By Alec Pruchnicki, MD
On July 17th, the Lenox Hill Healthplex, now to be renamed Lenox Health Greenwich Village, celebrated the first anniversary of its opening. How is it doing?
To answer this question, Executive Director Alex Hellinger gave a tour of the facility to this writer and WestView photographer Maggie Berkvist. Although there have been anecdotal stories, some of which have appeared in WestView, the overall volume of the center has steadily increased from fifty a day to about one-hundred a day, which would give it a yearly visit volume of almost forty-thousand.
About 50% of patients are walk-ins and the others are brought in by EMS ambulances, similar to previous patterns. According to Medical Director Eric Cruzen, about 7% require hospitalization (about the same as other free standing emergency departments) with the majority going to Lenox Hill on the Upper East Side, but the others going to relatively nearby Beth Israel, or facilities of their choice. About 20% of these admissions go into intensive care units.
Although most visits are lower level emergencies, Lenox Health still gets strokes, heart attacks and low level trauma cases, which appear to be treated on a level similar to hospital based EDs before transfer to in-patient facilities.
EMS ambulances frequently screen higher level emergencies which are taken directly to in-patient facilities. Lenox Health also has started to institute observation status, which is common in most EDs for patients where the choice between discharge or admission has not been determined.
The Lenox Health staff also seems proud of the patient oriented, bottom up planning that occurred, often with the extensive help of the North Shore/LIJ Health System staff, to organize the operation of the facility. Individual rooms (no curtains between crowded beds), specialized psychiatric and sexual abuse rooms, personal pagers instead of overhead speakers, and even some TV and Internet access makes the visit as tolerable as possible.
According to Dr. Cruzen, there have been about thirty-five deaths at the facility with many, but not all, predictable advanced illness cases. No births yet.
The Emergency Department is not the only resource planned for this building. Director Hellinger showed the fifth and sixth floors which will contain private doctors’ offices, along with a separate entrance on 13th street. Additionally, this floor will have a separate area that will house conference rooms and meeting spaces for community use, spaces specifically planned with their needs in mind.
There will be an imaging center which would provide routine x-rays, CT and MRI scans, ultra-sounds, mammograms, and some specialized pediatric services. There will also be an entire floor for an out-patient, same-day surgery center similar to other ambulatory surgery facilities. Most of these services are scheduled to open in early 2016.
At a time when the Federal, State, and City governments are looking for ways to decrease hospital beds and more treatment is on an out-patient basis, establishment of a new hospital on the West Side is an uphill fight at best, and virtually impossible at worst.
But, free standing EDs throughout the country, in the Bronx, and possibly in Brooklyn (at the old LICH site) are multiplying to meet some of the community’s needs. This appears to be working as well as can be expected and possibly better than anticipated. It had better work out, since this is what will be available for the foreseeable future.