ST. ALBANS — With one construction project nearing completion, leaders at Northwestern Medical Center (NMC) are hoping to begin another before the year is out.
The new $31 million project will include the construction of a two-story medical office building and changes to the hospital itself to allow for 34 private rooms and new space for medical exams.
The current project, which will be complete in August, reconfigures parking and a roadway on the campus to improve traffic flow and safety.
“It’s a once-in-a-generation kind of investment that realigns the hospital with the direction health care is going,” said Jonathan Billings, NMC’s vice president of planning and community relations.
That direction includes more room for onsite primary care and space for specialists to see patients.
Currently, a number of rooms at NMC are semi-private, including for intensive care patients. The planned renovation will mean all patients in the hospital overnight have a private room.
“Medicine has evolved and health care has advanced,” said Billings. “Best practice is to have private rooms.”
Somewhat counter intuitively, having 34 private rooms rather than 20 semi-private rooms will allow NMC to serve more patients. The nature of their illness may mean that some patients can’t have a roommate, while at other times the hospital may have a female patient who needs to be admitted, but men occupy all of the semi-private rooms, explained Billings. Those issues aren’t a consideration when all rooms are private.
Private rooms help with infection control, allow patients to rest more easily and make patient education easier because there are fewer distractions, said Billings.
Asked if the change was motivated by a need to compete with other hospitals for patients, Billings said, “Patients clearly have choice, and I think ultimately we will get to a spot in the country in which people will expect private rooms. This is more driven by improving the quality of care for our patients.”
He expects other Vermont hospitals will do the same as their buildings age and the time comes to make renovations.
The entrance to the hospital will also be renovated with a new centralized location for registration for routine services. The change will be both more convenient for patients and more efficient, suggested Billings.
Cardiology and pulmonology practices are currently operating out of what used to be the medical records department and have outgrown the space. They will move to new offices at the front of the hospital. Northwestern Obstetrics and Gynecology will also move from the Doctors Office Common to new space in the hospital.
In addition, there will be exam rooms and clinical care space available for use by a wide variety of specialists. Some specialists can’t maintain a full-time practice in Franklin County because there isn’t enough need for their services, explained Billings. NMC hopes to use the new exam space to bring doctors in some of those specialties, such as neurology, endocrinology and rheumatology, to the hospital to see patients one or two days per week.
With the option of seeing patients at NMC, “we think it will be easier to re-establish these specialty services here in the community,” Billings said.
The new building
A two-story medical building with a walkway connecting it to the hospital is planned for the east side of the hospital. There will be 21,000 square feet of space per floor and only the first floor will be occupied initially.
Northwestern Primary Care and Northwestern Urgent Care will relocate there, allowing them to expand. “If primary care and urgent care are front and center for patients, you don’t default to the emergency department for things that are not emergent,” said Billings.
Northwestern Orthopedics will also move to the new building. “This will give them flexible, efficient space,” said Billings. The new building will have x-ray facilities, as well.
The changes will open up space in the Cobblestone building. “We envision that Cobblestone will evolve into more of a wellness pavilion,” said Billings, with wellness and prevention services as well as physical therapy and rehabilitation services.
The $31 million final cost is still an estimate as equipment and office needs are still being determined.
The hospital board has created cash reserves for building upgrades, said Billings when asked about the possible impact of the project on the billing rate.
“Our board has worked really hard to put the hospital in a financial position to minimize the impact on the community,” he said. “The board has seen this coming and set monies aside.”
In addition, the hospital will be doing a capital campaign to raise money for the project, with borrowing to complete the financing.
Before the project can continue, the hospital must secure the approval of the Green Mountain Care Board (GMCB). One of the things the board will look at is the financing. “Have you planned the financing wisely so it makes sense for the local community and Vermont? We think we have,” said Billings.
GMCB will also consider whether the proposed improvements are needed. They will consider the changes to the hospital building itself and the new medical office building separately.
NMC must also go through the permit processes in both St. Albans City and Town, as well as securing needed state permits.
Asked about stormwater, Billings said the project will not add a lot of impervious surface, and that most runoff will be directed into NMC’s existing retention pond. In one low-lying area, drainage will tie into the city’s stormwater system.