Urgent care clinic delayed, staff, procedures plans in place

The Stephens Memorial Hospital board may have delayed plans to open an urgent care/after hours clinic in 2017, but plans for the clinic became more concrete during last Thursday’s board meeting.

The urgent care/after hours clinic was originally planned to open sometime this month, but officials overseeing the project suggested the board push those plans back in order to have a strong foundation for when the clinic opens in 2018.

“What we’re thinking is starting small,” Stephens Memorial CEO Matt Kempton said. “If it attracts attention and does well, then we could possibly expand it. We’re thinking of starting on weekends.”

During the meeting, hospital officials provided additional details regarding the clinic. They suggested opening the clinic Saturday and Sunday from 8 a.m. to 8 p.m. It would be located at the hospital’s main entrance with a dedicated clerk to check in patients. The clerk would then lead the patient to the radiology waiting room, then to an ultrasound room, where an on-staff nurse will triage patients. Once a physician completes an examination, the clerk would then return to collect any co-payment from the patient. Kempton estimates the cost per visit at $100.

“We originally thought we could run this in the E.R.,” Kempton said. “… For many reasons we felt it was not appropriate to run it in the E.R. We want to separate it out and run it in the hospital, but not in the E.R.”

Although not taking place in the emergency room, plans for the facility could require the E.R. nursing staff to examine patients. If the E.R. nursing staff become overwhelmed by patients, the medical/surgery staff would step in and begin triaging patients. The physicians required to run the facility would come from those contracted through Concord E.R. Physicians, with whom SMH would have a 60/40 profit split. If there are more than three patients waiting for treatment, then the hospital could request service from another provider, BMC, who would have a similar agreement in place.

“What happens if we’re really busy in the E.R.?” Kempton said. “Let’s say they have five patients in the E.R. They are staffed for five patients and have five treatment rooms. Obviously, the priority is E.R. instead of urgent care. At that point, that would trigger med-surg staff to come in a triage the patient.”

Should a patient seek attention at the clinic, and it becomes an emergency, the hospital would credit $100 paid upfront by the patient to the patient’s medical bill.

“This is just an initial discussion for now,” SMH Quality Management Director Sarah Nadanamoorthi said. “There are a lot of things we need to consider and need to hash out. If we did see a positive advancement with patients coming in, we would want to add a provider. That is the goal. We want to utilize our providers as well. We don’t want to just use the E.R. Concord providers.”

Nadanamoorthi said the the proposed clinic has many similarities to a clinic operated out of Henrietta, but feels the hospital could better utilize its resources throughout the area.

“[Henrietta] has slightly lower volume in their E.R. than ours, but they have had pretty good use of their urgent care,” She said. “Their set up is a little different, but the type of patients that they see is about the same. Their area is similar to ours, but we may have better utilization from some of the surrounding areas than they would have.”