Phelps Memorial opened its new emergency department in 2008 as part of its $50 million expansion.

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In the 19 years CEO Keith Safian has been at Phelps Memorial Hospital Center in Sleepy Hollow, N.Y., the organization has grown from, 187 members of the medical community to 450, its staff has nearly doubled from 800 employees to 1,525 and it went from being the 50th largest employer in Westchester County to around the 10th largest. In addition, the community hospital sees over 22,000 patients a month – a significant increase compared to years past.    

“Our hallmark has been growth,” Safian says, “and we’ve made significant investments to accommodate that growth.”   

Phelps Memorial’s recent $50 million expansion includes a state-of-the-art emergency department that opened in December 2008.        

The addition triples the department’s space to more than 18,000 square feet, boosting the number of treatment areas from 14 curtained partitions to 30 private rooms. Dedicated specialty rooms and a 24-hour CT/radiology suite have been added as well as an enlarged centralized nursing station, all made possible by the community’s financial support.

‘A Huge Commitment’
One unique factor, Safian notes, is that the new emergency department contains no patient waiting room, despite the hospital’s volume. “When patients arrive, they are met by a staff person who does a quick verbal triage and then go immediately into an exam room,” he says.    

“We found that one of the biggest sources of frustration and fear for patients was having to wait in a waiting room, so we decided to eliminate that stress. That was a huge commitment from our board and a testament to its vision of doing anything we can for our patients.”    

Visitors’ chairs are positioned inside each exam room and a children’s play area was included for healthy siblings and pediatric patients. “The overall gestalt is the new ER is designed for patients and their families,” Safian continues.    

“We’ve really tried to be patient-focused with the design and have seen a 13 percent increase in ER visits, so clearly the word is out that this is the place to go for emergency care. Another unexpected surprise is we already hired another full-time ER physician. Two on duty was not enough, so we added a third.    

“That’s another confirmation of our commitment to make sure patient care is excellent and waiting times are lower. The hospital is doing the right thing for the patients, and the feedback has been very positive.”

High-Tech Hospital
Phelps Memorial increased its technology capabilities within the emergency department, as well. A pneumatic tube system was included to send specimens to the lab and obtain prescriptions from the hospital pharmacy quickly, cutting waiting time down by at least 20 minutes, Safian says.    

“We’ve also implemented Meditech physician order entry,” he adds. “Twelve computers on wheels are available for doctors and nurses to enter orders and view results. Another piece of technology we have is a digital, portable, wireless X-ray machine.   

“X-rays are sent to a digital archiving system and may immediately be viewed by a radiologist in the radiology department as well as by an ER physician sitting at his desk. “We’ve embraced technology at unprecedented levels,” Safian continues. “We were one of the first hospitals in the nation to use bedside medication verification where we scan a patient’s barcode on their wristband, which authorizes the nurse to give medication to the patient. It also records the fact that the patient was given a dose at that time.”   

Phelps Memorial also utilizes a computerized medical record system, which eliminates much of the need for paper. “When patients arrive at our hospital, we can electronically get information from a doctor’s visit three days ago or an emergency room visit from three years ago,” Safian says. “When the caregiver has access to historical information, it enables us to do a better job in caring for our patients.”    

The use of technology is evident among the hospital’s staff, many of whom wear futuristic pendants that function “like a Star Trek communicator,” he describes. “You can achieve voice-to-voice communication just by touching a button and mentioning somebody’s name.    

“It eliminates phone tag, which reduces patients’ time spent at the hospital and has spawned an enormous improvement in communication,” Safian notes. “Everything has gone to electronics in healthcare, but we use the technology to improve communication and patient flow. It enhances our caregivers’ role in caring for the patients.”

Enhanced Pediatric Care
Another area of expansion was the hospital’s pediatrics department. “Many of our hospitals in our community have cut back and even closed down their pediatrics and obstetrics services – two services that our board of directors believes every community hospital really needs to have,” Safian says. “To assure the quality and caliber of our pediatrics services, we made a huge investment in expanding it.    

“Through our local academic medical center, Westchester Medical Center, two pediatric subspecialty practices have been added to our campus,” he continues. “A pediatric hospitalist program is now available 24 hours a day. Fifty pediatricians are on our staff, half of which are specialists. If you think about one-stop shopping for patients, they might come here for a pediatric visit and require a specialist consultation and those specialists are now in the same building.”   

Similarly, Phelps Memorial has invested in its maternity services. “Most hospitals’ maternity programs lose money, but we felt it was part of our core mission, so we created a new special care nursery,” Safian says. “Our regular nursery was redecorated and we added deluxe patient rooms for mothers in our postpartum unit that are even more luxurious and comfortable for patients.    

“We even put in Murphy beds for fathers to stay with the mother and baby at the hospital. They no longer have to sleep on cots.”

Going the Extra Mile
As a key part of the master plan – designed by New York City-based architect Perkins Eastman – a five-story, 100,000-square-foot medical services building was constructed on campus. The building features a 20-foot-by-40-foot aqua-therapy pool.    

“We saw that as an opportunity for the aging population and sports enthusiasts,” Safian explains. “We also saw that the trend was going towards increased rehabilitation, physical therapy and occupational therapy needs, and our board had the wisdom to make an enormous investment in these programs.”   

The new building also houses the hospital’s emergency training center, a program that has provided paramedic and first-aid training to 35,000 first-responders, clinicians and community members since its inception in 1984. The master plan also involves expanding Phelps Memorial’s south wing and constructing a 150-space parking garage.    

“We built a parking garage that’s larger than we need,” Safian notes, “one that would meet our needs for 10 years so we don’t run out of parking spaces in three or five years.”

Continued Growth
As the hospital’s size and service reach increase, Phelps Memorial’s strategic plan identified a need to augment its medical staff. “Some physicians are facing retirement age, so we’re planning to recruit new doctors,” Safian says. “As our patient activity and sophistication have increased, we’re looking for subspecialists that we didn’t really need before.    

“We’re moving increasingly into the world of tertiary care. For example, we were the first community hospital in our region to have endoscopic ultrasound and the first to do an aortic stint – treatments previously done in academic centers that have been proven safe and effective. Now, we are recruiting more physicians who have been trained to perform these procedures.   

“Phelps Memorial Hospital Center offers more programs and services than any other community hospital in this region,” Safian declares. “So, our strategic direction is to have space available, expand programs and services, and recruit new doctors as we continue to grow and excel.”