Emergency accommodations

Emergency medicine tends to be a fast-moving specialty, but even mobile practitioners like a place to settle down. That’s been a challenge the past three years at Enloe Medical Center, where the emergency department itself has been in flux.

Enloe’s Century Project reshaped the main hospital, most conspicuously with the construction of the five-story Magnolia Tower. That structure was first occupied in November 2012; renovations in the older facility continued through this spring. Throughout, the emergency department made a sequence of hopscotch jumps, as certain ER services and patient rooms were temporarily relocated across the complex while the number of patients steadily increased.

The new emergency medical building opened last August, but even then it wasn’t complete. Phase I added 25 patient beds, a large trauma room and ER-dedicated X-ray and CT equipment; only last Tuesday (June 9) was Phase II finished and the space wholly open.

The sleek and shiny emergency department now commands almost 25,000 square feet—7,000 more than the first phase and 15,000 more overall—and totals 39 beds, plus surge capacity for more. The single-floor building features a hallway design optimized for smooth flow along with privacy.

Dr. Monty Leavitt, a 20-year member of the department who now serves as its medical director, is pleased to call the “big and beautiful” place his professional home.

“We’ve been displaced from place to place, just annexing other areas in the hospital to keep functioning,” Leavitt said. “We like this a lot.”

So does Judy Cline, director of emergency and trauma services. She’s a nurse, which makes her particularly attuned to how patients experience the ER.

“We hope that we’ll be more efficient being back in one space,” she said. “Our goals are always to get to our patients as quickly as we possibly can; I know for some it seems like a very long wait, because you never know how many more sick individuals come in ahead of you, and you can’t see the ambulances come in and the helicopters landing … but we hope with more beds, and with that efficiency of not having to run down to an entire other side of the hospital to find a bed for you, that our wait times will actually get much better.”

Considering the increased demand for Enloe’s emergency services, efficiency is important. The ER saw around 40,000 patients in 2013. Last year, that total increased to 48,000. This year, the department is on pace for 60,000.

Leavitt said this upward spike has come while the percentage of hospital admissions decreased the past year, suggesting that the emergency department and its “unique facility” has a wider draw.

Enloe CEO Mike Wiltermood, meanwhile, attributed the increase in ER patients to expanded insurance through the Affordable Care Act and the shortage of local primary care physicians.

“It doesn’t matter what kind of insurance you have,” he said. “I’m talking to people moving into Northern California who can’t find a physician; everybody’s booked.”

The larger space would be hollow, though, without adequate staffing.

Enloe has recruited 10 board-certified emergency physicians in the past three years, expanding the department to 23 full-time doctors. Leavitt credits Dr. Stephen Shipley with creating a “pipeline” of ER doctors into Chico amid the physician shortage, especially for rural areas. Shipley came from San Diego, and after reaching out to colleagues, he lured nine others northward.

Including around 75 nurses and other support staff, the emergency department is staffed by 150 employees. Cline says around two-thirds of the nurses were trained at Butte College or Chico State. Technicians also tend to come from local training programs.

“We’re very, very lucky to have the schools we have here locally to keep talented help,” she said.

Completion of the emergency department marks completion of all building construction for the Century Project. It’s not, however, the end of work. The $175 million expansion, which began in 2006, includes a community park that’s in its earliest stages.

The park will comprise just over 2 acres, west of the medical center (bounded by Magnolia, Arcadian, West Fifth and West Sixth avenues), serving as a buffer between hospital buildings and neighboring residences.

“It is intended as both a resource for the neighborhood—a place people can wander around and for quiet enjoyment—and a place for our patients and our staff members to go outside and enjoy nature,” said Bill Seguine, Enloe’s facilities director. “It does not have ball fields, big grass areas, places to play Frisbee and let the dogs run around…. It’s a place where we can have some quiet outdoor space that doesn’t otherwise attract traffic here to the area.”

The park already has “a small play structure for small children,” thanks to a local Rotary club’s donation. Plans include benches, paths and ornamental plants.

“Because of our water situation, it does present both unique and interesting challenges, along with opportunities,” Seguine said. “With the drought and our water needs, we don’t want to be putting in high-water-use plants or other things—but, fortunately, we’d already been planning on that.”

The property reserved for the park mostly has been cleared for repurposing. The last structure to remove is where Seguine happens to work.

“The very last thing I do for the Century Project is destroy my own office,” he said, chuckling. “Somewhere, I need to build myself a new home.”

Until then, he’ll enjoy his view of the work already done. About the emergency department in particular, but applicable to the whole project, Seguine said: “I’m extremely pleased with how it all turned out. It’s a huge effort from a lot of people … we succeeded as a team.”