The Emergency Department entrance at Lancaster General Hospital.
Penn Medicine Lancaster General Health is considering an expansion of Lancaster General Hospital that would double the size of the facility’s Emergency Department and modernize its comprehensive food service operations serving patients, employees and visitors. In addition, LG Health is evaluating whether to increase the number of inpatient rooms at the Duke Street hospital.
The project’s total scope and cost have yet to be finalized. Planning and design will continue over the next several weeks, followed by a series of municipal reviews and approvals. Among the first steps: The Lancaster General Health Board of Trustees is expected to decide in May whether to pursue some or all of the project’s components.
“This is the culmination of years of planning by Lancaster General Health to ensure the most strategic approach to addressing the growth in demand for our services,” said Jan Bergen, President and CEO, Penn Medicine Lancaster General Health. “We’ve made great strides over the past five years enhancing access to our care while guiding people to the optimal settings for their medical needs, such as our urgent care centers or outpatient facilities. Increasing demand, population growth and changes in the local provider landscape require a thoughtful expansion of Lancaster General Hospital.”
The Duke Street Expansion Project includes three primary components under consideration:
- A renovated and expanded Emergency Department on the hospital’s ground floor that would double its capacity to about 95 total treatment beds.
- A new and expanded food service department offering an even wider selection of healthy foods for thousands of patients and health system employees each day. The expansion would include a comforting environment serving as the hospital’s communal hub for patients, visitors and employees.
- A potential tower with private patient rooms along Duke Street to increase the hospital’s complement of 537 beds and to enable the re-purposing of two existing hospital patient wings that date back to the 1940s and 50s.
Preliminary estimates for the emergency department and kitchen/dining area components of the project total about $115 million. No cost estimate is yet determined for the patient tower. Costs are dependent upon final equipment costs, interior and exterior architectural designs, local and state municipal approvals and other factors.
“We will work closely with City government, community groups, and all interested stakeholders to advance Lancaster General Health’s mission and to meet our region’s health needs while remaining a good neighbor and strong community partner,” Bergen said.
New and Expanded Food Service Department and Dining Area
During the first phase of the project, the hospital’s expansive food service department and 350-seat dining area would be relocated. Last renovated more than 30 years ago, the hospital’s kitchen prepares 3,500 meals each day to patients, visitors and employees.
Hospitals nationwide are upgrading their dining offerings to emphasize healthful eating and wellness, as well as to promote a sense of community through indoor and outdoor seating areas.
Demand for meals is projected to increase by 20 percent as a result of the expansion, necessitating a food-prep design featuring multiple stations that flex production based on daily demand. Energy-efficient equipment will accompany a new, water-management system that will limit waste put into the municipal sewer system.
Early concepts of the dining area envision dynamic stations offering handcrafted food, defined areas to relax, refresh and rejuvenate, and a teaching kitchen for cooking demonstrations for staff, patients and the public. A retail zone including the hospital’s gift shop is also envisioned.
Expanded storage and refrigeration, combined with a restaurant-style production kitchen, would enable LGH to expand its healthy and locally sourced menu offerings to patients, visitors and employees.
Emergency Department Renovation and Expansion
After the new kitchen and dining areas are completed, the hospital’s Emergency Department (ED) would be renovated and redesigned to enhance clinical effectiveness and to improve the overall patient experience. It would also expand into neighboring ground-floor space occupied by the former kitchen and dining area.
The department, last renovated in 2003 and designed to optimally accommodate 90,000 visits annually, saw nearly 118,000 visits last fiscal year. Trauma cases also increased 23 percent in 2017, continuing steady growth seen during the past 15 years.
Demand increased earlier this year with the recent closure of UPMC Pinnacle Lancaster, leaving LGH as the only acute inpatient hospital in Lancaster City. A nine-treatment-bay temporary addition to the Department, opening this June, will provide limited but crucial short-term capacity. LG Health projects the hospital’s annual emergency cases could reach about 140,000 in 10 years.
About 32,550 square feet of new emergency department space will be built in the space left after relocation of the hospital’s ground-floor kitchen and dining area. When the new ED work is completed, the existing 38,650-square-foot department would be renovated.
The expansion would increase overall department capacity from 54 treatment bays to about 95 bays, depending on final interior design. Four bays would be dedicated to an expanded area for trauma cases. Additional expanded areas would be designated for behavioral-health and pediatric patients, and for urgent care.
Duke Street Patient Tower
LG Health is also evaluating the feasibility of an inpatient tower similar in design to the hospital’s Frederick Building, offering modern, private rooms that enhance safety and privacy and promote comfort and healing.
“With so many resources devoted to building the new Emergency Department, kitchen and dining areas, it’s prudent to think about the efficiency of also replacing nursing units that have served us well for decades,” Bergen said. “By acting today, we could avoid returning in future years with another major and disruptive construction project.”
The proposed tower could be large enough to replace beds offered today within LGH’s existing East and West wings. The lower half of those eight-story wings opened more than 70 years ago, and range in size from 176 to 218 square feet per room. In comparison, patient rooms in the Lime Street Building are 384 square feet.
Larger, single-patient rooms have become the industry standard in new construction of acute-care facilities in the United States. Private rooms reduce the possibilities for infection, facilitate nurses and healthcare workers’ ability to do their jobs efficiently, provide adequate spaces for family members to participate in the healing process of the patients, and afford a greater measure of privacy for the delivery of bedside treatments and for sensitive discussions with healthcare personnel.
The East and West wings would continue to be used for future medical services, including outpatient care, observation beds, and additional inpatient capacity during periods of extraordinary demand. Project architects are working to finalize the scope and cost of the proposed patient tower and the best timing for its construction.
Assuming zoning and regulatory approvals are granted through the summer and fall months, the project would be expected to begin in winter 2020 and take up to three years to complete.
“If fully developed, this project would be the largest single expansion of Lancaster General Hospital in its history and likely the last major expansion conducted at our Duke Street campus,” Bergen noted.