FARMINGTON — At the Select Board meeting on Nov. 12, Barbara Sergio, president of Maine Health Franklin Hospital shared details about upcoming emergency department [ED] renovations.

This drawing shows the current layout of the emergency department at MaineHealth Franklin Hospital in Farmington. A renovation project will begin Dec. 9 and take about 24 months to complete. Screenshot

“It really is going to be an amazing project when it is done, but it’s going to be painful for our community,” Sergio said. The ED has 10 rooms, is original from the 1970s building with a slight rebuild in the 1990s, she noted.

“In 2018/2019 we saw approximately 13,000 to 14,000 patients annually through the emergency room, 2020/2021 we are up to between 21,000 and 22,000 ER visits,” Segio said. “We sort of stabilized a little bit, have come back down around that 20,000 mark. We feel that’s probably where we are going to stay.”

This drawing shows what the new emergency department and front of MaineHealth Franklin Hospital in Farmington will look like when completed. Screenshot

The ED was crunched at 13,000, was never built for that, Sergio noted. It frequently causes long waits, is poorly designed and there is no clear line of site, she said. “I have been here for five and a half years and we have been talking about this for three and a half years.”

About 18 months ago, a firm was hired to design a plan which involved adding on to the building but MaineHealth was not able to undertake it, Sergio said. Another firm has been hired, will start Dec. 9. The ED now has 10 exam rooms, a trauma room, one bathroom and a small space for clinical staff to do their charts, she noted.

“The project will include five phases over approximately two years,” Sergio said. “We have to keep an operating ER during this, so that is where it gets tricky,” she stated. “We will still have eight to 12 rooms that our patients can be seen for trauma. One bathroom for 10 rooms, it causes problems. The ambulance and walk-in traffic are all in the same place. That is not ideal so we have attempted to rectify a lot of this stuff.”

When finished the ED will include:

• 16 exam rooms.

• 1 large trauma room.

• 4 fast track chairs where patients will be triaged with less severe issues being treated there.

• 4 behavioral health spaces, 2 of which will be secured for seclusion and 2 which can be converted to a regular ER room.

• A separate space for telehealth or psychiatric consultations.

Sergio said currently mental health patients can be in the ER for hours or days depending on placement availability. “It has been a real issue, not just here but across the state and nation,” she noted.

Renovations will mean a change to the entire front of the hospital, dealing with plywood walls, corridors and paper signs, Sergio said. “We are trying to make it as friendly as possible,” she noted. “Some stuff to the left of the entrance will stay the same. The whole hallway changes and gets rerouted.”

The right side will go directly to the ER entrance for check-in and triage,” Sergio said. “It is safer for everybody, makes for a better patient experience,” she stated. “We are super excited.”

The project is estimated to cost about $11.5 million, with hopes of federal funding being earmarked, Sergio said. One additional doctor or physician’s assistant and two to four more nurses/ER staff are expected to be hired, she noted.

Selectman Richard Morton asked how the new urgent care center would impact the hospital’s plans.

Sprained ankles, things of that nature are what urgent care are for, Sergio responded. “If we lose that, we are fine,” she stated. MaineHealth is constantly trying to educate the community on what might require an ER visit, she said. Urgent care could take some pressure off the ER, she noted.

Selectman Dennis O’Neil suggested some ER visits were from people without health care or a regular doctor.

That is a problem, it drives people to the ER, Sergio agreed. MaineHealth has started leaving slots open for same day acute or sick day visits, is keeping track of how many of those are filled, she said.

“It is going to be a mess for at least one and a half years,” Sergio said. She is pushing for the work to be completed in 14 months but has been told it will probably take 24 months.

“It sounds like a great plan,” Chair Joshua Bell said.