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HOSPITAL TO OPEN KIDS-ONLY E.R.

Rubenstein, howardDr. Howard Rubinstein at the nursing station of the new ground-floor facility, which opens its doors March 17.

Howard Rubinstein remembers a childhood trip to a hospital emergency room in Rahway in the 1960s. He’d broken his arm and sat in pain while waiting for long delayed attention. But layered on top of the physical trauma was confusion at what was going on around him in that urban crucible of illness and injury.

“It really scared me,” he says.

A Tinton Falls resident and physician, Rubinstein now heads up emergency care at Red Bank’s Riverview Medical Center, where next week he’ll help unveil the latest in care for kids: a dedicated emergency room, complete with Gameboy setups near every gurney.

The new pediatric care center is, to be sure, the product of many forces, including a precipitous drop in childhood hospital admissions in recent decades and the need for hospitals to compete as never before. But it’s also about a desire to make emergency care as pleasant an experience as possible for kids, Rubinstein says.

“We don’t want them in the ER with a code going on in one room and a drunk screaming in the next room,” he says.

The 1,800-square-foot ground-floor facility, accessible from the interior of the hospital only, features two emergency care treatment beds and three 24-hour beds.

Begining Tuesday, children arriving at the hospital will first be seen by a triage nurse as they now are, and those with garden variety bumps, fevers and tummyaches will be taken directly to the new unit, which is staffed entirely by pediatric specialists, says Rubinstein.

Those with serious conditions will be treated in the main ER, and those requiring more than 24-hour stays can be transported to the K. Hovnanian Children’s Hospital at Jersey Shore Medical Center in Neptune — a Riverview
sibling hospital under the Meridian Health ownership umbrella.

Getting children out of the general ER population makes logistical sense, hospital officials say. Since Rubinstein arrived at Riverview seven years ago, the overall number of
patients seen on an emergency basis has soared from 31,500 to more than
40,000 last year. About 17 percent of last year’s patients were minors.

The kinds of childhood illnesses and injuries that a generation ago would result
in hospital stays of a couple of days are now quickly treatable, with the effect that 99 percent of kids get sent home within hours of first being seen. But precisely because their complaints are routine, kids are often the patients who have to wait longest in ERs while more critical cases are tended to, Rubinstein says.

Riverview set up a ‘fast track’ ER-within-the-ER for non-critical cases some years ago, but that area, too, has been strained as more people use the hospital as their sole or primary source of care, officials say.

Carving out the new pediatric ER next door to the larger one meant eliminating about five offices and a conference room, and cost $750,000 to build and equip, says Tony Cava, Riverview’s director of strategic planning. That includes the Gameboys.

“We have the luxury of space to be able to do this here,” he says.

In conjunction with its partnership with Jersey Shore, Riverview has also decommissioned its fifth-floor
pediatric ward, a five-bed facility that treated only 83 patients in
all of 2008. Thirty years ago, the ward had 35 beds to accommodate weeklong stays for tonsillectomies and other procedures that are now done on an outpatient basis.

Both moves are part of the continuing evolution at a facility that hospital officials acknowledge provided a sub-par experience for visitors just a decade ago when, Meridian took over.

Then, the emergency room was in a basement — Rubinstein likened it to a “dungeon” — and patient satisfaction scores were in the 20 percent and lower range. Last year, the ER was one of just seven in the nation to capture a J.D. Power excellence award.

More broadly, says Riverview president and Red Banker Tim Hogan, the hospital has become more market savvy, developing niches such as high acuity surgery, cancer treatment and cardiac care, while fulfilling its role as a community hospital.

In recent years, the nonprofit has managed to eke out a one- or two-percent surplus while other New Jersey hospitals have failed or gone baknkrupt, Hogan says.

“That’s being successful, in this environment,” he says.

On Sunday, March 28th the hospital is hosting ‘Riverview Kids Rock‘ in support of the new center. Running from 11a to 2p, the event is designed as a fun, informative childrens’ health fair, complete with CPR basics and a laparoscopic surgery demonstration using Gummy Bears, wii tournaments and a Guitar Hero challenge. To register, call 1-800-DOCTORS.

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