Gone are the days of South Louisville residents getting their ears checked in closets at Sts. Mary and Elizabeth Hospital. As part of the just completed $9 million renovation and expansion of the emergency room there, walls have been added to give patients more privacy, and the space has more than doubled.
“We went from a space that was comparable to a third-world clinic that we were so busy, we’d have patients in chairs, and we’d pull them into a closet to look in their ears because we were so limited by the physical plan,” said Eric Fulcher, emergency department medical director.
The hospital, part of KentuckyOne Health, serves a racially and economically diverse South Louisville, which has about 176,000 residents. It’s the only hospital in the the area and more than 75 percent of all patients admitted come first through the emergency department. That’s compared with a national average of around 50 percent.
With an increased focus on patient satisfaction scores, which are now incorporated into hospital payments, there’s a new focus on making the experience quieter and cleaner for patients. While the emergency department staff is trained to work in chaos, patients are not.
“Coming to the hospital for anything can be very overwhelming,” Fulcher said. “You compound that with the chaos you see here, it’s just not optimal. We’ve been able to mitigate that by redesigning and creating the space.”
Jennifer Nolan, president of Sts. Mary and Elizabeth Hospital, said that while the population has grown in the area overall, the hospital has also seen an uptick in the number of patients visiting the ER because of the 2014 Medicaid expansion. The program enlarged the eligibility pool for Medicaid by accepting people with incomes up to 138 percent of the federal poverty level — $16,242 for a childless adult.
Nolan said many people who fall into that category still use the ER for issues that could be treated elsewhere.
“With Medicaid expansion, there are most folks that unfortunately use the emergency department as primary care because maybe they haven’t been connected in the past,” she said.
Gov. Matt Bevin this year submitted a proposal to the federal government to trim back benefits in the Medicaid expansion program. His proposal seeks to implement monthly payments, make dental and vision care benefits one earns, and increase deductibles.
With President-elect Donald Trump coming into office in January, the likelihood that the changes will be approved, or that the program could be scrapped altogether, are high.