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T he average person spends more than three hours in the emergency depart- ment at Kaweah Delta Medical Cen- ter. That's a long time to wait to find out the severity of an illness or injury, or if a loved one will make it through the night. And while that time is about average for hospitals na- tionwide, Kaweah Delta wants the experi- ence to be better by adding more space, comfort and staff. On Monday, Dec. 4, Kaweah Delta closed down the primary entrance to its emergency department (ED) to begin construction to ex- pand the ED. The two-year, $32.8 million proj- ect will nearly double the size of the ED from 41 to 74 beds and will more than double the size of the waiting area to accommodate over 100 people compared to about 65 currently. Kaweah Delta CEO Gary Herbst said the hospital's ED was built in 1992 to accommo- date 36,000 patient visits per year. When the Acequia Wing was built in 2009, the ED was expanded to accommodate 72,000 patients per year. But less than five years later the de- mand for care at the ED had already outpaced space. The ED saw more than 80,000 patients in 2013 and more than 93,000 in 2015. In 2017, Kaweah Delta's ED sees more than 250 patients per day. Herbst said he expects those numbers to grow. "If this hospital were in Los Angeles, it would be the third busiest ED in town," Herb- st said. The reason for increased demand at the ED is three-fold. Kaweah Delta is the only Level III Trauma hospital between Fresno and Ba- kersfield and serves about 600,000 people between Tulare and Kings counties. EDs are required by law to treat every patient, regard- less of the acuity of their condition and their ability to pay. And, many people misuse the ED for conditions such minor strains, sprains, lacerations, fractures and cold and flu symp- toms for the elderly and those with related health concerns (such as asthma). Herbst said those patients should go to urgent care, where they could be treated more efficiently and less costly. EDs should only be used for open frac- tures, severe trauma (such as a traffic accident or falling off a roof), gunshot wounds, chest pains, emphysema or patients who are not responsive. Last winter, a temporary reception tent was set up outside of the hospital's normal emer- gency department (ED) entrance to receive, evaluate, and register ED patients during peri- ods of peak demand, such as flu season. The hospital set up the tent again this winter to help treat patients more quickly. The tent is a fully operable "room" which includes elec- tricity, HVAC, and various supplies. Patients inside the tent are monitored by staff. The ad- ditional square footage in the tent allows the hospital to use the ED lobby to treat patients with minor conditions. The tent has become increasingly necess- sary due to overcrowding, coupled with the recent closure of Tulare Regional Medical Center and its emergency department and an early onset of influenza. Kaweah Delta was admitting about 10 people with the flu in the ED each week in October but that number has now risen to between 50 and 65 cases per week. This forced Kaweah Delta to set up the tent outside of the ED six weeks earlier than last year. In order to treat patients with non-life threatening injuries or conditions without turning them away, Kaweah Delta will also be carving out a new Fast Track section behind the main lobby to act as an on-site urgent care. Dan Allain, assistant chief nursing of- ficer for critical care administration, said the Fast Track will have eight exam rooms to see patients with non-life threatening conditions. "Most hospitals now have a similar place for those patients," Allain said. The current ED will not be affected, except for the occasional construction noises, and all of the hospital's services will remain open during construction, but there will be changes for those arriving at the hospital on their own. Patients requiring emergency care will enter t e x t a n d p h o t o g r a p h y b y r e g g i e e l l i s Kaweah Delta Medical Center will double the size of its emergency department over the next two years with more exam rooms, larger waiting room and more staff E.D. constriction Kaweah Delta begins construction to alleviate MINERAL KING PUBLISHING INC | FSGNEWS.COM | 3 EMERGENCY CARE

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