By Kirk Johannesen, The Republic
johannesen@therepublic.com
Columbus Regional Hospital today resumes offering the level of emergency care to patients it did before a flood shut down the hospital two weeks ago.
A 14-bed mobile emergency department from Charlotte, N.C., called Carolinas MED-1, will be used while CRH works to reopen its 20-bed emergency department in four to six weeks.
The mobile unit is scheduled to offer around-the-clock services starting at 8 a.m., said Jim Bickel, CRH's president and chief executive officer. MED-1 is located in a parking lot a little west of CRH's emergency department.
"For a temporary solution, this is tremendous," Bickel said.
Crucial services
According to CRH's agreement with Carolinas Medical Center, which developed MED-1 and owns it, MED-1 is providing for six weeks a staff of about 25 people to teach CRH employees how to use the mobile emergency department, and assist if needed, said Dr. Tom Blackwell, medical director of MED-1.
The mobile unit includes one 53-foot tractor-trailer for patients and staff, and another 53-footer for supplies and storage.
MED-1's staff includes physicians, nurses and paramedics. The physicians have received privileges to treat patients at CRH, if needed.
CRH's entire emergency department staff, which includes 13 physicians, will be the primary caregivers for patients.
MED-1 has the ability to function as a Level 1 emergency department, and its presence allows CRH to continue functioning at its Level 2 emergency department status.
The difference between Levels 1 and 2 departments is Level 1 departments have some key specialists on site all the time, such as a neurosurgeon, said Dr. Tom Sonderman, CRH chief medical officer and an emergency department physician.
Level 2 centers have access to those specialists, but not on site all the time.
The goal of the mobile emergency department is to treat patients or stabilize them before transferring them to another hospital where they can be admitted, Blackwell said.
Six beds line each side of the trailer, and two can fit in an operating/resuscitation room at the front. Open-chest and abdominal surgeries can be performed in the mobile department if necessary.
Four beds provide intensive care services, and the remaining beds are for acute care.
The mobile unit has a digital X-ray machine that can show images on monitors within 30 seconds. Another machine can determine a person's blood cell count in 60 seconds, and a hand-held machine can read a blood sample and analyze cardiac enzymes to reveal heart attacks.
Two big tool chests one would expect to find in a NASCAR trailer serve as a pharmacy and orthopedic supply carts, where drugs, splints and wraps are kept.
MED-1 was sent to Waveland and Bay St. Louis in Mississippi, after Hurricane Katrina slammed into Louisiana, Mississippi and Alabama in 2005.
MED-1 served 7,500 patients in a seven-week period, including 15 that required surgeries.
Also, MED-1 assisted New Orleans in 2006 during Mardi Gras, because local hospitals hadn't rebuilt enough to keep up with the volume of patients.
Significant cost
The cost of MED-1 for six weeks is $1,433,000, said Mike Garvey, chief of staff for Indiana Department of Homeland Security.
Bickel said CRH is trying to learn what assistance it might receive to pay for MED-1, and how much it has to pay.
CRH also is trying to understand if it and its physicians can bill patients. That could generate needed revenue for the hospital, which has estimated damages of at least $125 million.
CRH is trying to get use of a 100x100-foot tent MED-1 has, to cover the trailers and create a waiting room area, and provide shelter and privacy. The tent would be added to the cost.
After the flooding shut down CRH entirely, reopening the emergency department became the top priority.
Initial options included using large field tents to create a department, or doing without the services until the department was reopened.
"We didn't think it was prudent to leave the community underserved for that length of time," Sonderman said.
MED-1 first was discussed as an option during hospital meetings June 20.
That day, CRH contacted Carolinas Medical Center, which developed and owns MED-1, and described its plight. A deal was reached Friday for CRH to use MED-1.
"It was a critical need to establish emergency services," Bickel said.
CRH serves patients from 10 counties and is the largest hospital within the Indy-Louisville-Cincinnati triangle.
MED-1 staff began driving the trailers to Columbus on Saturday and arrived at CRH early Sunday.