SALEM — The number of patients treated at the Salem Hospital emergency room is on the rise, as more people are being transported from Lynn due to the impending closure of Union Hospital.
But officials say they have been able to handle the influx through increased efficiency, and have in fact reduced wait times. The average wait time for a patient to be taken to a treatment room is now 37 minutes, down eight minutes from last year, according to hospital officials.
Dr. Phillip Rice, chairman of emergency medicine at North Shore Medical Center, said the hospital has added more doctors and nurses and changed procedures to free up beds and create a better flow of patients in and out of the ER.
"There's a number of different things that we've tried and we're continuing to try," Rice said. "It's by no means solved. We want to try to continue to get these times down even further."
Lynn fire Capt. Joseph Zukas, the emergency medical services director for the city, said paramedics and EMTs are opting to take Lynn patients to Salem because Union Hospital no longer has services, such as operating rooms, that they will need. Only 20 percent of the department's ambulance transports are going to Union Hospital, as compared with 60 percent a few years ago, he said.
"They're saying, 'I'm not taking them to Union because they can't handle them,'" Zukas said.
North Shore Medical Center, which includes Salem and Union hospitals and is part of Partners HealthCare, has been gradually reducing services at Union while undertaking a $207 million expansion of its Salem campus. That project will include a new and expanded emergency department designed to handle the extra patients from Lynn.
But the new ER is not scheduled to open until October. In the meantime, the 51-bay Salem emergency room is handling the extra volume. It has seen an increase of more than 1,900 patients over the last seven months compared to the same time period the year before, while patient volume at Union Hospital's ER dropped by more than 2,300.
Zukas said he has been told by his ambulance crews that the wait times at Salem Hospital are getting longer. But hospital officials provided numbers showing that wait times have actually dropped.
Patients arriving at the ER now wait an average of 37 minutes to be taken to a treatment room and 68 minutes to see a doctor, according to the hospital. Those times represent reductions of eight and 10 minutes, respectively, over the previous year.
North Shore Medical Center spokeswoman Laura Fleming acknowledged that space at the Salem ER is "somewhat tight right now," but said the hospital is doing "impressive work" to keep wait times down.
The impact of Union Hospital's closure was a concern of state regulators when they approved the plan in 2016. The state's public health council said it would monitor patient volume and emergency room wait times after Union's closure to see how the Salem campus is handling the increased number of patients.
Streamlining the process
Rice, the head of emergency medicine, said North Shore Medical Center CEO Dr. David Roberts formed a "flow committee" shortly after he took over in 2017. The committee examined the movement of patients from the time they entered the emergency department to the time they were discharged, and formed teams to look at how to eliminate or reduce any "bottlenecks," Rice said.
That involved a range of areas, from streamlining the admitting process to making sure patients have a ride home at the time of their discharge, he said.
The new emergency department in Salem will have 65 bays, including a 10-bed observation unit and dedicated treatment areas for adults and children. There will also be a dedicated area for patients with behavioral health needs.
The hospital will also maintain 12 beds in the pediatric emergency department that could be used during peak times, such as flu season, officials said.
Hospital officials said the ER will also benefit from the new behavioral health center that is being built as part of the expansion, by freeing up beds in the ER that are often occupied by psychiatry patients. The new emergency department will also include a radiology suite that will improve efficiency, Rice said.
"We want to provide a better service because people deserve it," Rice said. "That's what should happen."
The ER at Union Hospital will be converted to a temporary urgent care center in November that will remain in place until a permanent urgent care center — which is under construction — is completed next spring, the hospital said. The center will be part of a "medical village" that will replace Union Hospital.
Zukas, the Lynn fire captain, said he is concerned that the new Salem emergency room will not be big enough to handle the increased volume.
"I just thought if you were going to build a new facility you'd build it a little bigger," he said. "But I would defer to them. I'm not in the business of building facilities. We're going to work with them on whatever plan they have."
Staff writer Paul Leighton can be reached at 978-338-2675 or email@example.com.
Salem Hospital ER patient volume
Oct. '17-May '18 — 32,940
Oct. '18-May '19 — 34,849
Change — plus 1,909
Union Hospital ER patient volume
Oct. '17-May '18 — 14,580
Oct. '18-May '19 — 12,246
Change — minus 2,334