The exploding population growth along Highway 280 in Shelby County has caused several local hospitals to consider expansion plans in the area. In June, Brookwood Medical Center filed a Certificate of Need application to build a $19 million free-standing emergency department at U.S. 280 and Alabama 119. “That area has been a strong corridor for Brookwood in terms of where our patients come from,” said Vince McVittie, Brookwood’s chief development officer. “We believe there is going to be an increasing need for medical services in that corridor. So we are, in essence, following the population. We are going to bring the medical services to them.” In the meantime, St. Vincent’s Health System has filed a letter of intent with state regulators, outlining St. Vincent’s desire to build a free-standing emergency department on its 35-acre One Nineteen Health and Wellness Center campus, which is next door to the proposed Brookwood site. The Certificate of Need Review Board is unlikely to approve both projects. St. Vincent’s executives argue that their project should have priority because they already have some infrastructure in place at the One Nineteen Center. “We made a substantial investment in the community with the opening of One Nineteen in January 2005,” said Jeri Evans, Executive Director of One Nineteen. “Physician offices, diagnostic services, physical therapy, wellness services, a fitness center and spa are a part of the integrated One Nineteen services. We have since added a GI Lab and sought approval for an ambulatory surgery center.” In addition, a senior living center, Somerby at St. Vincent’s, will be built on the campus. Brookwood officials believe that Brookwood is best positioned to build an emergency department in the area because Brookwood is the closest hospital to the proposed site, is the largest provider of inpatient care to 280-area residents, and participates in the Birmingham Regional Emergency Medical Services System for coordinating trauma care. Regardless of which health system ultimately receives approval, the free-standing emergency department will be a first for Alabama. The Brookwood-planned facility will be a 24-hour ED. It will be a true emergency department — “an extension of the hospital’s emergency department,” McVittie said. “It will be staffed by emergency department physicians and emergency department nurses and other personnel, and it will provide virtually all the services of a hospital-based ED.” According to McVittie, the facility will handle “most any emergency. We are not a Level 1 trauma center at the hospital or otherwise. There are certain trauma cases or burn cases, things of that nature, that would not be handled at the free-standing emergency department, but that’s no different than any ED.” But why simply an emergency department? Why not a full-service hospital? “An emergency department is the most vital service for the burgeoning population, and it’s something that you can bring to the residents a little more quickly than a full-scale hospital,” McVittie said. Currently, the state health planning department does not provide for additional beds in Shelby County. “Frankly, a need for a full-scale hospital is something that might come up in the next couple of years, as the population continues to grow,” McVittie said. “But we certainly know that the population in that corridor can support emergency and other outpatient services right now.” An emergency department in the 280-area would benefit local physicians as well as patients in the area. “On occasion, there is a patient who presents to a physician’s office who actually needs to be triaged to an ED because of high blood pressure or an irregular heartbeat or any number of symptoms,” McVittie said, “and this would provide them a closer facility to refer their patients who might be in need of emergent care.” “As the population moves outward from the core of Birmingham, clinical services need to be made available to them, closer to where they live,” McVittie said. “This is part of Brookwood’s strategy to do that. Whether it’s delivering primary care or other outpatient services, this is part of our strategy to reach out to where the population is moving.” August 2008