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Improving care close to home | Health | unionleader.com - The Union Leader

Improvements to ICU, Step-Down Unit, Emergency Department, new MRI units.

DEAN CARUCCI, chief executive officer for Portsmouth Regional Hospital, has a lot on his plate, including a multi-million dollar renovation and expansion project. But he’s also happy about the little things, including the wait times at the hospital’s three facilities. On a recent afternoon the Seabrook facility was showing a two-minute wait time; the main campus, three minutes; and the Dover facility, four minutes. “One of our goals,” Carucci said, “is to make sure nobody has to wait more than 10 minutes.”

The hospital is in a season of unprecedented growth, fueled by a multi-year strategic plan. To the tune of $21 million, the main facility on Portsmouth’s Borthwick Avenue is poised to reach more Seacoast residents with the care they need.

The hospital is in the process of expanding its ICU, or Intensive Care Unit, from 18 beds to 29. “We are at capacity,” Carucci said in a phone interview. “This is a 60 percent increase.”

The hospital is also adding eight beds to its Step-Down Unit, a unit serving patients who are out of ICU but still require a high level of care. “We almost never discharge a patient directly from ICU,” he explained.

The last renovation to the Emergency Room was in 2009, according to Carucci. While the administration has done touch-ups, the current renovation is a complete overhaul, he said.

The hospital and its two other facilities, in Dover and Seabrook, are seeing increases in volume, and that has sparked some of the renovation, according to Carucci. But it’s a cycle, he added: “Whenever you build out service lines, people will flock to you.”

The hospital is also upgrading its two MRI units. “We are replacing the current units and making sure we have the most sophisticated ones available,” Carucci said. “The newer machines are much faster, and can push more people through the system.”

Portsmouth Regional was also recently certified as a Comprehensive Stroke Center by DNV GL Healthcare, a certification agency operating out of Norway. It is the only Comprehensive Stroke Center in New Hampshire, according to Carucci.

Certification is based on standards set forth by the Brain Attack Coalition and the American Stroke Association, and affirms that the hospital addresses the full spectrum of stroke care — diagnosis, treatment, rehabilitation, and education — and establishes clear metrics to evaluate outcomes.

“A CSC delivers the highest quality of care to the most complex cases, including those suffering a hemorrhagic or large ischemic strokes,” Carucci said in a press release. “This certification is a reflection of the relentless focus, work, and dedication of so many Portsmouth providers and staff over the past five years. The Seacoast community and those living in New Hampshire will benefit greatly from such highly specialized care being in the community in which they call home.”

Carucci explained that there are two types of strokes, hemorrhagic and ischemic. “If you show up in our emergency room, we first treat you with a clot-busting drug,” he said. “If you need a procedure, you can go in, and we’ll use a guide wire to pull out the clot.”

While ischemic strokes can be treated this way, hemorrhagic strokes, which happen when an artery in the brain leaks blood or ruptures, requires a different treatment.

And they have been honored by Anthem Blue Cross as a Blue Distinction Center for Bariatric Surgery, providing a full range of care for the weight-loss surgery.

The hospital continues to offer graduate medical programs in Internal Medicine, Family Medicine and Psychiatry. Carucci said these residencies are intended to accomplish three goals: to keep talented physicians in the PRH system, to keep the program participants in the community, and to keep them in New England. The hospital is partnering with Tufts Medical School for the academic work, he said.

The hospital kept busy during the height of the pandemic, though their numbers ranged from 120 percent capacity to low numbers. He’s proud that the hospital didn’t have to lay anyone off, and proud of his people. Though there was a “physical and emotional toll,” they stuck with it. And if there’s another round of COVID, they’ll deal with it, he said. Their current protocols include masks everywhere except in private offices.

The multi-year vision includes, for Carucci, providing a range of services for New Hampshire residents. “Nobody,” he said, “should have to leave the state. Nobody should have to leave their community.”

He also wants to serve the border areas, Northern Massachusetts and Southern Maine, and said, “the closer you are to home, the closer you are to family and friends to care for you.” And that in turn speeds healing, according to Carucci.

While the improvements are necessary, Carucci noted that it’s his people who keep patients and their families coming back to PRH.

“The bricks and mortar,” he said, “will always be there.”

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