County could have three new emergency rooms within a few years

Published 11:31 pm Monday, April 13, 2009

Snohomish County could get three new emergency rooms between Everett and Edmonds over the next few years.

Stevens Hospital in Edmonds and Seattle’s Swedish Medical Center are talking about the possibility of building new emergency rooms in the county.

And Providence Regional Medical Center Everett will open a new emergency department as part of its new $600 million medical tower scheduled to open in 2011.

But does the county really need three new emergency rooms along the I-5 corridor?

“That’s a really fair question and I don’t know the answer,” said Fred Langer, one of five members of the publicly elected Stevens Hospital board.

Rick Cooper, chief executive of The Everett Clinic, said that over the past 25 or 30 years, the county’s population has grown from about 280,000 to nearly 700,000.

During that time there have not been major upgrades to the emergency rooms at the hospitals in Edmonds, Everett, Arlington and Monroe, he said.

So what looks like a spurt of growth in emergency rooms in part is playing catch-up. “There’s no doubt we need new investment,” Cooper said.

Add to that the economic trends that have more people using hospital emergency rooms for basic medical care, he said. Because patients often put off getting medical care due to its expense, they’re sicker when they arrive.

Even so, “You have to ask yourself: Will there be the demand to support three new or upgraded, expanded, emergency room facilities?” he said.

The fact that one other area hospital — Cascade Valley Hospital in Arlington — is also building a new emergency room with 16 patient treatment areas only underscores the question, he said.

“If the cost of the product that you’re offering goes up as a result of this investment, you’ve got a business risk,” he said.

There needs to be other options for uninsured patients to get routine care than the emergency room, he said, where the bill is far higher for basic health care than it would be in a medical clinic.

When Providence’s new 67,460-square-foot emergency department opens in 2011, it will be roughly the size of two football fields and have the capacity to treat up to 80 patients at one time. The cost of building and outfitting it with high-tech equipment is estimated at $39.4 million.

Hospital officials say that size and capacity is needed to keep up with demand at one of the state’s busiest emergency rooms, which treated more than 105,000 patients last year.

Stevens Hospital has been considering a new emergency room since at least 2005. Its 11,000-square-foot emergency department has 16 patient treatment rooms.

The cost of a new emergency room for the Edmonds hospital is estimated at $40 million, and would take a voter-approved tax increase to help pay for it.

An upgrade is needed, hospital officials say, because its emergency room now treats about 42,000 patients a year, nearly twice the number the space was built for.

In trying to decide whether the hospital should go ahead with plans for a new emergency room, “I believe we should look at this question from a regional sense rather than strictly through the eyes of Stevens Hospital,” Langer said.

The money the hospital gets from the state is expected to drop by about $2 million this year, Langer said, due to Olympia’s own multibillion-dollar budget woes.

Langer said he supports asking voters to approve an increase in the hospital’s maintenance and operations levy this year.

Rather than building a new emergency room, maybe the money should be used differently, he said, such as helping offset the loss of state money and the rising costs of medical care to people who are uninsured or can’t pay their medical bills.

“I’m not convinced we have enough data to see whether or not the public needs a new emergency room,” he said.

Dr. Ralph G. Althouse, regional medical director of Swedish’s heart services at Stevens Hospital, said there are other factors to consider.

“It’s a competitive world,” Althouse said. Patients like going to hospitals that look nice as well as provide good care, he said, “kind of like the Nordstrom approach.”

Other community hospitals, like Kirkland’s Evergreen Hospital Medical Center, have done a good job of building up their facilities, he said.

“What we want to do … is make people feel as if they’re getting state-of-the-art care,” he added.

Voters in Edmonds, Mountlake Terrace, Lynnwood, Woodway, Brier and surrounding unincorporated areas of Snohomish County would have to approve any request for an increase in its maintenance and operation levy.

Seattle’s Swedish Medical Center is considering whether to open a satellite emergency room in the Mill Creek area, possibly near the 128th Street exit of I-5.

It would probably be similar to one it opened in 2005 in Issaquah. That $20 million building has 17 exam rooms, a sleep lab, an imaging department and a laboratory. An announcement on the project could come within the next several months.

“We’re looking at a project up there that we think is great for the community,” said Cal Knight, Swedish’s president and chief operating officer. But he added: “We haven’t made any commitments.”

Dave Brooks, chief executive for Providence Regional Medical Center Everett, said any such move by Swedish would not affect his organization’s plans for its emergency room.

“Whether it’s needed … or is an appropriate way to deliver care will need to be judged by others,” he said.

Reporter Sharon Salyer: 425-339-3486, salyer@heraldnet.com.