In the last issue of WestView News, the opening of the new Lenox Hill Healthplex in the former O’Toole building of St. Vincent’s Hospital was explored. But, this is a view from the outside, the community, looking in. What is the view of the workers there? In order to get their opinions on the newly opened facility, Westview conducted interviews with several staff members.
First, was Dr. Eric Cruzen, Director of Emergency Medicine, who has previously appeared in presentations to community organizations and also helped conduct a tour of the facility for WestView during its construction. He stated that after about one month, this ER had seen about 1100 individuals, with about 7% requiring hospitalization. Most hospitalizations were to Lenox Hill, but some were to other hospitals depending on the request of the patient. More complete data on the center’s performance would probably not be available until about a year into its operation when the seasonal variations in illness could be examined. He then arranged for interviews with several other staff members.
Peter Glennon is a Registered Nurse who worked as an EMT for the NYFD before becoming an RN. He also worked at Long Island College Hospital before the Healthplex. He said that the performance of the Healplex was ” blowing expectations out of the water” in his opinion and it was the highest quality care of anywhere he had worked. He was especially impressed by the extensive 12 week orientation he received, including disaster preparedness.
Next up was Jennifer Siller a Nurse Practioner who has worked in a variety of emergency rooms (including the main Lenox Hill hospital ER), critical care units, and even a cardiac catherization unit. She is now enrolled in a program for her Doctorate in Nurse Practice. She described the Healthplex as ” …fabulous, great…” with fast patient intake and nobody in the waiting area. Whether this can continue when they become busier is hard to tell at this time, she said. Concerning transfers, she pointed out that one transfer was to Columbia Presbyterian Hospital on 165th street. As for cardiac catheterization, a process that requires fast intervention, she stated that the most important measurement is “doorway to EKG” time. That is, when a patient enters the facility with symptoms suggestive of a heart attack, how much time does it take to get the first EKG, which is needed to determine if a catheterization is warranted. At the Healthplex, this time is within five minutes, which is as good as any hospital based ER, and better than some.
Lastly came Dr. Alexander Gorodnitskiy who was a medical resident at St. Vincent’s Hospital from 2005 to 2008, and a fellow in cardiology there until the closing of the hospital forced him to complete his training elsewhere. He has worked in the cardiology departments of Columbia and Lenox Hill hospitals. The fact that he was “dedicated” to the Healthplex (meaning that this is his primary medical duty) is very unusual for an ER. Usually, in hospital based ERs, a new cardiac patient will be seen by the ER doctors, residents, and maybe a cardiology fellow, but seldom an attending level physician such as himself. He thought this was a much better way of doing things compared to other ERs.
There were some points that almost all of the four interviewees made. The first was that the lack of an attached hospital gave them more flexibility than most ERs. If a patient needs transfer to a hospital, it can be done to any hospital in Manhattan, and possibly also the boroughs or northern New Jersey. In a traditional ER, the patient stays there until the hospital bed opens up in that facility, and transfer to another institution from the ER is very unusual. Here, the patient can decide where to go if the medical situation is stable enough. Also, this Healthplex was designed from the bottom up, with no preconditions, the newest medical standards being used rather then institutional habits and culture at other places ( such as “…that’s the way we’ve always done it here…” ). The transfer to other hospitals can also be done faster, because of patient choice, than hospital-based ERs. For example, if a direct admit to a hospital bed, or ICU, or surgical/cath suite at one hospital is delayed, the patient can opt for transfer to another hospital even if it wasn’t the original first choice. This flexibility isn’t available at hospital-based ERs.
It is true that these interviews were arranged by Dr. Cruzen and they all voluntarily came forward. It isn’t possible for Westview to know, at this time, if there were any critics or malcontents or whistle blowers hidden away someplace. But, as far as can be determined with these brief interviews only a month into operations, they all seemed hopeful and even enthusiastic. This is not the common attitude of ER staff at most hospitals. Let’s hope it continues, and the performance matches the hopefulness.
Alec Pruchnicki, MD, was on the staff at St. Vincent’s Hospital in the Geriatrics Division from 2003 until the hospital’s closing in 2010.