By Caroline Benveniste
George and I visited the Lenox Health Greenwich Village facility on August 25th, about a month after the opening of their new imaging center—Northwell Health Imaging. We met with Alex Hellinger, the Executive Director of the facility. I had met with Alex earlier this year when Lenox Health Greenwich Village was nominated for a Greenwich Village Society of Historic Preservation Village Award, and had made it to the final round.
We were taken on an hour-long tour, and were both very impressed with the way the building looked, especially compared to how it had looked when it was the Theresa O’Toole Medical Services Building of St. Vincent’s Hospital. We first visited the new imaging center on the fifth floor of the building. The entry to the upper floors is through a door on 13th Street. This flow was designed so that patients coming in for surgery or imaging would not have to go through the emergency area. In the waiting room of the imaging center is a photomontage of the Village and the High Line; the designers have gone to great lengths to stress the building’s association with the neighborhood.
The Northwell Health Imaging center was beautiful. We saw a new GE MRI machine which cost around $1.3 million, and which was being upgraded with software that would allow for 4D cardiac imaging, something that no other facility is able to do. A breast imaging specialist has been hired, and she oversees a large assortment of breast imaging machines including mammograms, ultrasound, and a stereotactic biopsy machine that uses a computer and imaging to remove tissue for evaluation, usually in cases of breast calcifications.
When North Shore/LIJ (now Northwell Health) took over the building, they consulted with Albert Ledner, the original architect of the building, to get his input on the renovations. Alex commented that their guiding principle was to respect the very colorful and unique history of the facility and the surrounding neighborhood throughout the process. After the tiles had been removed, the building was painted with the same paint that was used on the Guggenheim and it now gleams. And while the building was donated, it was in such a terrible state that a gut renovation was necessary. So far, $150 million has been spent on the building.
The designers were very thoughtful and deliberate in their decisions. Much of the design downstairs was done to create a calm environment, which would be as comfortable as possible for patients, unlike many emergency rooms. The choice of colors (blues) and shapes (lots of circles) bring to mind a ship. The downstairs has rooms for patients to be seen by physicians, including facilities for telemedicine, and also rooms with testing equipment, including very high-resolution CAT scan and X-ray machines. In the basement, a lab can process samples and deliver results in less than 20 minutes.
The Emergency Center is staffed with board-certified ER doctors and a full-time cardiologist. Psychiatry consults are done via telemedicine and interpreters are accessed via iPad. While we were there, we saw the images of a patient who had come in with chest pains and had an abnormal chest X-ray; a doctor was reading a CAT scan of his heart to rule out aortic dissection.
The Emergency Center has now been open for just over two years, and last year about 33,600 patients were seen. When they opened, they anticipated that they would be seeing 20,000 patients in the first year, and that this would ramp up to 30,000 in five years. So, clearly, they have been largely exceeding expectations. Of the patients that are seen in the Emergency Center, the vast majority can be treated and released. But there are some patients who need to be admitted to a full-service hospital, and these make up about 7% of the total.
Out of those 7%, 20% are time-sensitive medical emergencies, and for that group of patients the protocol is to start treatment (e.g., In the case of a stroke, when appropriate, clot-busting medication would be immediately administered) and then transfer them to the nearest hospital, which for now is Beth Israel. Beth Israel is alerted so when the patient arrives the medical teams are ready to go. This means that for cardiac incidents, the “door to balloon time” can be kept low. So far, there have been approximately twelve patients who have been transferred to the Beth Israel cardiac Cath Lab. The remaining 80% are asked which hospital they would prefer to be transferred to—70% end up at Lenox Hill and 10% at other hospitals.
Construction is ongoing in the Ambulatory Surgery Center, which will open in the first quarter of 2017 on the fourth floor of the building. There will be six operating rooms and two procedure rooms. Doctors’ offices will populate the sixth floor, along with conference rooms and community space.