Baltimore-Area Hospital to Expand

Aug. 4--Howard County General Hospital will add a 10-bed mental health unit to its emergency room that will ease admission of involuntary psychiatric patients and improve emergency operations, hospital officials confirmed this week.

The $775,000 project is scheduled to begin next week and be completed by January, said Beth Plavner, the hospital's construction consultant. It will be an addition of almost 2,200 square feet and will have three locked rooms and seven cubicles -- expanding the emergency room from 36 adult beds to 46.

The unit would be staffed with a nurse and a hospital security guard 24 hours a day, according to Debbie Fleischmann, administrative director of the Emergency Department.

Of the approximately 76,000 patients who came to the Howard County General emergency room between July 2005 and June 2006, about 3,000 were there because of psychiatric problems, according to Mary Patton, the hospital spokeswoman.

Currently, emergency psychiatric patients are treated in the same area as other emergency patients. Hospital officials said that providing a safer and more private environment are the objectives of the addition.

"We've increased our capacity to manage patients in a safe location because many of these patients may be at risk of hurting themselves," Fleischmann said. "[The new unit] is designed so there aren't any wires or cables or cords or things they could hurt themselves with."

The locked rooms will have only a bed, while the cubicles will have a recliner chair, Fleischmann said.

"When [psychiatric patients] feel very agitated they want to throw things -- they will not be able to throw these beds," said Fleischmann.

She added that having a designated area for psychiatric cases is good for everyone.

"The emergency department is a very public place," Fleischmann said. "This could be your neighbor or this could be somebody you work with who you may see at the emergency department at a time when they wouldn't want you to see them."

Pam Barclay, director of the center for hospital services of the Maryland Health Care Commission, said it has become common in recent years for hospitals to designate specialized care areas in emergency rooms. Other emergency specialty areas being created are pediatrics and fast-track urgent care, which focuses on patients who don't have severe injuries and can be treated quickly.

"Part of it is to reorganize services of emergency departments to serve areas with specific needs," Barclay said. "It's to improve the flow of patients ... and focus resources where they're needed."

The Howard County hospital began admitting involuntary psychiatric patients in October as part of a pilot program. Before that, the hospital transferred involuntary psychiatric patients to other institutions.

The old system contributed to emergency room bottlenecks, officials said, because patients would be held two or three days in the emergency room before being transferred.

St. Agnes Hospital in Baltimore does not have a psychiatric unit. The hospital's emergency room admits psychiatric patients, but after stabilizing them transfers them to other facilities, said John Welby, a hospital spokesman.

Laurel Regional Hospital, which has a psychiatric department, does not admit involuntary psychiatric patients, said Suzanne Almalel, a hospital spokeswoman. Involuntary psychiatric patients are transferred after being stabilized and evaluated, she said.

Meanwhile, the 33-year-old Howard County hospital, which has been undergoing renovations since the mid-1990s, is scheduled to add a four-story tower that will add 42 beds, bringing the total to 229. Construction on the project, which will include a 660-space parking garage, is scheduled to begin late this year or early 2007.

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