U.S. 63 landscape to change dramatically with TCMH project

The landscape along U.S. 63 in Houston will begin to change dramatically this year as Texas County Memorial Hospital begins a 58,000 square foot expansion project, the largest expansion in the hospital’s 53-year history.
“The same holds true today as it did 50 years ago—‘How do we better take care of our patients?’” Wes Murray, chief executive officer at TCMH, asked. Murray often refers to the history of TCMH when in the early 1950s various leaders in Texas County traveled throughout the county — sometimes on horseback — rallying support to build a hospital at the county seat.
TCMH was built with a combination of local tax funds and federal funding from the Hill-Burton Act that enabled rural areas across America to build healthcare facilities. Before building TCMH, Texas County residents traveled frequently to Waynesville and Springfield for hospital care.
“With this expansion, we can build a facility that can be used by the residents of Texas County 50 years from now,” Murray said.
Tax funds have not been utilized by the county hospital in almost 20 years, but the hospital has continued to grow and add services such as a sleep studies laboratory and an in-house MRI to meet the needs of patients in Texas County.
“We have no illusions that we will do open heart surgery or neurosurgery at TCMH in the future,” Murray said. “We know that Texas County doesn’t have a large enough patient base to support those specialized services in a county hospital setting.”
Murray added that the hospital’s board of trustees is committed to providing high quality primary care at TCMH.
“We strive to provide excellent primary care for patients of all ages in Texas County, and this expansion will help our physicians and staff continue to provide some of the best primary care you can find in rural America,” Murray said.
Expansion planning at TCMH began in early 2007 when hospital officials began looking at a way to increase the size of the hospital’s emergency department as volumes continued to grow. The emergency department addition and remodel was going to cost several million dollars, would completely disrupt aspects of patient care at the hospital and would not entirely meet the needs of the TCMH emergency department.
TCMH board members agreed to bring in a facilities planning firm to help the hospital gather data on volume, departmental and medical staff needs and strategic plan goals.
“Our greatest challenge in looking at the hospital’s overall needs is that the majority of our patient care was being provided in a facility that was built 40 to 50 years ago,” Murray noted.
The south and the east wings have been “grandfathered” in to meeting state hospital codes and guidelines, but they are still very outdated in size and amenities for today’s patients. Private and patient areas intermingle throughout the hospital creating infection control risks and opportunities for patient privacy violations.
All hospital departments are completely out of storage space as well as room for growth, creating inefficiencies throughout most departments. The hospital’s radiology department is spread out through three hallways in the hospital, creating major inefficiencies for a department which provides care for many hospital inpatients and for outpatients.
“It would be financially impossible for us to update our current facility to meet today’s technology needs,” Murray said. “Not only will this expansion create new patient care areas, it will expand current patient care areas to accommodate today’s technology needs.
For example, the private patient rooms on the second floor medical surgical department will feature a small side window outside each room where a computer will be placed allowing staff to do electronic medical records documentation at each patient’s bedside. Currently, TCMH has “computers on wheels” that are wheeled up and down hallways as needed.
The ground floor of the expansion project will house a new, 13-bed emergency department, a radiology suite, an outpatient clinic and a registration department.
The new TCMH emergency department will have a “front door” entrance; the expansion will extend out in front of the current hospital facility. The department will feature rooms that are privatized with walls and doors for each room as opposed to the curtains that are pulled open or closed in the current ER patient rooms. The department will have two trauma rooms instead of one, and the outpatient clinic area will be connected to the ER so it can be utilized during overflow times or as an urgent care clinic if ER volumes grow.
The radiology suite will be attached to the new emergency department because the ER heavily utilizes some radiologic exams. All radiologic equipment will be in rooms within the suite, eliminating the need for patients and staff to walk through public hallways for an exam.
The hospital’s most recent on-campus construction addition was a space added in 2006 at the back of the hospital to house an MRI machine. A room will be built off the radiology suite to hold a new MRI when the current machine needs to be replaced.
“It is extremely expensive and difficult to move an MRI,” Murray explained. “However, when the time comes for us to replace the magnet in our current MRI, we will relocate the machine to the new space.”
MRI magnets typically last about 10 years.
The second floor of the expansion project will contain the hospital’s medical surgical department which will feature 20 private patient rooms. The floor will also have two rooms specifically designed for bariatric patients. Six semi-private rooms will also be part of the floor. All rooms will have a full bathroom attached.
In addition to computers at each patient room, they will have large windows to allow in a lot of natural light. More space will be available in rooms to accommodate visitors and family members.
“A hospital is a place where people come to heal, and today’s patients expect amenities such as private rooms and plenty of space for friends and family to be with them,” Murray said.
Additional benefits to private rooms include increased patient privacy and improved infection control for patients.
The medical surgical floor will have rooms placed around a centralized nurses’ station. Offices for staff that work with patients, such as the hospital social worker and hospital case manager, will also be on the second floor.
TCMH plans to take the hospital’s south wing—the original section of the hospital opened in 1958—out of patient care. The east wing of the hospital will continue to be used for swing bed—patients that require long-term hospitalized care.
As the radiology and emergency departments vacate their current locations to move into the expansion, 17 additional TCMH departments will expand into the vacated areas and “second phase” of construction.
“Not only will the additional space allow our departments to have more storage space and increase efficiency for those departments, the new space will allow those departments to grow as needed,” Murray explained.
Departments that will increase in physical size include pharmacy, physical therapy, dietary, laboratory, cardiopulmonary and cardiac rehabilitation. With the second phase, additional space will be available for meetings and educational functions at the hospital, too.
“The most important facet of this expansion project is that many of our major patient care areas will be moved into brand new facilities rather than relying on the 53-year old core of the hospital to meet current patient and technology needs,” Murray explained.
The hospital also believes that the construction project will enhance physician recruiting and retention efforts.
“Today’s physicians are training in state-of-the-art academic medical centers,” Murray said, “And they have expectations about the facilities where they provide healthcare.”
Murray noted that the TCMH medical staff is “very supportive” of the hospital’s expansion plans, and many medical staff members have been very involved in designing patient care areas.
TCMH has organized a “TCMH Ambassador” program that keeps specific TCMH employees informed regarding expansion plans. Murray also encourages members of the public that have questions about the project to ask.
“Rather than speculate about what’s happening at your county hospital, please ask a member of administration,” Murray said. “This is your county hospital, and we want you to know what we’re doing to provide for your healthcare now and in the future.”
TCMH plans to have architectural renderings of patient rooms as well as blueprints for both floors hanging in the hospital’s main hallway by the end of the month.
To fund the expansion, TCMH received an $18 million, low-interest loan from the U.S. Department of Agriculture. About $16.9 million will fund the 58,000 square foot expansion, and the second phase of renovation will be funded by $1.1 million.
The hospital hopes to fund a third phase of construction and renovation for the hospital’s obstetrics, ICU and surgery departments in the future.
TCMH is planning a groundbreaking for the expansion project at 1 p.m. Thursday, April 28, on the hospital grounds. The event is open to the public.
For additional information, contact Joleen Senter Durham, director of public relations at TCMH, 417-967-1258 or joleen@tcmh.org.


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