Ambulances traditionally pull up to the front of the University of Mississippi Medical Center Holmes County - but now, they're circling to temporary headquarters on the back side.
That's because the gutted Emergency Department is being rebuilt from the ground up on the hospital's south side. That construction competes with the sound of hammering and sawing as former first-floor offices are converted into patient rehabilitative services, including occupational therapy, speech-language programs, and the county's only physical therapy services.
It's all part of a $4 million renovation of the 25-bed facility in Lexington, originally built in 1950 as Holmes County Community Hospital, that's providing care to a growing number of residents from the Holmes County region north to Grenada.
And, the transformation couldn't come soon enough, said chief executive officer David Putt.
Since April 2014, "admissions are up by 32 percent, and traffic in our Emergency Department is up 15 percent," said Putt, who also serves as CEO of UMMC Grenada. Radiology services are up 11 percent and clinic visits 10 percent over last year, he said. The hospital this year anticipates about 500 admissions and 9,000 patient encounters of all kinds.
Coffee (left) confers with Jacque Ward, accounts payable clerk, at the newly designed reception desk
Patient services coordinator Marie Coffee has worked at UMMC Holmes County for the past 15 years, driving about 20 miles each way from her home in Attala County. She's watched the construction as it transforms the hospital. The noise, she said, is a small price to pay for a better facility.
"I can see a great, great future here," Coffee said. "Our numbers have picked up. A lot of our patients really like it here, and I've gotten to know them just like family."
No hospital operations are services have been interrupted by the construction, which is expected to wrap up in March 2016.
Renovations also include:
- ED upgrades that make that space more functional, giving it five treatment rooms plus a two-bed trauma room
- A new room to house a CT scan
- Relocation of the patient registration and information desk in close proximity to the hospital business office
- New flooring in older clinic space
- Conversion of temporary ED space into respiratory therapy services and additional clinic space
- Design improvements to outpatient and specialty clinics that provide better traffic flow
Trauma rooms in the Emergency Department of UMMC Holmes County are equipped with the latest technology needed to assess patients who are acutely ill before possible transport to UMMC Grenada or UMMC's Jackson campus.
Former state Rep. Mary Ann Stevens of West, whose district includes Holmes County, has been eagerly keeping up with the construction. Stevens serves on the hospital's community advisory board.
"UMMC Holmes County is a great asset to Holmes County, and it will make it that much better to update it," she said. "They have a great physical therapy department, and it will be in a completely new area of the hospital when the construction is finished."
The Lexington hospital came into UMMC's hands in 2000, and about a decade ago became one of Mississippi's critical access hospitals providing care for patients with acute illnesses or conditions that require observation or hospital admission. The last 15 years have seen it transform from a small rural facility to a 100-employee trailblazer in the use of telehealth to diagnose and treat patients.
The critical access designation means UMMC Holmes County must have no more than 25 beds, must have a full Emergency Department, and must admit patients for no more than 96 hours. The construction project directly addresses that designation through ED improvements and strengthening of other patient services, Putt said. A total 16,425 square feet are affected - about a third of the campus, he said.
Maximum functionality for a facility that gives initial care to many trauma patients is critical to the hospital's ED, said Jason Rogers, a nurse practitioner at UMMC Holmes County since 2011 and a UMMC employee since 2002. He sees an average 25-30 patients daily in the ED and consults via TelEmergency with physicians in UMMC's ED in Jackson. Of patients he tends to, about four or five are admitted each day.
"For a small ER, Holmes County has some of the highest acuity," Rogers said. "We're 45 minutes from the closest hospital, and we get a lot of trauma here. It's good that Holmes County has a hospital, or there would be a lot of mortality."
Expansion of services made possible by the construction program further enhances the relationship between UMMC Holmes County and UMMC Grenada, which has 340 employees and is licensed for 156 beds. The two campuses share top leadership, including the CEO, nursing executives, and directors of human resources, ambulatory operations, and purchasing.
That relationship includes a number of patient treatment collaborations. For example, patients in the Grenada area and surrounding counties who need wound management or rehabilitation services can receive that at the Lexington hospital. A physician from the Grenada hospital visits the Lexington campus several times a month to provide colonoscopies and a number of gastrointestinal services, but performs more intricate procedures on those patients at the Grenada campus.
Pummer (center) gives patient John Townsend of Minter City a status report on his healing wounds with assistance from licensed practical nurse Cynthia Boyd.
Dr. Terry Pummer, a physician in the Center for Wound Care and Hyperbaric Medicine at UMMC Grenada, travels to UMMC Holmes County every Wednesday to provide wound care. His climbing patient load is just one more reason why the Lexington hospital must make the most efficient use of space and design.
"We may end up expanding because we're at capacity," he said of treating patients whose wounds won't heal, a service that qualifies for inpatient care at the Lexington hospital beyond the maximum 96-hour stay. "The need is unbelievable down here."
Patients at the Holmes County hospital and clinics often go to the Grenada hospital for surgery rather than expending time and money getting the same procedures done on the UMMC campus in Jackson. "There's a continuum of care," said Dewery Montgomery, director of ambulatory operations for the UMMC's Holmes County and Grenada campuses.
Also, a number of staff members from both hospitals are cross trained so that they can work on either campus. "Our patients go both ways, just as our staff does," said chief nursing officer Carla Stanley. "And by not duplicating services, we keep costs down. It behooves us to think outside the box and cross-utilize our campuses. It's about quality and cost. It makes dollars and sense."
UMMC Holmes County gives care to many of the region's poorest residents who have few resources, Putt said. "Patients who come here get great care, but often, there's no place for their families to stay or 24-hour availability of food," he said. "That's why the hospital plans to incorporate two hotel-style rooms for use by patient families so that families can be with them and feel more comfortable."
Stevens, who broke her arm in March, said a physical therapist from UMMC Holmes County is visiting her in her home as she recuperates from her injury. "They have been a tremendous help to me in getting the use of my arm back," she said.
The hospital, she said, "has saved many lives. A lot of people wouldn't make it to Jackson. I don't know what people would do without it."