Hospital draws from past lessons to build better ED

The new ED at The Elliot Hospital includes engineering features to help prevent infection spread.

Image by John Cannon

The new emergency department (ED) at The Elliot Hospital in Manchester, N.H., was built with the recent past in mind. 

Pulling from best practices learned during the COVID-19 pandemic, the new ED features advanced infection control with state-of-the-art negative-pressure rooms and HVAC technology. With this design, clinicians can better isolate infectious patients, increase ventilation, enhance air filtration and provide additional oxygen ports to care for an increased number of patients. As such, the design helps to simultaneously control the spread of infection and meet patient surges during high demand — two care abilities that are apt to come into play during future disease outbreaks. 

“The emergency department has the ability to flex from its everyday use to creating zones,” says Chris Fogg, vice president of integrated services at Bond Building Construction in Medford, Mass., the general contractor on the project. 

“The rapid triage and treatment area can be quickly converted into a negative-pressure area that isolates and fully exhausts the air changes within the space,” Fogg says. “As a result, none of the air from that zone is recirculated back into the rest of the emergency department. So, if another pandemic or airborne infectious disease scenario occurs, patients would be protected.”

The new facility also addresses patient flow challenges. 

“During a pandemic situation, a sick patient would be able to come in, get treated and leave through a separate exit. So, the patient would not go back into the lobby and intermingle with other patients who are coming in,” Fogg says. 

In addition, the newly designed facility accommodates the ability to put up a tent in the parking lot that is staffed with clinicians who can perform early screening or provide additional support for the emergency department.

Overall, the project, which ran from March 2021 to June 2023, added 22,000 square feet to the existing building and is expected to help the hospital serve the more than 55,000 patients per year who seek treatment in the facility. The expansion added 28 new private exam rooms for a total of 32 private exam rooms, three new trauma rooms, and a larger rapid triage and treatment area. 

“The Elliot provides the highest level of care and responsiveness possible to our patients,” says Matthew Dayno, M.D., FACEP, section chief and medical director at The Elliot Hospital department of emergency medicine. “The emergency department serves patients who are facing emergent illnesses and injuries, and we continue to harness innovation and technology to improve the quality of care and patient experience. This new emergency department delivers on our commitment to patients.”