With more than 50,000 patients using Johnston Medical Center–Smithfield’s emergency department every year, efficient care is critical.

That’s why Christine Barrett, director of emergency nursing, is so focused on streamlining services. She has initiated several new processes to help cut down on delays, including the use of “service-specific” carts that can be rolled to a patient’s bedside.

“The service-specific carts create a universal room in the emergency department, so that if the physician is doing an eye exam or sutures or deliv­ering a baby, the appropriate cart will just be rolled to the bedside,” Barrett says. “It makes it much more convenient than moving the patient to the service. When you create universal rooms, you create carts to go with them.”

Working with Dr. Brett Cannon – a Johnston County native who is returning to the community as emergency medical director – Barrett and her staff of 80 are putting such ideas into place in antic­ipation of an emergency department opening in July 2009 at the brand-new Johnston Medical Center–Clayton.

The Clayton emergency department will include a 10-bed unit with state-of-the-art medical equipment to provide services for patients of all ages.

With more off-site clinics affiliated with the hospital’s system, people in need of care have more options – and that should translate into fewer emer­gency-room visits.

“We’ll see anyone 24/7, but emer­gency treatment is the most expensive care,” Barrett says. “We are helping people identify how they can get care efficiently if they don’t need to use the ER.”

Barrett is also initiating a concierge concept to help with patient satisfaction.

“Anyone who has ever been in an emergency department knows it can quickly become saturated,” she says. “Triage nurses sort patients first based on their acuity presentation, and then a certified assistant will be in the visitor room offering blankets, fluids, taking care of family needs. You keep them busy while they’re waiting and you let them know we are there to help them.”

The emergency department is short­ening patient wait times by changing how information is obtained. A triage process takes fewer than 10 minutes in most cases, resulting in more immediate patient treatment and a more satisfied patient, Barrett says.

With an eye always focused on improvement, she is working to have JMC–Smithfield deemed a designated chest pain and stroke center.

“We have lots of good things hap­pening in this community,” Barrett says. “We have a very engaged nursing staff working well with these changes. I feel very good about the delivery of emer­gency care at this hospital.”

Surgery at Johnston Health has always been on the cutting edge, and these days that means fewer knives.

The health-care system’s surgeons are choosing minimally invasive lapa­roscopic techniques whenever possible, using the most sophisticated and precise equipment.

“The biggest trends emerging on the surgical front are minimally invasive and outpatient surgeries,” says Dr. Dennis Koffer, a general surgeon and chief of staff at Johnston Medical Center –Smithfield. “Many surgeries are now getting done with as little invasion as possible, so that the patient gets home more quickly and has a shorter recovery period.”

Johnston Health’s multi-million-dollar hospital-growth program includes the most advanced laparoscopic video equip­ment on the market.

“This equipment will be standard in each of our surgical suites, as opposed to it being brought in for specific cases,” Koffer says.

Laparoscopy is commonly used in procedures involving gall bladders, bowel resections, hysterectomies and appendectomies.

But utilizing the latest technology is nothing new for JMC–Smithfield.

“We were the first hospital in this entire area – even before the university hospitals – to use a robot in laparoscopic surgeries,” Koffer says.

It’s no wonder that Johnston Health has been exceptionally successful in recruiting a varied and highly skilled group of surgeons to the hospital, Koffer says.

The county’s explosive growth has increased the demand for surgeons, and specialties of those on staff include vas­cular and thoracic surgery, orthopedics and special partial joint replacement procedures, urology, plastic surgery, women’s services and intensive care skills – all part of an impressive array of services offered at a community hospital.

“We have seen a huge increase in the volume of work we are doing,” Koffer says. “The more procedures we have, the better we get. We are offering more services to sicker people because of the excellent professionals we have been able to bring to this community. Advanced cardiology, intensive care support, cancer patient support – we are better staffed and can deliver outstanding service.”

Johnston Health offers a true com­munity health-care system, Koffer says, and its future is bright.

“The fact is that doctors are attracted to facilities as they grow, and Johnston Health is certainly growing,” he says. “We have very fertile ground to assure our doctors and surgeons of a very successful practice. We will be sending fewer patients out of our community for their health-care needs.”

