Piedmont Mountainside Hospital's Freestanding Emergency Department
- Need: The North Georgia Medical Center (NGMC) of Ellijay, Georgia had been losing money and patients. Many residents living in Ellijay were seeking hospital care elsewhere, leaving NGMC treating an average of only 6 patients in the year prior to closing their doors in 2016.
- Intervention: With approval from the state, Piedmont Mountainside Hospital (PMH) leased the space from NGMC and opened the state's first freestanding emergency department. Medical services were again made available for patients in Ellijay and surrounding areas.
- Results: Within the first 6 months of operation, over 5,000 emergency visits were made to the freestanding ED, an average of 30 patients per day.
Over the past decade, the North Georgia Medical Center (NGMC) of Ellijay, Georgia, had been losing money and patients. Many residents were seeking hospital care elsewhere, leaving NGMC with an average of only 6 inpatients in the year prior to the closing their hospital and emergency department doors in 2016.
Piedmont Mountainside Hospital (PMH), an expanding Atlanta-based nonprofit healthcare system, approached the SunLink Healthcare, owner of the Ellijay hospital, with an offer to lease the NGMC space as a freestanding emergency department (ED). SunLink agreed to the arrangement and the Georgia Department of Community Health approved the opening of a freestanding ED.
After going through a structural update, the Piedmont Mountainside Hospital Emergency Services opened in April 2017 as a freestanding ED, one of the first in the state of Georgia. Emergency department services were available again for patients in Ellijay and surrounding areas. In addition to the 5-year lease of ED space, Piedmont Healthcare leased the use of the NGMC's medical office building and the attached community center. The freestanding ED is now fully funded by Piedmont Healthcare.
The Piedmont Mountainside Hospital Emergency Services operates in a similar way to a hospital's emergency room, addressing medical needs ranging from emergency situations (heart attack, stroke) to minor trauma with 24-hour access to:
- Emergency physicians
- Radiology technicians
Services and equipment reflect that of a hospital ER:
- Moderate-complexity blood testing
- Advanced imaging
- CT scanner
- X-ray and ultrasound machine
Since the time they started, Piedmont Mountainside Hospital has hired 35 employees to man the freestanding ED. An average of 30 patients a day were treated and within the first 6 months of operation, over 5,000 emergency visits were made to the freestanding ED.
PMH works collaboratively with Gilmer County's EMS/ambulance service to ensure patients requiring a higher level of care are transported to the most appropriate facility to meet their needs.
The Piedmont Mountainside Hospital Emergency Services is mentioned in the following publications:
- Case Study: Ensuring Access by Converting a Hospital to a Freestanding ED, Hospitals & Health Networks, November 2017
- ER to Replace Full-Service Ellijay Hospital, Georgia Health News, June 2016
- Piedmont Plans to Expand Presence in Mountains as Ellijay Hospital Downsizes, Georgia Health News, January 2016
The following were the main difficulties the Piedmont Mountainside Hospital faced when setting up Ellijay's freestanding ED:
- Initial distrust in the community – Despite their existing medical presence in Ellijay (cardiac imaging center, outpatient diagnostic center, MRI services, and a sleep center), the motivation behind PMH's move to start a freestanding ED was questioned by members of the community and caused uncertainty in staff who sought jobs elsewhere after the closure.
- Bureaucratic and legal obstacles – Because of freestanding ED regulations, PMH needed to go through evaluations and approval processes from state agencies (for instance, the State Fire Marshall) and federal agencies (for instance, the Centers for Medicare & Medicaid Services).
- Appeals from competitors – WellStar, the largest health system in Georgia, representatives from Ellijay, several Gilmer County commissioners, and the Greater Joint Development Authority appealed the freestanding ED request granted by the state. Georgia House Speaker David Ralston, an Ellijay native, helped build trust in the community and bridge the communication gap between the county and the new operators.
Open communication with the local community and important representatives is key to its success.
Closures of healthcare facilities and services
Emergency department and urgent care services
Service delivery models
December 5, 2017
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