Foreground: Colleen Walker, a student intern in Biomedical Engineering, chats with emergency physician Christopher Baugh in the Emergency Department expansion area. Background: Molly Donahue, student intern in Biomed.

A project nearly five years in the making, the Emergency Department (ED) expansion celebrated a significant milestone this week when its newest pods opened for patient care on Dec. 1.

The opening marks the completion of the project’s first of three main phases. The conclusion of phase one expanded the ED’s footprint into a new space on the Lower Pike and added 39 beds. At the same time, the team has kicked off phase two by closing 29 beds in the ED’s original space to renovate that area.

The current net gain of 10 rooms will allow the ED to shift care-initiation activities that previously took place in the waiting room to patient rooms, while further reducing the density of patients and staff in the department during periods of extreme census. The project’s final phase will begin near the end of summer 2021, when two more of the department’s existing pods will be temporarily closed for lighter renovations.

The ED expansion area, prior to opening. (Click image to enlarge.)

Once completed, the expansion will increase the ED’s total capacity from 49 beds to 81 beds. By the end of the project, which is expected to conclude next fall, the space will contain a dedicated area for behavioral health patients and, eventually, a specialized oncology pod (the oncology pod’s opening date will be determined by the status of COVID-19 pandemic).

In recent years, the Brigham’s ED has regularly experienced a high census and significant inpatient boarding challenges, requiring staff to see patients in hallways and set up surge areas in the waiting room when beds are unavailable. The expansion will address many of these challenges while also creating a more modern space with new amenities that promote safety, comfort and healing. For example, the renovations will convert additional rooms to support negative-pressure airflow — a newer addition to the project — and replace curtained treatment areas with private, walled rooms for all patient care and confidential communications.

“Although we are not quite there with the completion of the first phase of this project, I am most excited that we will eventually have a department that is big enough to meet the needs of our community and minimize the amount of care taking place in nontraditional spaces, such as hallways,” said Brendan Russell, executive director of the Department of Emergency Medicine. “Careful and thoughtful planning, input from staff and tremendous collaboration between nursing, physician and administrative leadership have all been vital to this project’s success thus far.”

Christopher Baugh, MD, MBA, vice chair of Clinical Affairs in Emergency Medicine, said the team looks forward to being able to better serve patients and families through this expansion.

“The idea is to right-size our department for our current patient population, with the ability to accommodate a little bit of growth over time,” Baugh said. “One challenge we’ve faced has been remaining available to receive transfers because of how crowded the ED gets, so this expansion will help keep our doors open to the community — especially to those patients for whom it could be lifechanging to have access to the specialists in our hospital.”

Biomed staff install new monitoring devices in an ED patient room.

Anna Meyer, DNP, RN, nursing director for Emergency Medicine, noted the importance of multidisciplinary collaboration in the leadup to the recent opening.

“One component of this project that has been absolutely pivotal is the input we received from staff in a variety of roles across the ED,” Meyer said. “Everyone worked together to make this work shine. I am especially proud of our ED nurses’ outstanding contributions to this project — leading efforts to maximize the patient experience, enhance efficiency and create a more comfortable, healing environment.”

In addition to opening the new area, the ED has adopted a new naming convention for its five pods. Previously known as Alpha, Bravo and Charlie, the ED pods will now draw their names from well-known Boston streets: Berkeley (formerly Charlie), Clarendon (formerly Bravo), Dartmouth (formerly Alpha) and, in the new space, Exeter and Fairfield. A future intake area will be called Arlington.

To help familiarize staff with the new layout, the ED will feature a variety of wayfinding resources, including maps on the wall with “you are here” stickers. (View a map of the new ED layout. Mass General Brigham login required for access.) The ED’s business specialists will also be positioned at strategic points throughout the area to provide directions and answer questions.

The COVID-19 pandemic disrupted numerous facets of hospital operations throughout the year, and the ED expansion project was no exception. But, after multiple conversations with Infection Control, construction teams and local regulatory agencies, the project was permitted to continue. As a second COVID-19 surge bears down on the Greater Boston area, Baugh said ED staff will remain flexible and responsive to the institution’s needs in the coming months.

“We’re still currently on schedule for the project to be completed next year, but as we manage volume, we’re examining all our options,” Baugh said.