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Mount Desert Island Hospital, in the coastal Hancock County town of Bar Harbor, serves a year-round population of some 5,500 plus a seasonal spike of summer residents and Acadia National Park visitors.
The need can be daunting for a hospital whose last major renovation to its emergency department took place more than 20 years ago and whose surgical suites haven’t changed in 30 years.
An expansion project is underway to address those needs.
“Since our ED was last renovated more than 20 years ago, there have been major advances in treatments, methods and care,” says Christina Maguire, the hospital’s president and CEO.
“The global pandemic brought to light the urgent need for a new facility as it changed how care is delivered, requiring better airflow and handling, and separate zones for optimal infection control.”
MDI Hospital is one of a number of expansion projects planned, underway or recently completed at hospitals and health care centers around Maine.
The projects range from the recent completion of Maine Medical Center’s 300,000-square-foot Malone Family Tower in Maine’s largest city, to moving a midcoast island’s clinic into its own building, to converting a former dental clinic into a comprehensive health center in the forested north.
MDI Hospital has its own niche. Patients come in from surroundings that are often isolated and remote; travel can be arduous, especially in winter.
During the summer and fall, the area experiences a marked increase in population from summer residents and temporary workforce. As a national park gateway community, Bar Harbor also sees a major influx of tourist visitors.
“In 2023, the state of Maine counted 15.3 million tourist visits across all modes of transportation, and Mount Desert Island welcomed 25% of those vacationers,” notes Maguire.
As a critical access hospital and safety-net health care provider, first responders rely on MDIH’s 24-hour accessibility — especially in the busy months from June through October, when emergency department visits triple.
Annually, MDIH logs more than 70,000 visits across the year-round and visitor constituencies.
“With one roadway on and off Mount Desert Island and the potential for extreme weather conditions that prevent air and sea travel, MDIH’s readiness and the quality of our health care are essential to our community’s health and safety,” says Maguire.
The entire expansion comprises 42,600 square feet. The emergency department portion equals 10,524 square feet, tripling its footprint.
The updated department will include 16 care spaces, including designated and urgently needed behavioral health care rooms; multiple triage areas for rapid and immediate patient assessment; appropriate facilities and improved airflow to address infectious diseases; and an increased number of patient care rooms which will be larger, more private and suitable for critical care patients as needed.
Technology, equipment and infrastructure will be upgraded, and a dedicated emergency room patient entrance and a covered ambulance bay will be added, thereby improving accessibility for patients and emergency medical service providers.
After the emergency department is completed, restructuring and modernization will begin on the hospital’s surgical suites — increasing capacity, comfort and privacy for patients and families, and upgrading space for staff and surgical functions.
The surgical suites will increase their square footage to 9,340 square feet through a redesign within the hospital’s current footprint, gaining centralized storage solutions and increasing patient and family privacy with nine prep and recovery bays.
A newly aligned main entrance, facing Bar Harbor’s Main Street for the first time in the hospital’s history, will increase access and visibility to the campus. Patient flow through the campus will be improved, and entry to medical suites and key services such as lab, pharmacy, and imaging will be centralized. The project will allow 85% of the hospital’s power to be offset through clean energy credits for the first time.
Goals include supporting current and emerging priorities such as workforce stability, recruitment and retention, obstetrics, primary care, medical education and behavioral health.
Construction is slated to begin in April 2025 and end mid-2028.
The overall project cost is $41.3 million. Financing includes federal funds; philanthropic donations from individuals, foundations and businesses; internal board-designated funding; and lines of credit.
The architect is SMRT Architects and Engineers in Portland. Landry/French in Scarborough is the construction manager.
The emergency department currently has only one critical care room, yet often has more than one critical care patient in the unit.
“When this happens, ED patients must be seen in multiple bed areas, even in hallways, because of the increasing demand for emergency care. Adding critical care space will alleviate this problem,” says Maguire.
Calais Community Hospital has a project underway to renovate a 4,260-square-foot former dental practice building as a new clinic called the Baileyville Rural Health Center.
