The WakeMed Health and Hospitals freestanding emergency department in Garner runs consistently at or near capacity. On a recent Tuesday morning, Doctor Erik Manring rifled through the admissions.
"And in the last 30 minutes, one, two, three, four, five, six, seven, eight, nine people just checked in," he said. "That fast."
That adds up to a lot of patients in one year.
"We're going to about 35,000 patients that we're going to see this year, compared to last year it was 31,000 or 32,000," said healthplex manager Karen Weaver. "So we're definitely seeing more patients."
This healthplex is a freestanding emergency department - not a full hospital. This means it doesn't offer inpatient hospital services or surgeries. And that creates an added backlog as patients wait in these emergency room beds, instead of being transported - and sometimes better served - in an inpatient bed.
That's why WakeMed has applied with state regulators to build a new full service hospital in Garner. Weaver explained that currently, patients are transferred 10 miles to the Raleigh campus when they need more than emergency care.
"So we would have to do ED-to-ED for emergent transport for them to be seen by a specialist at the Raleigh campus," Weaver said. "Whereas we would have lots of specialties at the hospital. So we wouldn't have to do that transferring."
This would help alleviate at least one bottleneck in the ED because doctors could send patients to the hospital right on the same campus.
"Having those beds would be so beneficial for us," said Weaver.
Those hospital beds would benefit patients like Joyce Sathoff, who was admitted on that Tuesday with what appeared to be a severe allergic reaction. Dr. Manring checked in on her.
"We're not completely sure the cause. Could be latex," he said.
Sathoff is an interior designer and had been in a room that was recently painted and had all new furniture, so her allergic reaction possibly started there.
"It just started on my face, and then it became beet red immediately," she said. "And it just started spreading down my body. And when it got to my neck I thought, 'My throat could close up.'"
After receiving treatment, Sathoff felt much better and the color of her skin had returned closer to its normal hue. But had her symptoms progressed, she might have needed inpatient services. Had that happened, she would have had to wait until a bed opened up at WakeMed Raleigh or Cary.
Competition for services in Wake County
North Carolina is what's known as a certificate of need state. Health care services here are tightly regulated. That means WakeMed can't just build a new hospital, it first needs approval from state regulators. Duke Health and UNC-Rex Healthcare have also applied for more inpatient beds, proposing to add the services in Raleigh and Holly Springs.
A total of 45 beds are coming available in the county. WakeMed is applying for only nine, and would move 22 beds from the Raleigh campus to Garner to fill out the rest of the 31-bed hospital. Health system CEO Donald Gintzig called that a value proposition to an area with no hospital currently nearby.
"We asked for nine, and through the state allocating nine beds to WakeMed, the Garner service area gets a full service hospital," Gintzig said.
The application process is competitive. In addition to the nine beds, WakeMed is also asking for two operating rooms to fill out the hospital. Duke and UNC-Rex, along with three other surgery practices, applied for those two operating rooms as well, making them even more competitive than the beds. Gintzig hopes the state will see the value proposition in Garner.
"There is a need in Garner. We've had a healthplex there, it is our busiest healthplex. Tracking this year for over 35,000 emergency room visits," he said. "There are a lot of hospitals in North Carolina that don't do that much as a hospital."
State regulators with the Department of Health and Human Services will review applications and award the beds and operating rooms in the coming months.
Here's a breakdown of which health care providers have applied for new services in Wake County:
- WakeMed: Develop a new 31-bed hospital in Garner by adding nine new acute care beds, relocating 22 acute care beds from WakeMed Raleigh, and adding two new operating rooms. Estimated cost: $214 million
- UNC Rex Healthcare: Add 36 acute care beds at Rex Hospital in Raleigh, bringing its total to 534 acute care beds, and add two operating rooms. Add nine acute care beds at UNC Rex Holly Springs Hospital, bringing its total to 59 acute care beds. Estimated cost: $20 million
- Duke Health: Add 45 new acute care beds at Duke Raleigh Hospital, bringing its total to 191 acute care beds. Add two new operating rooms at Duke Health Green Level Ambulatory Surgical Center. Estimated cost: $4 million
- Oakview Ambulatory Surgery Center: Build a single-specialty ambulatory surgical facility with one operating room. Estimated cost: $6.3 million
- KM Surgery Center: Build a multi-specialty ambulatory surgical facility with one operating room. Estimated cost: $10.6 million
- Triangle Vascular Care: Build an ambulatory surgical center with one operating room. Estimated cost: $5.3 million
Note: Cost estimates can vary widely because some hospitals can add acute care beds in empty or available areas on an existing campus, while some projects require new construction. More detail available here.
