First phase of new emergency room at NCH Baker Hospital Downtown nearing completion

Liz Freeman
Naples Daily News

NCH Healthcare System remains on track with a $35 million renovation and expansion of its emergency room at Baker Hospital Downtown.

The first of a four-phase project to double the footprint of the emergency room is slated for completion in late December. It entails building a two-story, 19,000-square-foot addition that is the centerpiece of the expansion.

What comes next in January is phased remodeling of the existing emergency department because it must remain open for patient care. The project has been on the drawing board for several years to address ongoing growth in the community.

Workers make progress during remodeling work at NCH Baker Hospital Downtown, Monday, Oct. 19. 2020, in Naples.

The Downtown hospital is located at 350 Seventh St. N. The emergency room is on Fourth Avenue North.

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Ultimately, the new emergency room will have 47,000 square feet of space that is designed for optimal patient flow with separate care areas depending on the level of acuity, said Dr. Todd Bethel, systems medical director of NCH’s emergency rooms.

For this upcoming winter season when the hospital is busiest, the current emergency room will be operational along with 10 rooms from the expansion, Bethel said.

The entire project is targeted for completion in February 2022.

NCH is the largest hospital provider in Collier County with a combined 716 beds at its two campuses and 730 physicians on staff. NCH has about 4,300 employees.

The nonprofit hospital system has been at the forefront of the COVID-19 pandemic in the community since it began in March by offering drive-up testing in the parking lot of the Downtown Baker hospital.

To date, NCH has tested more than 33,500 people for the virus, which includes at its in-house laboratory. In its emergency rooms, separate triage areas are established for people who potentially have COVID-19.

NCH projects a decrease in net income of $23 million due to the COVID-19 pandemic, according to spokesman Shawn McConnell.

Work at NCH Baker Hospital Downtown's new emergency room continues, Monday, Oct. 19. 2020, in Naples.

That's due to expenses related to COVID-19 and revenue losses, which includes elective surgeries being cancelled for months statewide at hospitals at the direction of Gov. Ron DeSantis for patient and employee safety.

NCH ended the most recent fiscal year Sept. 30 with projected revenue at $526 million and is forecasting revenue in 2021 at $568 million, according to McConnell.

Other capital projects in the works at NCH include renovation of the NCH Wellness Center at Greentree Plaza in North Naples that will reopen next spring and renovation and upgrades to operating rooms on the second floor of the Baker hospital.

One project on hold because of the pandemic is an upgrade to one nursing floor at the North Naples hospital.

September was a good month with surgeries starting to tick up, said Phil Dutcher, chief operations officer.

In contrast, the publicly-operated Lee Health in Lee County has put all capital improvement projects on hold except for an ongoing project at Gulf Coast Medical Center in Fort Myers because of COVD-19.

Lee Health is projecting a $20 million shortfall due to COVID-19 and is freezing salaries of its 13,500 employees.

Dr. Todd Bethel, center, a systems medical director at  NCH Healthcare System goes over the blueprints of the new emergency room during a tour on Monday, Oct. 19. 2020, at NCH Downtown Baker Hospital.

The new emergency room at the NCH Downtown hospital with added capacity will be able to serve the hospital for the next 15 to 20 years, Dutcher said.

The project has been going smoothly and is on time and on budget, Dutcher said.

The Downtown campus emergency room sees roughly 40,000 patient visits a year and is the busiest of the two hospital-based emergency rooms; the other is at NCH North Naples Hospital off Immokalee Road.

Work inside an observation room continues at the new emergency room at NCH Downtown Baker Hospital on Monday, Oct. 19. 2020.

The nonprofit system also operates freestanding emergency departments in North Naples and Bonita Springs.

Paul Hiltz, president and CEO of NCH, said in a statement that maintaining a “world class” emergency room in the heart of the community and with population growth is essential.

“I’m proud to say that NCH has always been a leader in providing quality care, and this new state-of-the-art renovation to the (emergency room) is another example of our commitment to innovation, technology and providing exceptional facilities for our community,” Hiltz said.

To date, $24.3 million of the project cost has been raised through donations, according to NCH’s Center for Philanthropy.

The design was a collaboration of physicians and nurses with the architect, Bethel said. Some design elements from NCH’s other emergency rooms are being included.

“This ER will be our best yet,” Bethel said.

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The current emergency room has 33 beds and the new one will increase to 43 beds; instead of one triage area to assess patients that exists now there will be two.

The existing ER has 18 observation bays and that will increase to 24 bays in the second floor of the addition.

 “(Those are for patients) who are too sick to be discharged home so we keep them overnight, like for chest pain,” Bethel said.

There’s also a patient fast track area that can accommodate three patients at a time for minor issues like ankle sprains. There will be a separate area for patients waiting for test results.

“There will be a nurse’s station for about every four rooms, so there will be eight to 10 nurses stations,” Bethel said.

Because patient volumes fluctuate between lows in the summer months and highs in winter, the design allows for closing down space that is not needed in the summer.

For instance, on a typical day in January, the ER may see 140 patients and that goes down to 75 on a day in July, Bethel said.

The design also is flexible to make changes for future needs, said Chris Raphael, administrative director of critical care and emergency services.

The two-story addition facing Fourth Avenue North features a curved contemporary front with lots of glass for natural lighting. That’s where the new patient entrance will be and waiting room, Bethel said.

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A security office will be inside the entrance so hospital security can see everyone coming and going.