For a trip to the ER, the express lane is now open

Tobey launches $1m quick-care unit

Nurses Sharon Barsano, Mary Kelley (in sling), and Carol Taormina demonstrating the new patient lift system at Tobey Hospital in Wareham. (Paul E. Kandarian/Globe Correspondent)

WAREHAM - This is peak season in Tobey Hospital's emergency room.

Vacationers and beachgoers flock to the Buzzards Bay community in the summer, doubling Wareham's population. As a result, 35 percent of the hospital's yearly emergency room visits occur from June through August, said Elaine R. Meredith, vice president of Southcoast Hospitals Group.

That can mean a long wait for a patient with a sprained ankle or an ear infection.

But Tobey Hospital recently opened a $1 million ExpressCare unit, whose goal is to get those noncritical emergency patients in, treated, and discharged within an hour, said Meredith.

"We want to process those patients more quickly, but more importantly safely and thoroughly," she said. "Urgent patients still receive the same high-priority care, while patients with less critical illnesses, such as flu, ear infections, sprains, and suture removals, are treated by a separate team of health-care providers."

Since 1996, the not-for-profit Tobey Hospital has been part of the Southcoast Hospitals Group, which includes St. Luke's Hospital in New Bedford and Charlton Memorial Hospital in Fall River.

ExpressCare is the latest in a five-year run of improvements at Tobey Hospital, much of which were paid for by philanthropic endeavors, said Joyce Brennan, Southcoast spokeswoman.

In 2004, a $12 million expansion and construction project that included state-of-the-art surgical suites and new intensive care and post-anesthesia recovery units was paid for entirely by community support, she said.

Donations covered much of the cost of the new ExpressCare facility, as well. "The community has always been behind the hospital," Brennan said.

Tobey's emergency room usage has grown by 40 percent in the past 10 years, Meredith said. Last year, the 70-bed hospital had 28,000 emergency room visits, and this year is averaging 100 a day.

"That's a lot for a small hospital, and this year we'll surpass last year's total," she said.

By comparison, St. Luke's 350-bed facility gets about 200 emergency room visits a day, some 73,000 a year. Jordan Hospital in Plymouth, with 150 beds, had 50,397 emergency room visits in fiscal 2006, the most recent year for which the state Department of Public Health had statistics.

The new ExpressCare unit at Tobey Hospital will be open from 11 a.m. to 9 p.m. seven days a week. The unit has 21 full-time staffers, including nurses and administrative personnel.

Suzanne Robbins, nursing manager of the emergency department and intensive care at Tobey, said lab facilities in the treatment area should cut the time it takes to analyze tests by at least one hour.

Children with high fevers will still go to the usual emergency room, as will people 75 and older because, Robbins said, "older people often have other existing issues compounded by small problems they may currently be having."

Also new at Tobey in the past five years is a $400,000 digital mammography machine that allows far greater detail, a 64-slice CT scanner with cardiac imaging software, and a "gamma camera," which works with radioactive dye injected into patients. The hospital also has begun doing gastric-bypass surgery.

And some improvements seem relatively minor but factor big in helping patients and staff alike: The hospital is now using patient slings, a hydraulic lift system that takes patients from their beds and swings them gently to a gurney for transport, or into a wheelchair, something larger hospitals utilize.

"This is great; it can adjust to any size patient and it cuts down on staff injuries," said Sharon Barsano, a nurse in the Tobey intensive-care unit, as she and fellow nurses Mary Kelley and Carol Taormina demonstrated the lift. "One person can do this without the risk of straining their back."

Tobey is also a pilot site for complete patient record computerization, putting all their data online and greatly expediting review, Meredith said.

And in the fall, Tobey doctors and others in the hospital group will be able to use a surgical program at Charlton Hospital that will allow surgeons to perform robot-assisted, minimally invasive procedures, such as prostate cancer surgery, with much greater precision, said Keith A. Hovan, president of Southcoast Hospitals Group.

Meredith was at the Wareham hospital before the merger in 1996. "I can tell you there never would have been $21 million spent here because the hospital just didn't have the money," she said. "The merger allowed us to do so many things that never would have been possible."