flow through the redesigning of the pre-operative holding and post-operative care areas, allowing the surgical team to meet patient care needs.

STATE-OF-THE-ART IMAGING The North Carolina Department of Health estimates that 49 women in McDowell County will receive a breast cancer diagnosis next year. While advances in treatment have improved survival rates, one of the keys to that success is early detection. Women whose breast cancer is detected at an early stage have a 93 percent (or greater) survival rate in the first five years.

The National Cancer Institute (NCI) reports that approximately 20% of cancers are missed at 2D mammography screenings. Enhancing diagnosis, care, and treatment starts with state-of-theart technology. The new gold standard for early detection is 3D tomosynthesis, which allows radiologists to see through layers of tissue to detect small cancers, multiple tumors, or invasive breast cancer.

Standard mammograms take one fixed picture of compressed breast tissue from the top, and one picture from the side. In 3D tomosynthesis, the X-ray tube moves in an arc around the breast that has been secured, and takes images that are sent to a computer to be assembled into a highly focused, three-dimensional view. The process takes a few seconds longer than 2D. The new technology effectively arranges the images of the breast into readable segments that allow a radiologist to see underlying structures more easily.

Approximately two-thirds of women under 50, and 25% of women over 50, have dense breast tissue (more fibrous) that appears white on the image, making small and invasive tumors harder to detect using conventional mammography. For any woman who has received the “results inconclusive, more tests necessary� call or letter, the benefits of 3D high-resolution imaging can include less follow-up imaging and reduced anxiety.

Preliminary results on 3D tomosynthesis have demonstrated that call-backs for further tests or imaging are down by as much as 15%. Additionally, there has been a 29% increase in overall breast cancer detection over 2D imaging. Detection at earlier stages of the disease saves lives.

Medicare began covering 3D tomosynthesis in 2015. Many other insurers will not cover the cost of 3D tomosynthesis at this time, but women can choose a co-pay of $30 - $75 to have 3D rather than 2D images made.

CENTRALIZING THE IMAGING CENTER In the current hospital configuration, imaging services are scattered throughout the hospital. For example, McDowell’s MRI is currently outside of the imaging suite, in a room with air filtration capabilities not up to the task of keeping that machinery cool. The new facility will eliminate these issues by integrating a new MRI into a space that is designed for its safe operation.

A state-of-the-art CT (Computerized Tomography) unit will be installed in this area, too.

Providing state-of-the-art CT (Computerized Tomography) has been the commitment of Mission Health System and McDowell Hospital since investment in this technology was made in 2015.

Located in a separate area of the facility, the CT suite will be located within the imaging center, making it convenient to the Emergency Services Department.

The Nuclear Medicine department needs to be upgraded in anticipation of the coming year’s revolutionary cardiology services. It is exciting to be able to bring this expertise to McDowell Hospital, but having up-to-date technologies is an essential component of keeping them here and offering best practices to cardiology patients.

ROOM(S) TO GROW Anyone who has spent time at McDowell Hospital, as a patient or a guest, knows that the rooms have been shrinking. Equipment has been taking over the rooms and hallways. During family visits, a patient’s bed is crowded by guests, their nurse, and their doctor, leaving no room for the medical staff to maneuver. Short of standing in the hallway and waiting, there really is nowhere for the family to go to make room for them. Nurses also struggle to find instruments in the room that inevitably seemed to be on the other side of the bed. The small rooms and lack of storage space pushes extra machinery into other storage areas, requiring the nursing staff to “hunt� for their equipment and supplies.

Rooms in the new facility will be large enough to accommodate the technology and equipment being used at bedsides, both now and in the future. There will be space for a comfortable family alcove, and a more efficient design that emphasizes efficient storage and easy access to instruments.

Consultation areas will be available to provide comfort and privacy during conversations with physicians. Strategically placed equipment alcoves and storage areas will ensure convenient access while maintaining a warm and inviting environment of care, where patients can recuperate and families can support them.

MEDICAL OFFICE BUILDING Creating a “home” for doctors’ practices, a future clinic, and other services is an important element in ensuring that the new facility is patient-friendly and convenient. Ambulatory care, where patients receive same-day appointments and treatment, are both cost-effective and preferred by patients and their families who want to heal at home. Included in the new building will be an infusion center for intravenous chronic disease and cancer treatments, and, in the future, a cardiac rehabilitation area that will give the hospital’s cardiac patients the best access to care as they continue their recovery journey. Surgical services, including general surgery and urology, cardiology, oncology, and OBGYN - along with other specialists - will have convenient offices in this building, offering practitioners easy access to surgery, the LDRP suites, inpatient care, and outpatient diagnostics.

HOW CAN YOU HELP? The new McDowell Hospital is an affirmation of this community’s intention to have highquality healthcare close to home. With hospital rooms properly sized for patient comfort, a focus on ambulatory care, and the goal of directing more people to primary care and prevention, we can work together to keep healthcare costs low while improving patient health and satisfaction.

Exciting innovations in healthcare technologies are helping to drive the need for this new facility, but we know that the potential that they have to promote earlier diagnosis or improve the efficacy of treatment regimens, among many other functionalities, makes this investment worthwhile. When the new hospital opens, it will be a facility that functions to promote health and well-being in the community, while delivering excellence in inpatient and emergency care when it is warranted.

Area Of Need

Cost Per Opportunity

Naming Opportunity

Total Need

Regional Hospital

$5,000,000

1

$5,000,000

Surgery Center

$ 1,500,000 $100,000

1 3

$1,500,000 $300,000

$1,000,000 $50,000

1 2

$1,000,000

Exam Room

$25,000

13

$100,000 $275,000

Imaging Center

$500,000

1

$500,000

Infusion Center

$250,000

1

$250,000

Cardiology Suite

$125,000

1

$125,000

Nursery

$100,000

1

$100,000

Cafeteria

1

Chapel

$100,000 $50,000

1

$100,000 $50,000

Terrace

$50,000

1

$50,000

Conference Room

$35,000

1

$35,000

Patient Room

$25,000

25

$625,000

Labor & Delivery Room

$40,000

5

$200,000

OR Suite Emergency Dept Trauma Room

Rooms