Transcription:
Welcome to the Next Generation of Emergency Medicine

Intro: Riverside Healthcare, puts the health and wellness information you need well within reach.

Gabby Cinnamon (Host): In December of 2022, Riverside Healthcare ushered in the next generation of emergency care for the region with the completion of the final phase of an 18-month remodel to its emergency department. Joining us today to talk about Riverside's new ER is Cris Langellier, Director of Emergency Services, and Dr. John Vasko, emergency medicine provider.

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Gabby Cinnamon (Host): I'm back with Chris and Dr. Vasko. Thank you both for coming on the podcast today. Before we get into our new ER, can you both tell us a little about yourselves? This is your first podcast with us.

Dr John Vasko: Yes, it is. So, I grew up in Illinois, suburbs of Chicago. My whole family's there. I did undergraduate at University of Illinois, medical school at Northwestern, and then residency at UIC in Chicago. I started at Riverside about five years ago. I've loved it here ever since, so recently took the associate medical director role and getting more involved, kind of with the department as a whole rather than just providing clinical care in the emergency department. And that's where we are now today, taking the director role in a few months, which we're pretty excited about. And we're really excited to continue to provide great care to the community and grow from there.

Cris Langellier: I totally grew up at Riverside. I grew up in Wilmington and live in St. Anne right now. Started here in 1997, so 26 years ago as an ER tech. I've been a tech here and a nurse here. I was a team leader and then became the nurse manager. I was the educator for a while. And now, I'm currently the emergency department director, been in that role since 2020. And I'm really excited right now to be telling you all about our new emergency department. It's honestly a dream come true to have this beautiful department for our community and for our patients and our staff.

Gabby Cinnamon (Host): Cris, I think this question is for you. Why did Riverside decide to remodel its emergency department?

Cris Langellier: Well, we've had the same ER the entire time that I've been here. This ER, we've expanded, but the main core of the ER has been the same since the early 1990s. So, we needed more space, and we needed to find ways to do that throughout the years, and we needed just to modernize. We had rooms that were shared and divided by just curtains. So, that was one of the things we wanted to do, was make private rooms. And we had other things that we needed to kind of fix throughout the time. So throughout the years, as we kind of looked at our ER, we just had more problems than we had solutions. So in the end, it was just what we needed to do, was just start from scratch. So, it was just time.

Gabby Cinnamon (Host): Yeah. It had been a long time coming for sure.

Cris Langellier: Definitely. Yeah.

Gabby Cinnamon (Host): If you had seen the old ER and see what it looks like now, it's worlds apart.

Cris Langellier: Absolutely.

Gabby Cinnamon (Host): A lot of planning went into redesigning the new ER. Can you talk about that process and how you guys decided what you wanted to do, what you wanted it to look like?

Cris Langellier: So, we created a dream team. We had a whole bunch of people throughout the whole hospital that was part of that. We had nurses, we had doctors, we had advanced practice providers. So, we had physician assistants, nurse practitioners, techs, representatives from all kinds of departments who work in the ER, lab and X-ray. We had housekeepers, respiratory, security, information technology. People from facilities all came to the table and we talked about what worked in the department and what didn't work. And we just really talked about what we would want to see in that department and what we needed to get rid of.

And then, we went out and we toured departments throughout the state. And we took what worked in those departments and we brought them to ours. And then, we worked with an architect team and a great project manager who works for Riverside and then builders that are just really great, they're local builders who have done other projects here at Riverside. And they really helped guide us to make a space that could be as efficient as possible and that would really help us build for the future, because our volume is just growing and we were just busting at the seams at the time that we decided to do this. So, we knew that we needed to be ready for the future, and that's what we did.

Gabby Cinnamon (Host): Yeah. The old ER hadn't caught up with the community the way the community was growing and the community's needs too, and the new one seems to fit those needs better.

Cris Langellier: Right. For sure. Like when we walk through the ER right now, we can say, "This, we borrowed from a different er and it really worked for them. And this, we borrowed from another ER," and I mean, we have the best of multiple places.

Gabby Cinnamon (Host): Yeah. Dr. Vasko, can you talk about the features of the new ER and why they are important?

Dr John Vasko: Yeah. There are so many new features that are so important that we could probably talk a very long time about it. But like Cris mentioned, space, for one, is huge. Privacy is huge. All our rooms are private. They're much bigger now. I think one of the needs that the new ER has really addressed for the community is mental health. So, we have a whole pod of the ER, that we call the swing rooms because they are either fully fashioned for sick medical patients, but they can also be turned into a pod for mental health, patients who are coming in, you know, with a variety of issues. And with the real crisis in our country with mental health right now, we're able to provide that service better than ever. There's a whole team that sits right there with the mental health patients that works with them closely, works with our psychiatrists. So, I think that's a huge one.

