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With Latest Expansion, KRMC Seeks to Address Overcrowding in the ER

Kalispell Regional Medical Center raising public support to upgrade emergency services

By Dillon Tabish

Among employees in the emergency room at Kalispell Regional Medical Center, the word “quiet” is frequently avoided.

The congested space on the south end of the hospital’s campus brims with nurses and doctors who eschew the term with a sort of superstition, well aware that any moment multiple urgent incidents could disrupt the calm.

“Right now is the most peaceful time of day. But yesterday in here at noon, it was insane,” said Mary Mae Stubbs, director of emergency services at Kalispell Regional Healthcare. “You couldn’t hear anything. And that wasn’t even close to peak hours.”

In a valley with more than 90,000 residents, and hundreds of thousands of visitors annually, the demand for emergency services remains high.

According to KRMC administrators, the hospital served 22,618 patients in 2012 through its emergency department and trauma center. The ALERT program, which includes multiple aircraft that provide life-flight services across Northwest Montana, transported 452 critically ill patients.

Yet while the need has expanded, the amount of space in Kalispell has not. The 8,179-square-foot ER remains largely in the same footprint as when it was first developed in 1976, and improvements that were made in the last remodel in 1991 have already become outdated and deficient.

Hallways are cramped with overflowing supplies and nurse workstations. Gurneys carrying patients can narrowly navigate most of the corridors, and the doorways are almost all scuffed at the edges from run-ins. The 13 patient rooms, also cluttered with the typical array of hospital resources, are confined spaces that are hardly private. During the peak of summer, patients are sometimes placed in the hallways awaiting an open room while others endure long wait times before receiving initial care.

“It’s cramped. It’s tight. And it’s so loud, sometimes, when you’re trying to coordinate the whole department, you just feel like pulling your hair out and running to the bathroom to hide,” Stubbs said.

In an effort to address the growing strain on the emergency services department and prepare for population growth into the future, the Kalispell Regional Healthcare Foundation is raising public support for a $14 million expansion and upgrade at the hospital. Foundation board members, volunteers and KRMC staff and administrators have pledged $5.4 million as of last summer, according to the hospital. The remaining funds are being rallied in the community through private donors.

“We have never done a public campaign before and we wouldn’t do one unless we absolutely needed it,” said Tagen Vine, president of the Kalispell Regional Healthcare Foundation. “With emergency services, there is no new revenue generated from this. This is just a replacement of a facility and expansion that will cost more. So if we can do it through philanthropy, it keeps us from having to do other things to offset the investment.”

The expansion and upgrades would increase the ER space from 8,179 square-feet to 37,516 square-feet. The number of patient rooms would jump from 13 to 30, with new specialized treatment rooms for trauma patients, sexual assault victims and psychiatric and detox incidents. There would also be three nursing stations, instead of only one, and a large private family waiting area.

The development would require the hospital to expand the ER onto Conway Drive, forcing both the road and the ALERT hanger to be relocated along with underground utilities. This added an additional $10 million to the project’s overall cost.

The ALERT program, with an annual operating cost of $3.2 million, loses roughly $770,000 each year, according to KRMC.

The hospital has envisioned boosting its emergency services for years. But before being able to do that, the first phase of development involving the surgical services department needed to relocate many adjacent departments. In early 2013, the hospital completed a $42 million project that added a three-story tower onto the campus. The expansion doubled the size of the former surgical department, adding eight new operating rooms, 18 same-day surgery beds, 18 post-anesthesia care beds, two endoscopy and two fluoroscopy procedure rooms as well as nurse care and physician stations.

The expansion also opened up a new section of campus that could be utilized for emergency services.

As always, health care needs are complex. At KRMC, the types of urgent incidents span a wide range, including vehicle accidents, bear attacks, drug overdoses and sexual assaults.

An average of nearly 70 sexual assault victims a year seek ER services at KRMC, according to Vine. Yet the hospital lacks proper accommodations, such as a room specifically designed for extremely sensitive situations such as those.

“That would be a great thing for us to be able to provide,” Vine said.

There is also an increasing amount of drug abuse and detox incidents flooding into the ER year-round, according to the hospital. In 2012, the hospital treated 667 patients with alcohol, drug and/or mental health issues, according to KRMC. These patients, demanding unique placement and attention, stay an average of five hours in the ER, and currently only one room is dedicated to detox and psychiatric care. Before an individual can be sent to Pathways Treatment Center, they must be examined and properly treated through the ER.

In light of recent nationwide events, the hospital has also identified the need for a mass decontamination room in case of biological or chemical disasters.

As the population of Northwest Montana grows, KRMC expects to see roughly 27,000 patients in its ER by next year. The hospital currently serves a six-county area with roughly 200,000 residents, and 30 percent of the patients at KRMC are from outside the Flathead Valley, according to the hospital.

“I’m really proud of what we have here and what we do,” Stubbs said. “We have a great team and we take good care of people.”

For more information about supporting the emergency services expansion and upgrade, contact the Kalispell Regional Healthcare Foundation at 751-6930.