Kalispell Regional's expanded ER, a yearslong effort, reflects a growing valley

For all the chaos that can fill an emergency room, Kalispell Regional Medical Center’s emergency department appeared crisp and airy on a recent Wednesday morning, with wide hallways, extra-large doors and a skylight ­— elements from its recently completed ER wing that opened Aug. 22. With the opening of its new ambulance bay in October, the hospital will wrap up the renovation and expansion of its ER, a yearslong project designed to handle the health crises of the Flathead for decades to come.

The new emergency center of spacious rooms and mobile equipment is a welcome update of the hospital’s previous emergency facilities, which were rooted in decades past. Prior to the $14 million renovation of the past couple of years, which expanded the department from 8,000 square feet to over 35,000, the emergency department’s footprint had not changed since the facility was built in 1976, according to Kalispell Regional Foundation President Tagen Vine.

The valley’s population, of course, has increased significantly since then. The old ER “was built for 8,000 patients and we’re seeing 24,000,” said Mae Stubbs, a registered nurse and Kalispell Regional’s director of emergency services. “We needed three times the space, easy.”

Kalispell Regional Healthcare has mirrored the valley’s growth; the revamped ER is just one of a spate of ambitious expansion projects Kalispell Regional has undertaken in recent years, such as its $42 million surgical-services tower, opened in 2013; its $12 million Digestive Health Institute, slated to open next month; and the $40 million Montana Children’s Center, designed to make the hospital a regional destination for pediatric care when it opens next year.

The new Emergency Services Department, however, was a long overdue investment in one of the hospital’s core services, offering a more comfortable, spacious and organized environment for patients and significantly easing stress for staff.

The old layout struggled to serve the patient load, let alone the storage and administrative space required to manage an emergency department. A 1991 renovation opened up more space for care by converting old offices and closets into patient rooms, but still, the design did little to help health-care providers.

Old patient rooms were “just super tight. It was hard to do anything in those rooms, hard to get through the door even,” Stubbs said.

Starting in 2010, nursing and emergency staff offered input on their ideal design improvements. There could be more psych rooms, proofed for self-harm and bigger than the current one that was “like a little closet,” according to Stubbs. They’d need a decontamination room for hazardous materials or quarantine situations, and bigger emergency rooms to fit cases such as trauma or transfusions, when upward of five or six professionals surround a patient’s bed.

The new ER reflects this feedback.

Now, “if a patient is coming in [the emergency room] on a stretcher and they’re coding or doing CPR, you’ve got medics all around the stretcher, so it’s super neat to be able to have all this space,” Stubbs said. There are two large resuscitation rooms that are double the size of rooms that used to hold two patients — an improvement for both patient care and privacy. There are several new patient exam rooms with codified supplies and room to maneuver, as well as four psych rooms and a decontamination area. A wing designed specifically to ease care for sexual-assault patients opened last summer, while a “Sunset Room” to provide privacy for grieving families separate from the bustle of the department opened in June.

There’s also desk space for doctors and other personnel who work in the ER, such as mental-health professionals, social workers, case managers and pharmacists.

“They all need space to be here to support us,” Stubbs said. “We’re kind of a high-maintenance department that way,” she said with a laugh.

Before, “it was sensory overload,” Nurse Manager Margaret Skinner pointed out.

But now, “We just feel like we’re breathing again. We can square-dance all around” the new space, Stubbs added.

“We wanted [the new rooms] to be as flexible as we could for now and also for 20 years from now,” she said, “because we’re probably not going to be able to do another renovation for a long time.”

The process has been a lengthy one — design input was first solicited over eight years ago, when plans began in earnest to construct the new surgical services tower. The new ER expanded into the old surgical services wing once it moved in 2013.

“You really have to look at the [surgical services] tower and the emergency department as one eight-year-long project,” Vine said. According to Vine, building out the new tower first, then phasing in the emergency department into the vacated space over time, as opposed to building a new ER first, saved the hospital over $10 million.

“This is just a quality of care, quality of staffing, quality of service expansion to meet the growing needs of the valley,” he said, noting that across the country, it’s difficult to borrow money for building an emergency-services department, which typically doesn’t bring in significant revenue. Thus, the project depended heavily on philanthropy. The hospital raised $14 million in donations from the community, including $5.5 million from its own doctors, employees, board members and volunteers. “You don’t see that in many communities,” Stubbs noted. “When I tell people that, they’re like, ‘What?’”

For staff, “it’s been such a long road,” said Skinner. “Now we can move on and work on those processes and figure out how we’re going to get the best use out of this space.”

“We’re still getting used to it. “We’re not as efficient as we’re going to be, but we’re working on it,” added Stubbs. “We love being ER nurses and we’re always trying to do the best that we can.”

Reporter Adrian Horton can be reached at 758-4439 or ahorton@dailyinterlake.com