The other one that is probably my favorite is our new trauma and resuscitation rooms. A lot of ERs our size have maybe one, it's maybe a little bit bigger, it's maybe a little bit brighter, maybe some things are more accessible. But now, we have two very big, very bright rooms with a storeroom between them with everything you could need for severe traumas, profoundly sick patients with medical emergencies. And there's so much space for the whole team to be there, you know, multiple nurses, docs, respiratory therapists, consultants. And everything is so easily accessible, that, I think that's a huge change to provide really lifesaving care in those situations.

And then, the other kind of big one is, as emergency medicine has changed, we provide more and more services. The scope of our practice has gotten broader and broader over the last 20, 30 years. And now, we have kind of a-- it's not separate, it's still part of the ER, but an area that we call the Apex, where we staff primarily with our APPs or nurse practitioners or PAs. And they're seeing patients in a different way than the main er where they can hopefully see them quickly, and efficiently and get them treated and back out of the ER in a faster way, rather than sitting in the waiting room for prolonged periods and then coming back to a room, finally seeing a provider and then getting out. So, I think those are probably my three favorite changes. The Apex, mental health and our trauma and resuscitation rooms.

Gabby Cinnamon (Host): On the topic of efficiency, you kind of talked about how the rapid treatment rooms help with efficiency. How has the remodel overall helped improving getting patients in and out? I know that, people don't like to wait. People are impatient, especially when they're sick, they think something's wrong. How has the remodel overall helped with that?

Dr John Vasko: I mean, it's helped immensely. I think having the Apex alone and kind of a dedicated space for quicker things that we can get in, get out, treat and help with that alone has changed a lot. And then, the reality of emergency medicine today is that a lot of places have waiting rooms with 50 plus patients in them waiting six, seven, eight hours. And thankfully, that's just not the case at Riverside anymore. We did have that. I think. But it's gotten so much better with just more space, and then this designated rapid assessment area, but it's just way better.

Gabby Cinnamon (Host): That's something for sure, I think, the community appreciates and will appreciate if God forbid they have to come to the ER. This remodel was for patients in the community, of course, but also to support the ED team and help you guys in your processes. What features do you think the emergency team appreciates the most?

Dr John Vasko: I mean, I can speak to it a little bit from my perspective. I know outside of the medicine side of things, there's a big nursing break room, which is nice with two refrigerators, which is huge.

Gabby Cinnamon (Host): The important things

Dr John Vasko: Yeah. You know, and that really is important because our shifts are long, our shifts are grueling. So, having a space to retreat to when you have the rare opportunity for a break is important for quality of life. So, I think that's a nice thing. They definitely thought about it and made that space nice for everybody. So, that's kind of the one quality of life thing from the nursing side. We do have like a little physician provider room too, where we can go and those are just, I think, really thoughtful changes that make all our lives working there a little bit better. From my perspective, those are two of the things. I don't know if you've gotten some feedback.

Cris Langellier: Yeah, for sure. I would agree. When you talk to the staff, they love the break room. We have the best Thanksgiving buffet .

Gabby Cinnamon (Host): Oh yeah. They have a huge like counter that they can put all these dishes. Yeah, it's awesome.

Cris Langellier: But truly, the staff, you hit it on the head when you talked about the behavioral health patients. Our staff really do have a heart for making sure that our patients have the best care. And having a private room for every patient has made a world of difference for the care our patients are receiving. And we have hit that mark right now. And right there is the best thing for our patients and for our staff.

Gabby Cinnamon (Host): I think that's something that unfortunately gets overlooked and for us to have that right here in the community is amazing. Now that the remodel is over, looking back, what would you say was the most challenging part of it all?

Dr John Vasko: So for anyone who's visited the ER during that time knows this, but we were split into two almost separate ERs that had quite a walk between them. Middle of the day, all that was open. But as people go and you shut down one side and you go down to almost half of an ER. And it was a small space. It was not initially designed to be an ER. And we had patients just packed all the way, every room, little curtains between them, people sharing rooms in some places, people in the hallway, which makes it difficult to provide quality care sometimes. I mean, we still did it, but also just uncomfortable for people too and really challenging, coming back to the mental health stuff a lot today, but even for those patients being in that kind of environment where it's really hectic. Everyone is, right next to each other and the ER is not a calm place generally. For them, it was super challenging too. So, having that split and then going down to half an ER for periods of time was really challenging.

Gabby Cinnamon (Host): Yeah. I think the few times that I had gone down there for whatever reason, I can't imagine being a patient or, you know, I think too, realizing patients don't realize either the impact that has on your team as well. Everyone's trying to do their best and, of course, emotions are high, but when it's that crowded and everything going on... So, it's really good that that part of this is over, I'm sure, for you guys, definitely.

Overall, so you guys have talked about the new aspects of the ER, kind of what can patients expect when they come to Riverside's new emergency room?

Cris Langellier: So, what's interesting is, recently, I met with a nurse who used to work here. And we had lunch and she came back and we did a tour. And we were standing in the sidelines and kind of looking. So, she was looking at it from a nurse perspective, but also from a patient perspective. And we used a word that we often don't use in the emergency department. She said, "Boy, It's quiet in here." but I'll tell you, it's a calm in the department. And that for me, when you come here, our space is bright, our space is clean. You're going to be cared for in the best possible space, by the best possible staff. We are ready to serve you. So if you came to us during the construction and you were in any level questioning, you need to give us another look because it's not the same.