A visit to the hospital can be a scary experience for a child, but Johnston Medical Center–Smithfield has created a serene environment to help young patients feel more at ease.

The pediatric suite has been transformed into a beach scene, from a tiled floor that resembles sand and water to walls painted with palm trees, beach houses and sea dwellers. At the end of the hall is the real thing – a saltwater tank full of fish that delights patients and their parents.

“Our patients just love it,” says Jackie Ring, chief operating officer and chief nursing officer. “Kids need a special place because their care is so specialized. They get to feed the fish, and they love watching them. They don’t want to leave!”

The re-do was created by local artists who are health-care professionals affiliated with the hospital, and it’s part of JMC–Smithfield’s emphasis on pediatric services.

Three new pediatric hospitalists are now on board, joining a staff of specially trained nurses and pediatricians. 

Having a baby is one of the most special moments in a woman’s life, and the professionals in the Women’s Services Department at Johnston Medical Center–Smithfield work hard to give new families the best experience possible.

“We have a very dedicated staff of caring doctors and nurses who are all prepared to deliver exceptional nursing care to our patients,” says Jackie Ring, chief operating officer and chief nursing officer for JMC–Smithfield. “Many of our nurses are cross-trained in that they can deliver the baby, take care of the postpartum needs of the mother and work with the newborn in the nursery.”

If the newborn goes to the nursery, that is.

With the recent expansion of the Women’s Pavilion – a project pushed up when almost 1,400 babies were born there in fiscal year 2007 – more women are choosing to keep their babies in the rooms with them. It’s an experience known as mother/baby couplet care.

“Our nurses are trained to take care of both patients,” Ring says.

This allows the new mother to bond with her baby while having the safety net of a professional helper.

The Women’s Pavilion, built in 2001 and expanded in 2008, has a separate entrance and is easily accessible.

On the horizon for JMC–Smithfield could be the development of a Level II infant nursery.

“We are limited with what we can do at the present time if we have a premature infant,” Ring says. “If we can obtain Level II, then we can do a lot more for the sick babies and keep family members from having to leave their community.”

Ring is also involved in the planning of women’s services at Johnston Medical Center–Clayton, which will include sophis­ticated diagnostic imaging equipment.

“My dream is to have a program of comprehensive services for women,” she says. “We want to have a center where a woman can get a mammogram, an ultrasound, an MRI or the stereotactic breast biopsy procedure and have answers within 48 hours.”

Johnston Health is leading the way in recruiting new doctors and specialists to the county, with more than 30 new doctors joining the organization in the past 18 months.

Once prospective physicians visit the community, it’s an easy sell, says Dr. Eric Gloss, vice president of medical affairs for Johnston Health. He has been in charge of physician recruitment since March 2007.

“This area is very desirable, with excellent schools, a university envi­ronment and a location that is close to a major metropolitan area,” Gloss says. “The climate is great, and we’re close to the ocean, close to the mountains. Even with more than 150,000 residents in the county, it still seems rural. Traffic is no big deal here. It’s a beautiful area.”

Many top-notch physicians already call Johnston County home.

“We have excellent physicians,” Gloss says, noting that two cardiologists on staff are ranked among the nation’s top 100. “We offer medical expertise that is close to home, with doctors who are providing outstanding care, and we continue to add to that.”

Johnston Health has created some innovative physician-recruitment tools to make the decision to relocate to Johnston County even easier. It offers assistance through three models - hospital employment, a solo practice or assistance with joining an existing practice.

As a hospital employee, the doctor receives all the benefits of salary and insurance without the headaches of owning and running a small business. If a physician chooses the business model, the hospital will fund the start-up with the doctor’s commitment to remain in the community for three to five years.

Liz Thurston, the staff physician liaison on board since July 2008, works to spread the word about Johnston Health and helps make doctors’ lives easier.

“Her role is to help promote the hospital and let the doctors know about new hospital services – and generally make it easier for the doctors to do their jobs,” Gloss says. “Her background is in information technology, so she works with them to set up systems that allow them to get lab results right within their offices, among other things.”

