Our Lady of the Lake's north Baton Rouge emergency room will not be able to treat patients with the most serious medical problems — such as a gunshot victim — but doctors working in the new eight-bed ER can stabilize these patients and route them to other campuses if necessary, administrators said on a tour of the facility Friday.
The ER will open at 1 p.m. on Wednesday, restoring some emergency care to north Baton Rouge that has been missing for years. But Our Lady of the Lake's north Baton Rouge emergency room cannot offer the same level of treatment as the full-fledged trauma center in the southern part of the parish, which means medical staff mostly will not treat people who have been shot, those who are having heart attacks and stroke victims.
Our Lady of the Lake North Emergency Room is set to open Nov. 15, which means that north Baton Rouge is just three weeks away from having its …
It has been unclear up until this point the extent of the capabilities that the north Baton Rouge emergency room would have. At its groundbreaking in January, Our Lady of the Lake's Associate Medical Director of Emergency Services Shammi Kataria said it would be a "fully functioning ER capable of taking care of any trauma."
But the ER's ability to take care of trauma patients is limited to a bay with two beds where a medical team can intubate and open an airway for a patient who can't breathe, start intravenous infusions — or drips — that cannot be done outside of an emergency room and stabilize a patient. The trauma bay also has a telemedicine machine where a neurologist can determine whether a patient is having a stroke, which would mean they would have to be transferred.
"We wanted to make certain that we had life-sustaining capability," said Terrie Sterling, the chief operating officer for Our Lady of the Lake. "It's always about that 'what if' scenario and having full capability to be able to stabilize."
The lack of an ER in north Baton Rouge is an issue that has been repeatedly pressed by community activists and politicians in recent years. The state closed LSU's Earl K. Long Medical Center in 2013, with Our Lady of the Lake Regional Medical Center contracting with the state to treat the uninsured patients who used to go to the public safety net hospital. Because of the long distance to OLOL in the southern part of the parish, many of those patients then started going to Baton Rouge General's Mid City Emergency Room, the closest ER to the north side of the city. Baton Rouge General closed its Mid City emergency room in 2015, saying it could not afford to keep treating uninsured patients without higher reimbursements from government.
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The state announced a year ago that it was adding $5.5 million to its existing contract with Our Lady of the Lake to help build the emergency room, which the hospital anticipates costing $7 million to $10 million a year to operate depending on how many patients they see.
Sterling said Our Lady of the Lake expects the breakdown of how people pay for their care at the north Baton Rouge emergency room to be similar to its Livingston freestanding ER, where 45 percent of patients pay with Medicaid, 20 percent pay with Medicare or a Medicare replacement and 20 percent pay with private insurance. The remaining 15 percent is a mixture of uninsured patients, those paying with worker's compensation, patients with military coverage and other sources of coverage.
They expect the north Baton Rouge ER to handle 10,000 to 15,000 visits annually.
One of the most important components of the new emergency room is its connectivity to the urgent care and primary care services already offered at Our Lady of the Lake's LSU Health North Clinic, Sterling said. The emergency room has two interior passageways into the urgent care center.
"The patient can be walked to the urgent care side if it's determined they do not have an emergency medical condition," Sterling said, adding that doing so continues the Lake's ongoing educational campaign about receiving the right care in the right setting.
Our Lady of the Lake is encouraging patients to only visit the emergency room when they need a high level of immediate care, such as in cases of serious head, neck or back injuries, unconsciousness, severe bleeding, difficulty breathing, seizures, severe abdominal pain, eye injuries and broken bones protruding through the skin. The urgent care, on the other hand, is better for treating fevers, sore throats, coughing fits, sprains, strains, minor broken bones, cuts that need stitches and rashes.
Both Earl K. Long and Baton Rouge General officials have said in the past that the number of patients going to their emergency rooms with non-emergency medical conditions was driving up costs. Four out of five of Baton Rouge General's Mid City emergency room patients would have been more appropriately treated in urgent or primary care, while 84 percent of Earl K. Long's patients in 2012 were also going to the ER when they did not have emergencies.
Freestanding emergency rooms aren’t capable of handling most life threatening emergencies and the problem of inequitable distribution of healt…
Urgent care visits average around 90 minutes, while emergency room visits are usually twice that long, Sterling said.
The north Baton Rouge ER also has a CT scanner, which Sterling said will be a necessary tool to determine what is happening inside of a patient and what level of care they need.
One lesson that Sterling said the Lake picked up from its stand-alone emergency room in Livingston is the need for a space for psychiatric patients. The north Baton Rouge emergency room has a psychiatric holding room where those patients cannot harm themselves or others. At the Livingston facility, Our Lady of the Lake had to make existing bays safe for psychiatric patients once they saw the need, Sterling said.
"It's very important ... that there is somewhere out of the way of what is the normal emergency room care until we can get them transferred to the appropriate facility," Sterling said.
The emergency room also has an isolation room in case someone needs to be stopped from spreading an infectious disease, along with an OB/GYN room. Alhough Our Lady of the Lake generally does not provide OB/GYN services, Sterling said the hospital delivers a few babies every year and that they wanted to have a room prepared in case a woman arrives in labor.