Community Project Funding/Congressionally Directed Spending - Construction - Millinocket Regional Hospital, 200 Somerset Street, Millinocket, Maine 04462 Project Director: Robert Peterson, D.Sc., FACHE, 207-723-3319 bpeterson@mrhme.org Millinocket Regional Hospital (MRH), located in Millinocket, Maine, will be renovating and expanding its Emergency Department (ED) to meet the projected needs of its large and very rural service area. Plans are in place to renovate the current ED space (4,386 sq. ft.) and add an additional 10,728 sq. ft. resulting in a modernized department of 15,114s q. ft. Throughout the COVID pandemic, the current ED was stressed beyond its working capacity on a daily basis. All treatment bays were typically filled with patients, and additional patients were being treated in the hallways. As a critical access hospital, MRH relies on transfers to tertiary centers for critically sick and injured patients after stabilization in the Emergency Department. The ability to transfer patients was significantly lessened during the pandemic. This resulted in ED treatment bays occupied by ICU level patients awaiting transfer. Treatment for other waiting ED patients was frequently delayed due to the lack of available treatment space. Unfortunately, this issue has not resolved post-COVID. Timely transfers remain problematic due to labor shortages and bed reductions. Similarly, hospital Emergency Departments are the first line of defense for psychiatric patients in crisis and substance use disorder patients. Many of these patients require in-patient treatment at specialized mental health facilities and rehabilitation facilities. Mental health and rehabilitation facilities in Maine are always at full capacity. Beds do not become available until another patient is discharged. As a result, the ED boards these patients until a bed becomes available. The waiting period for placement ranges from a few days (at best) to several months. This forces the ED to see emergency patients in the hallway or other temporary areas. This reality negatively affects care, privacy, and dignity. This issue pre-dates the pandemic and continues to the present. Millinocket Regional Hospital and its Emergency Department serve a vast geographic region in northern Maine. Our primary service area encompasses three towns (populations 4000, 2500, and 1500) and large tracts of unorganized territories. We provide care for native Americans living in the region as well as several Amish communities. Our residents have no other source of emergent critical care. The nearest tertiary center is 75 miles from the hospital and well over 100 miles from the edges of our service area. Without a fully functional ED, rural patients suffering from critical illness or injury would be forced to travel excessive distances for care. In the case of cardiac events, stroke, urgent surgical need, or trauma, any delay in care can be catastrophic. This eventuality must be avoided in America. Rural residents must have access to critical care services similar to those living in more urban areas. The ED renovation and expansion project will triple our working capacity, provide specialized treatment rooms for cardiac and trauma care, provide specialized rooms for psychiatric care and substance use disorder patients, and provide a designated overflow area to handle sudden unexpected influxes of patients. The unit will be set up to safely care for ICU level patients awaiting transfer. It is projected that completion of this project will serve our communities for the next 30 years and ensure the health and wellbeing of the patients we serve.
