The main challenge with the project is maintaining a fully functional ER with 35,000 visits annually and
completing construction within
that space.
Rutland Regional Medical Center in Rutland, Vt., is currently undergoing a renovation and expansion of its emergency department. The project began in February, and is expected to take up to 18 months while the emergency department remains fully operational.
The contract includes 1,840 sq. ft. (171 sq m) of new construction and partial renovations of the current 13,657 sq.-ft. (1,269 sq m) area. The number of emergency treatment rooms, currently 19, will be increased to 26 with the new addition designed for five behavioral health treatment rooms and two isolation rooms that can be converted to behavioral health rooms. In addition, the lobby area will be secured for the safety of patients, visitors and staff by creating a controlled access to public waiting areas. A new security office will be added along with enhanced security measures.
“We're extremely excited about what this expansion will provide for our community,” said Tom Huebner, CEO and president of Rutland Regional Medical Center. “In addition to increasing the overall ED space and number of treatment rooms to accommodate today's patients and caregiver needs, the project is designed with the goal of enhancing efficient flow and delivery of care for our patients and their loved ones.”
The full dollar amount of the project is $6 million, and the contract was awarded to H.P. Cummings Inc., where Dan Smith serves as the vice president. Work began in January 2016, and is expected to be complete in May 2017.
“Renovating space that is in use 24 hours a day will present a challenge to our staff and patients in the ED,” said Mary Nemeth, VP of support services. “However, we are confident that the staff and contractors will work together to see that the patients are served well during the process. The finished product will improve patient flow, lead to improved privacy, and allow our caregivers to continue to provide quality medical care.”
A total of 7,136 GSF will be renovated. The existing mechanical unit is expected to have capacity to support the addition. Minor redistribution will be required to accommodate the renovations.
In addition, the project will include renovation and expansion of the electrical distribution, renovation and expansion of tel/data distribution, and renovation and expansion of the nurse call system.
Program spaces include a renovated vestibule, renovated general waiting area, security office, staff and physician lockers and lounge, five offices, reception area, registration area, two triage areas, the nurse station, dictation, results waiting, two infusion bays, two isolation exam rooms, five psychiatric holding/exam rooms, a psychiatric nurse station, a psychiatric bathroom, two exam rooms, one gynecological exam room, a family waiting area, two public toilets and a storage area.
Corridors within the scope of work will be renovated to receive new flooring, painted walls, wall protection to handrail height, comer guards, ceilings and lighting.
Nemeth noted that over multiple phases of construction, psychiatric holding rooms will go from one existing to a total of five, with an additional two isolation rooms which can be easily converted to psyche. The security and safety of the patients, visitors and staff will be enhanced by creating a secured lobby area designed to control access to the public waiting areas and emergency department. Connectivity between the two existing areas of the emergency department will be accomplished by creating a new connecting corridor, nurse station, and staff support areas.
“Presently, there is one psychiatric holding room in the ED,” Nemeth said. “RRMC has recently expanded its psychiatric services, which placed an added burden to both the number of holding beds in the ED, but also to the level of psychiatric safety. The proposed plan will provide a five-bed psychiatric holding suite with dedicated bathroom and nurse station. The suite is located away from the fast paced activities of the ED to offer a calm environment for the patients and will have the option to independently secure the suite for the safety of all. A sixth holding room will be located outside of the suite and closer to the main nurse station. This is intended to offer flexibility to the intake of psychiatric patients and to offer separation of psychiatric acuity.”
The existing control doors for ED security place a number of staff and waiting public on the non-secure side of the ED. These areas include, general waiting, family waiting, consultation, the security office and triage. The proposed plan reorganizes these spaces to place them behind the security controlled doors. Both security and a reception desk will have full visibility of the drop off area, entrance vestibule and secured lobby from behind bullet resistant glass and walls. The intent is to allow staff to safely observe patients and visitors arriving in the ED and provide the opportunity to safely assess a potential threat, and control that threat in a timely manner.
Nemeth explained that the need to connect the two halves of the ED (acute side with fast track side) came out of the need to allow for patient volume flexibility. Often the high acuity side of the ED is out of beds while the Fast Track side of the ED is underutilized and has beds available. The existing floor plan does not provide a safe or convenient way for the higher acuity volume to expand into the Fast Track side of the ED.
According to Wayne Leonard, project manager, the main challenge with the project is maintaining a fully functional ER with 35,000 visits annually and completing construction within that space. Phasing of the construction in a very active ER makes the project unique.
Major subcontractors for the project include Interstate Electrical; New England Air; Tedesco Masonry; Fabian Earthwork; The Royal Group; O'Raine & Sun; Green Mountain Drywall; Fire Tech; VT Coatings; DG Roofing; Aubin Woodworking; and Chambers Communication.
Consultants for the project include Lavallee/Brensinger Manchester, N.H., architects; LN Consulting, Burlington. Vt.; Artisan Engineering, Burlington, Vt.; and Krebs and Lansing Engineers, Burlington, Vt.
“Utilizing a construction manager and creating a team approach from conception of the project to delivery is awesome,” Leonard said.
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