BAR HARBOR — For many people, summer tourism season is a busy time of swimming, hiking, bicycle riding, taking an ocean cruise and, unfortunately for some, a trip to the emergency department.
Just as area businesses and roads see an increase in activity during the peak tourism months, so too does the emergency department at Mount Desert Island Hospital, which often finds all six of its treatment rooms busy at the same time. When that happens, other spaces in the hospital are pressed into service.
“We go from just under 400 patients a month in January to a thousand-plus a month in July and August,” explains Christina Costello, RN, director of emergency services at MDI.
And, those patients can show up at any time of the night or day.
The services needed vary widely, from elderly patients seeking relief from chronic and age-related problems to people who have suffered accidental injuries from falls, bicycle accidents or car crashes who are in need of advanced orthopedic care.
In Acadia National Park, famous for its hiking trails and rugged, rocky coast, reports note that falls, both on trails and sidewalks, are the most common type of injury incurred by some of the more than 2.5 million people who visit each year.
“We get a lot of ankles,” Costello says.
Maine is a state that in some studies has the largest percentage of residents over age 65 in the country, Costello notes. The needs of the area’s older residents, including occasional emergency department visits, remain fairly constant throughout the year. But, according to Costello, many older visitors or seasonal residents to the area may have chronic health conditions and require emergency department care when experiencing a downturn while visiting here.
Cruise ship passengers also often seek care in the emergency room. Those patients range from people who are sick with a virus to those experiencing possible cardiac problems. “Some people on these cruise ships are heavily managed patients who have a crisis,” Costello notes.
And then there are the days, or nights, when a bad traffic accident happens and the emergency department must gear up to handle multiple trauma cases at the same time.
Planning for appropriate levels of staff coverage when volumes of patients vary so widely is not easy. And, along with caring for everyone who comes through the door, the staff constantly strives to be more efficient about providing care.
Over the past decade or so, emergency departments have adopted many new technologies for everything from imaging to IVs.
“It’s dynamic; it seems like it is changing every day,” Costello says.
The hospital tracks the emergency department’s handling of each patient. Wait times are also analyzed.
“We’ve been much faster this year,” Costello notes.
Being more efficient allows staff to spend more time with each patient.
“The bigger hospitals may not be able to do that,” she says.
In fact, many patients from out of state have given the MDI Hospital high marks in satisfaction surveys. It has been a 5-Star emergency department multiple times over the past eight years. People, especially from urban areas, “are relieved at the level of care they get in this small town,” Costello explains. “I think it is the culture of the entire hospital that makes it special.”
“That, and every once in a while there’s lobster rolls in the cafeteria,” she joked.
Advances in techniques, require the staff to remain up to date on the latest protocols. Using a protocol-based system, instead of the traditional method of prioritizing non-life-threatening cases on a triage basis, has helped get relief to patients faster and shave time off how long they spend in the emergency department.
Costello credited the recent arrival of Dr. Nate Donaldson, DO, the hospital’s new director of the emergency department, with keeping things fresh.
The hospital continues to be involved in a collaboration with Penn Medicine, sharing and exchanging personnel, with each organization learning from the other.
Costello said the key to providing top notch care in any emergency department is good people. MDI’s staff is first rate: compassionate, efficient, and up on the latest advancements, she notes. Together, with the medics, ambulance personnel and other health care professionals who work closely with the department, it’s a winning combination, she continues.
“The ED staff is fabulous to work with,” she says. “We’ve got a great team.”