Gabby Cinnamon (Host): You guys obviously cannot control what comes into the ER as far as emergencies, but the fact that your environment now is so much better and more in your control and how you want it to be, I'm sure helps in these terrible situations or these things that are happening. I'm sure that that is very helpful to know that at least that's within your control. Why is it important for our community to have this state-of-the-art emergency care so close to home?

Cris Langellier: We're caring for our family and friends. We're caring for our neighbors. Naturally, you want nothing but the best for those people. We have always had the best trained nurses and the best trained providers here at Riverside. We are the only Magnet hospital here in Kankakee County. And to that end, we teach all the Emergency Nurse Association courses here right on site to make sure our nurses are prepared for any emergency that rolls through the door. Our providers, they're trained to the same degree. Dr. Vasko, I'm sure you can talk to that.

Dr John Vasko: Oh, yeah. I mean, we've got a great team. I can't say enough about our nurses here. I think when I started at Riverside, that was probably the thing that was most surprising to me was how amazing they really are and how much they take ownership over their job and really just a lot of pride there. And we have a lot of experienced nurses who are not easily frazzled because it is easy to get frazzled in the ER, and I think that's key too. And they're really training up the next generation of ER nurses too, which has been a lot of fun to watch.

And then, on the provider side, we've constantly are working to improve ourselves and get better. And I think we have a good core. And we are really ready to deal with anything, as people and now in our environment, like you mentioned, it's been great. We've had some pretty wild cases the last month or so, and they've gone really well because of everything that we have in place now.

Cris Langellier: I remember one day when you first started and you had lunch in the break room, the old break room with the staff. And you had told the people you were eating with, the nurses that, "You know what, I feel comfortable sitting back here and having a bite to eat rather than rushing. I can take my time because I know that the nurses are taking good care of my patients because you are strong."

Dr John Vasko: Yep. It's totally true. They are your eyes and ears because, as a doc, you can't be in every room and having people you trust in those rooms who can come tell you like, "Hey, this doesn't look good" or "We might need to address this," they always got your back, which is just a really nice feeling to have.

Cris Langellier: So, when you're being cared for by an incredible crew, having this great facility to do it in, it's really just a cherry on top.

Gabby Cinnamon (Host): This question is kind of for the both of you. If someone asks you what the best feature is of the new ER, what do you tell them?

Dr John Vasko: I mean, for me as a doc, it's those recess rooms, those trauma rooms, which we talked about, because Emergency medicine's about a lot of things. We care for a lot of illness and that can be from ankle sprains and broken bones to severe traumas or bad heart attacks or whatnot. But at the end of the day, providing the best care to the sickest people is really what gets me up in the morning. And those places are where we do it. And that's just such an incredible resource to have. That's my favorite, definitely.

Cris Langellier: And for me it is clear hallways.

Gabby Cinnamon (Host): Cris is passionate about her hallways.

Cris Langellier: Yeah. And that's for many levels. So, one would be like equipment in the hallways. And two would be patients in hallways. And if you've ever been a patient in a hallway in an emergency department, you know what that means. There isn't privacy in there and there's so many things about that. It's not ideal. So when we first started on this journey, I took our architects on a tour and I showed them our hallways. I stood at the end of a hallway and I said, "If there is one thing that I want out of this, I want to clear our hallways." And we have managed on the most part at this point to do that now that our ER is open. And I'm so grateful to our staff and to this whole process that we're finally getting there.

Gabby Cinnamon (Host): Before we go, is there anything else that either of you would like to add?

Dr John Vasko: I think I'll reiterate something you said that was very true, it's that I can understand if people were hesitant when we were split in that north, south, about coming in. They probably heard that it was a little bit of a nightmare, and I would have a hard time disagreeing with them, to be honest. But I think, if that has kept people away, then I'd say fret no more because it's a beautiful space and the people are the same. The people have always been great. So, yeah, it's a great ER. I mean, it really is.

Cris Langellier: And what I would add is a thank you. A thank you to our staff who've been so dedicated to our patients and to our team through a really challenging construction process. And then, a message to our patients, a thank you for your loyalty and for your understanding through this whole process. And a thank you also to our board of directors and to our leaders here at Riverside for allowing us to do this because it has been incredible and I believe so worth it.

Gabby Cinnamon (Host): I think that's all we have for today. That's a great place to end off on. Thank you both for coming on the podcast today.

To our listeners, obviously, we hope you don't find yourself needing emergency medicine. But if you do, Riverside is here for you with a state-of-the-art ER right here in our community. Thanks for tuning in to Well Within Reach brought to you by Riverside Healthcare. For more information about Riverside's new emergency department, visit riversidehealthcare.org/er. Make sure to rate and leave a review on Apple, Spotify, or wherever you listen to our show.