Freestanding emergency departments are growing in popularity as hospitals and health systems continue to seek new ways to improve patient access and care while managing costs. The new Bon Secours Short Pump Emergency Center in Short Pump near Richmond, Virginia, became Virginia’s first “true” freestanding emergency department when it opened its doors in September 2018 after nearly four years in the making.

As with all things new and different, bringing it to life required solving unique challenges with exactly the type of out-of-the-box thinking for which Petra is known. Petra’s creative solutions made opening Virginia’s first freestanding emergency department a success.

“This freestanding emergency department project is a perfect example of how Petra thinks outside the box to find ways to achieve goals and save money without sacrificing client priorities,” says Jerry McPhail, Regional Director at Petra, which was a key player in Bon Secours Short Pump Emergency Center’s planning and development. Petra’s role included design and construction management, serving as the owner’s rep for client Bon Secours, and facilitating and coordinating interaction with both local and state authorities.

McPhail describes the Bon Secours freestanding emergency department project as “a unique project containing many non-unique elements that, when put together, resulted in a unique facility with unique challenges.” Petra not only had to apply its deep expertise in the complexities of facility design and construction management, it also had to navigate Virginia’s comparatively more stringent requirements as a certificate of need state. In addition, Petra needed to guide and educate local and state licensing and regulatory agencies throughout the process to help them understand the concept of a freestanding emergency department, because it is so new.

What Makes the Bon Secours Freestanding Emergency Department Unique?

First, a freestanding emergency department is not a “micro-hospital”—another growing healthcare building trend. Both have a smaller footprint and require less capital to develop than a hospital, and both are strategically located to provide care away from an existing main hospital. But there is a key difference: Freestanding emergency departments are strictly outpatient facilities.

All patients in a freestanding emergency department must be discharged within 24 hours, per state and federal guidelines. In some cases, patients requiring additional care are transferred to the affiliated larger hospital within that 24-hour window. Micro-hospitals, on the other hand, are designed and built to hold patients more than 24 hours—so different construction and regulatory standards apply.

What makes the Bon Secours Short Pump Emergency Center unique is that it was designed and built as a “true” outpatient facility. According to McPhail, other freestanding emergency department projects constructed in Virginia to date have been built according to inpatient hospital codes and standards, creating the opportunity for future conversion into an inpatient micro-hospital.

The Bon Secours facility is strictly outpatient and includes a 24/7/365 emergency department with all the services required for expert emergency care, like imaging and diagnostics. An ambulance is also on-site at all times—unlike at urgent care facilities, most of which are also not equipped to handle all emergencies like heart attacks, strokes, and head injuries. Not typical of a freestanding emergency department, Bon Secours has included outpatient primary care services as well as health education space to expand its patient care in that location. Additionally, there is land for potential development by Bon Secours that will allow for future expansion as the population continues to grow.

“The Bon Secours freestanding emergency department is a great example of a current trend in healthcare to build in a rapidly growing area surrounded by retail and residential development, so that people who live and work in the area have easy access to emergency care right in their neighborhood,” says McPhail.

The project’s newness not only added a layer of complexity and extra work to the planning process, which Petra managed throughout, it also created budget challenges.

“At the end of the day we were able to facilitate discussions with local and state authorities to get everyone on the same page, to complete the project and to stay on budget,” says McPhail. “This is what we excel at—helping project teams come up with creative solutions to save money without sacrificing priorities.”

McPhail says he sees freestanding emergency departments and micro-hospitals as a healthy trend for the U.S., and one that will continue as younger generations like Millennials and Generation Z change the way healthcare is going to be delivered in the future.

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