Hospital ER to become acute care clinic / Change becomes effective Sept. 1

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Ireland Army Community Hospital will transition its Emergency Services Department to an acute care clinic Sept. 1, and according to Col. Bob Cornes, IRACH commander, if anyone has an emergency after that date they should dial 911 or visit the closest emergency room.

“We want our beneficiaries and the public to understand that if they have an emergency situation they should not waste time but call 911 or go to the nearest ER,” he explained. “Since we won’t have an emergency department we won’t be able to treat situations that are a risk to life, limb or vision and we would have to transfer the patient to an ER—which would cost valuable time.”

Although IRACH is closing its ER, inpatient and surgical services, the facility will become an Army health clinic and continue to provide primary care services, For example family care; physical therapy; pediatrics; radiology, behavioral health, and the allergy clinic, in addition to having acute care services in place of the ER, will be provided in the health clinic.

According to Lt. Col. Sandra Rolph, the deputy commander of Medical Services and chief of the Department of Medicine, Army restructuring is only one reason for the change.

“We have also noted over several years a decline in emergency cases with a decrease in the number of patients arriving for care,” she said. “We are not considered a level 1 trauma center and have not found a need in our patient population to maintain this level of care.”

Rolph explained that IRACH is within the golden hour—the first hour after a traumatic injury which is considered the most critical for successful emergency treatment—of a level one trauma center at the University of Louisville. And she noted that 82 percent of patients who arrive to the IRACH ER are for nonemergent or minor illness care.

“The top diagnoses are upper respiratory infection, ear infections, lower back pain and sinusitis—sinus infection,” she said.

Maj. Tabitha Riley, the clinical nurse officer in charge, is a certified emergency nurse. She’s in charge of the Emergency Depart-ment at IRACH and said that the standard of care received in local civilian emergency departments won’t be any different than the care received in the IRACH emergency department.

“All of the local civilian emergency departments have undergone the same rigorous inspections that we have undergone at IRACH,” she explained. “In some cases, the patient’s care will be expedited since transfer to a specialized facility won’t be needed, for example, going to a stroke center or trauma center. Our post EMS service is well-versed in the best place for a patient for example, with chest pain to be taken.

“But our leadership has been working closely with local civilian hospitals to ensure our beneficiaries receive outstanding emergency care once our department transitions to an acute care clinic.”

The difference between an emergency room and the average acute care clinic, Rolph explained, is that an ER treats life threatening injuries and illnesses—something that endangers life, limb or vision. An ACC is for minor illnesses such as colds, the flu, ear infections, sore throats, fevers, rashes, minor cuts and burns and sprains.

The acute care clinic will see patients ages 2 years old and older, she added, and it will see patients by appointment with limited walk-in availability, from 11 a.m.-9 p.m., seven days a week except federal holidays.

The reason for the limit of ages that can be seen in the ACC is because to see patients less than 2 years of age providers must have special certifications. For example, a 4-month-old infant with a very high fever will need specialized evaluation due to their immune system not being fully developed.

The hospitals in the area are aware of the changes at IRACH and Health Net/Tricare have contacted the local health organizations and emergency rooms regarding the transition, she noted.

Cornes said IRACH has a long history in Kentucky, with a great record of looking out for the welfare of its community, and he believes the services outside the installation will continue to provide excellent care for military beneficiaries.

“We are geographically located close to several excellent medical facilities who we’ve already
been working with for some specialty services,” he said. “We are blessed to have such great providers right outside the gates—both in Louisville, Bardstown and at Hardin Memorial in Elizabethtown—and we are confident that these partnerships will provide our patients with the highest standard of care. They deserve no less.” n