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Busiest emergency rooms – not where you might expect

The new Good Samaritan medical tower in Puyallup includes an Emergency Department that nearly doubles the size of the old ER. It opens Thursday, Feb. 17.
Photo Courtsey of Good Samaritan
The new Good Samaritan medical tower in Puyallup includes an Emergency Department that nearly doubles the size of the old ER. It opens Thursday, Feb. 17.

http://stream.publicbroadcasting.net/production/mp3/kplu/local-kplu-952107.mp3

New emergency rooms keep opening around western Washington. It's part of a trend.

On Thursday (Feb. 17th), Swedish Medical Centers will open a free-standing Emergency Department in Mill Creek, between Seattle and Everett. And, on the same day, MultiCare opens a new medical tower at Good Samaritan Hospital in Puyallup -- which has the busiest ER in Pierce County. 

It turns out, the busiest ER’s in Washington are mostly outside the biggest cities.

The state’s only Level-1 trauma center, Harborview Hospital in Seattle, is just the 6th busiest emergency department in the state.

Number one on the list is in Vancouver, Wash. – Southwest Medical Center. It's followed by Yakima Valley Memorial Hospital.  

The top-10 (using 2009 data from the Washington Department of Health, based on number of visits*):

  1. Southwest Washington Medical Center in Vancouver (Level 2) - 84,350 visits
  2. Yakima Valley Memorial Hospital (Level 3) - 77,289
  3. Providence St. Peter Hospital in Olympia (Level 3) - 75,837
  4. Providence Holy Family Hospital in Spokane (Level 3) - 72,187
  5. Valley Medical Center in Renton (Level 3) - 70,179
  6. Harborview Medical Center in Seattle (Level 1) - 65,515
  7. Highline Community Hospital in Burien (Level 4) - 64,661
  8. Good Samaritan Hospital in Puyallup (Level 3) - 62,324
  9. Providence Regional Medical Center, Everett, Colby Campus (Level 3) - 59,856
  10. Harrison Medical Center, Bremerton campus (Level 3) - 49,328

At Good Samaritan, the number of visits has doubled in the past 25 years, going from 28,000 in 1985, to 62,324 last year. The old ER has been so crowded that patients are sometimes treated in the hallways.

"We have a whole area cordoned off by curtains. It's a big, open bay ward area with just curtains ," says Leah Gehri, director of the Emergency Department. "We see probably 40 patients a day greater than our predicted capacity." On a typical day, about 175 people seek treatment there.

The new Good Samaritan facility is part of a 9-story medical tower.

So, why are hospitals in mid-sized cities and suburbs so busy?

Cassie Sauer of the Washington State Hospital Association says it’s all about Geography.

"If you’ve only got one emergency room serving a pretty broad population area, especially in these areas that have grown tremendously, then you will see lot more going to those emergency rooms," she says.

There also happens to be a building-boom going on for hospital emergency departments, as KPLU reported last year. This is particularly true where competing hospitals are hoping to be the first to expand.  New emergency departments are opening in virtually every community.  Some -- such as Swedish's in Mill Creek -- are not even attached to the main hospital.

The hospitals have a financial incentive, since half the non-maternity patients who end up staying in the main hospital typically first come through the ER. 

(*Note: KPLU has adjusted data submitted to the DOH, because several hospitals report their number of visits by combining multiple branches. In Everett, Providence Regional Medical Center is preparing to merge two large Emergency Departments, and in June will move to #1 or #2 o this list.)

Keith Seinfeld is a former KNKX/KPLU reporter who covered health, science and the environment over his 17 years with the station. He also served as assistant news director. Prior to KLPU, he was a staff reporter at The Seattle Times and The News Tribune in Tacoma and a freelance writer-producer. His work has been honored by the American Association for the Advancement of Science (AAAS) and the Knight Science Journalism Fellowships at Massachusetts Institute of Technology.