Brooklyn Growing Rapidly: The need for a modernized emergency department at The Brooklyn Hospital Center
Review & Comment
The Brooklyn Hospital Center (TBHC) recently received a $25 million Statewide Health Care Facility Transformation Program grant award from the New York State Department of Health to modernize our Emergency Department (ED) facilities and improve access to quality care.
This funding will ensure that TBHC addresses urgent and emergent services for Brooklynites while we continue collaborations with other community-based providers, including skilled nursing facilities and federally qualified health centers to provide the best care in the appropriate setting for our residents.
The planned ED renovation is a key building block of TBHC’s capital expansion plans and its “Blueprint for Financial and Operational Success.” More importantly, it’s vitally needed in our neighborhood.
The modernized ED, targeted for completion by 2020, will expand TBHC’s capacity by 49 percent to meet today’s benchmarks for room size, allow for greater privacy and facilitate clinical efficiencies and workflows.
This investment is necessary.
Our current ED was designed for a maximum of 43,000 visits, yet today the hospital treats approximately 70,000 visits. It is estimated that by 2025, the population in Downtown Brooklyn will increase upwards of 60 percent. Our new and longtime neighbors need and deserve a state-of-the-art emergency care facility. TBHC intends to keep pace and meet the demands of our growing community.
A Backdrop of Improving Quality
TBHC has been working on all fronts to build on the historic foundation we have served for Brooklyn since 1845. This spring we launched The Brooklyn Heart Center to provide world-class comprehensive cardiovascular treatment services. No longer do Brooklynites have to travel across the bridge for primary and preventive cardiac care or diagnostic testing, electrophysiology procedures and percutaneous coronary interventions.
Several months ago, TBHC received The American Heart Association/American Stroke Association’s Get With The Guidelines® Heart Failure and Stroke Gold Plus Quality Achievement Awards. We rank in the top third of Brooklyn providers in the Leapfrog Patient Safety survey and have been recognized by US News and World Report as a high-performing hospital.
Quality will be elevated even further later this year as we launch a critical care service staffed by intensivists. These in-house physicians are highly trained specialists who manage critically ill patients.
Expanding Access to Ambulatory Care
TBHC offers the most advanced level of coordinated care with our nine Patient Centered Medical Home facilities, all designated at Level III status. The PCMH is a model of primary care that includes increasing access, team-based care and integrating evidenced-based medicine into the electronic health records. The model emphasizes care coordination to prevent unnecessary hospitalizations and services.
Currently, TBHC provides more than 300,000 outpatient visits in more than 20 community health centers throughout Brooklyn. Our newest site is the Church Avenue Family Health Center in Flatbush, which joins four other family health centers. We also address community needs by providing services through two HIV/AIDS PATH centers, the second largest WIC network (Women, Infants and Children Special Supplemental Nutrition Program) in the state and an ambulatory dialysis center that has garnered a five-star rating for quality care.
Next year we are adding to our ambulatory network by opening the first in a series of urgent, primary and multi-specialty care practices in the heart of Downtown Brooklyn. At this site we will deliver fast, convenient urgent care at one-third the cost of an ED visit. It will have the added benefit of continuity of care in the same location.
Lowering Costs to Elevate Value
TBHC is leading the way in managing care with the goal of avoiding unnecessary hospital admissions. Working with the Mount Sinai Health System, TBHC is developing new models of care to improve quality and access while reducing costs and unnecessary utilization through the Delivery System Reform Incentive Payment. A few of these innovative approaches include:
The new ED, which will provide for community-health navigators and caseworkers to intervene with individuals who have behavioral health issues. These patients are assessed, treated and then managed in the community providing the most appropriate and cost-effective care.
A recently introduced hospitalist service that features physicians who work with the ED team to assess if an individual truly requires admission. The first year of the hospitalist service has resulted in a reduced length of stay, less complications and improved patient satisfaction rates.
TBHC is on the move and relentless in our mission of “Keeping Brooklyn Healthy.”
While we seek to drive unnecessary emergency visits and admissions down, we also know that a modernized ED is lifesaving for our ever-growing community. The new ED, along with TBHC’s expanded ambulatory services and innovative care models, allow an integrated approach to provide high-quality comprehensive care for Brooklyn residents.
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Gary G. Terrinoni is the president and CEO of The Brooklyn Hospital Center (TBHC) in Downtown Brooklyn, N.Y. Under his leadership, TBHC has been developing a clinically integrated ambulatory strategy, improving its financial viability and focusing on clinical quality and the patient experience.
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