Office space has been a concern in the past, but Johnston Health is addres­sing that through renovation of existing space and construction of new buildings, including a 60,000-square-foot office condominium in Clayton, additional leased space at The Summit in Clayton and additional doctors’ offices and a walk-in clinic in the Medical Mall across the street from Johnston Medical Center–Smithfield.

With so much under way, Gloss sees a bright future for Johnston Health.

“I look forward to adding more physicians and meeting the needs of our communities,” he says.

The face of Johnston Health has changed through the years, but its commitment to growth and innovation remains constant.

Johnston Memorial Hospital, built at a cost of $1.25 million, opened its doors in December 1951 with 51,000 square feet and 100 patient rooms.

High demand soon prompted the hospital to add a five-story, 18,000-square-foot wing in 1958, followed by another twice the size in 1965.

A new mental health building was constructed in 1974, offering an inpatient unit operated by the hospital and an outpatient clinic run by the county.

In 1984 the hospital added 52,000 square feet, providing space for an additional 64 patient rooms, a new lobby, operating rooms and related services.

The 1990s focused on an expanded outpatient facility and a new emergency department.

The new millennium has brought about the greatest change – the construction and expansion of a Women’s Pavilion, cardiac catheterization lab and major renovations to the shuttered Burlington Industries plant just across the street from the hospital. Known as Johnston Health Medical Mall, this refurbished building houses the HealthQuest Wellness Center and Johnston
Medical Associates–Smithfield.

A vacant suite was recently remodeled to relocate the offices of QuikMed Urgent Care.

By 2010, the new addition to Johnston Medical Center–Smithfield and Johnston Medical Center–Clayton will be open and serving the health-care needs of thriving, vibrant and growing communities.

Providing health care in one of the state’s fastest-growing counties is a tall order, and the Johnston Health team has spent the last five years planning, reviewing trends and holding town hall meetings to design a program that is as dynamic as the communities it serves.

The result is a comprehensive, $144 million expansion and construction plan that will deliver top-quality health-care services to residents throughout the county.

As part of this expansion program, Johnston Medical Center–Smithfield will soon offer spacious inpatient suites.

“Each suite is large – almost 300 square feet,” says Johnston Health President and CEO Kevin Rogols. “These modern suites will feature private bath­rooms, bay windows and futon sleepers so that loved ones can stay with the patient the entire time they are there, if they wish. Each one will also have a dinette area, and we will offer 24-hour room service.”

Flat-screen TVs and anterooms where nurses or family members can talk privately will complete a space that is designed around the comfort and hospitality that patients and family members deserve, Rogols says.

New operating rooms, a new intensive care unit, a larger cafeteria and an inviting new entrance are planned as part of the five-story, 150,700-square-foot tower that will house the 101 patient rooms.

“Our goal is to meet the health-care needs of the residents of Johnston County and to have our hospital come to the tops of their minds and awareness when it comes to finding a health-care provider,” Rogols says. “We plan to be in all corners of Johnston County meeting the needs of our residents.”

Construction on the Smithfield tower is expected to be completed in December 2009, Rogols says, and renovation of the existing hospital – built in 1951 – will begin after that. Concurrent with the new construction in Smithfield is a new 51,000-square-foot medical center on a 75-acre tract in fast-growing Clayton. Johnston Medical Center–Clayton will feature an emergency department, a diagnostic imaging suite, operating rooms and lab services. Walk-in clinics and doctors’ offices are also sprouting up throughout the county.

Another plus: The projects are envi­ron­mentally friendly. A new central energy co-generation plant will have the ability to provide power back to Smithfield, Rogols says, and the entire Clayton project will feature a green campus.

“This was a collaborative decision with leaders in the Clayton community,” he says. “Together, we talked about the development of our 75 acres in addition to the property we have along the Highway 42 corridor, and there was a great level of interest from leaders to have a green focus. Johnston County is an absolutely beautiful county, and we’re supportive of anything we can do to sustain its beauty.”