In the small Washington County town, which shares a border with Canada, the project aims to address critical issues in a region characterized by limited health care infrastructure, detrimental social determinants of health rates and a high prevalence of chronic health conditions.
The goal is to establish a fully operational rural health clinic offering comprehensive medical services, including primary care, preventive care and chronic disease management.
The clinic will include patient waiting, reception, five exam rooms, procedure room, consult/telehealth room, lab/draw, soil utility, medication room, three offices, staff break area, conference room, housekeeping and provider workspace will be designed for optimal patient care workflow.
Preconstruction activities are expected to wrap up this October. Renovations, construction and equipment placement is anticipated to be completed by the fall of 2025. The estimated project cost is $1.365 million. The architect is Gawron Turgeon Dillon Architects.
The town of Islesboro is planning to renovate and furnish a 4,384-square-foot building as a standalone Islesboro Health Center.
An unbridged and medically underserved island in midcoast Maine, Islesboro has 600 year-round residents and over 2,000 in the summer.
Currently, the town-owned clinic is in the municipal building, along with fire, public safety and EMS. (There’s an overall plan to update facilities for policing, EMS and the fire department as well.)
The new clinic will be on the municipal campus but in its own building. Site preparation has begun. Construction could take about a year.
The architect is Stephen Blatt Architects in Portland. Ledgewood Construction in South Portland is the construction manager.
The larger clinic was needed because existing conditions are too crowded, says Lauren Bruce, vice chair of the select board and chair of the municipal building project committee.
“We have all these services in the municipal building and the building itself is not very large,” Bruce says.
The health center is at the core of the municipal building’s overcrowding. Today, it serves many more patients than when the building was renovated in 1991.
The staff has utilized every nook and cranny to confer with patients and store supplies, drugs, medical equipment and more. But for a long time, lack of space has been an everyday problem.
Examples? The staff “break area” houses a multi-use refrigerator and is inches from the medical lab/blood draw area, delineated by red tape. The trauma room is the only available storage area for oxygen tanks, sterilizing equipment and more.
The municipal building is a remodeled grocery store that was never properly ventilated, insulated, or soundproofed to assure privacy.
The projected cost for the entire municipal campus project is $4,465,990, with the health center estimated at $3.378 million. The project is fully funded, with donations totaling $1,849,658, and bonds $2,616,332. A federal grant of $845,000 will fund equipment.
When Islesboro Health Center moved into the municipal building in 1991, it had two physician assistants and a full-time administrative coordinator; the number of patient visits was in the hundreds.
In the following decade, Islesboro’s population grew, particularly the number of summer residents, and the center increased its emphasis on primary care.
By 2020, the average number of patient visits had risen to approximately 2,400 annually. More hires ensued. But for years, lack of space has been an everyday problem.
The needs include additional offices and exam rooms and separate rooms for telehealth and visiting specialists; blood draws, the lab and the kitchen break area; space for essential equipment such as oxygen tanks and sterilizers; better space for medications, which at present are stored with the cleaning supplies.
“The improved facility will be a major step forward in terms of the health care of the island,” says Bruce.
Eastport Health Care is in preconstruction to construct and equip a new dental, medical and behavioral health center at 75 Key St. to replace the current facility a couple of blocks away at 30 Boynton St.
The goal is to break ground this fall. “It’s a great, accessible location,” Ellen Krajewski, the center’s CEO, says of the new address.
Last fall, Eastport Health Care completed an expansion in Machias, combining its two Machias clinics, with the redevelopment of a 10,000-square-foot building at 160 Dublin St., for an influx of new pediatric and adult patients.
“We’ve grown four-fold at least in Machias,” says Krajewski. “There’s growth opportunity in Eastport as well.”
The new location will be 18,000 square feet, triple the current facility. Additional services will be a community room and diabetes center and possibly an in-house pharmacy. With about 40 professionals now, the expansion is expected to add five to 10 more on a staged timeline.
The project, which will be developed in two phases, is estimated to cost $12 million to $14 million. A fundraising campaign is underway.
“We want to provide the best space possible for our patients and for our team,” says Krajewski.
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