Scales, wheelchairs, portable patient monitors and rolling metal carts and gurneys piled high with medical equipment and supplies were just some of the last-minute items to find a home at Sonoma Valley Hospital's new emergency department Tuesday morning.
Meanwhile, nurses, doctors and medical staff worked throughout the morning to put everything in its place, as the first patients were brought into the new $43.8 million hospital wing, including a new second-floor surgical center.
Capt. Joe Morrison of the Sonoma Valley Fire and Rescue Authority, tagging along for the first ambulance drop-off, toured the new emergency department with other firefighters to get better acquainted with the facility.
"I just came in to look," he said. "It's beautiful. It's nice. We've been waiting for it for a while."
Outside, near the new entrance to the emergency department and hospital's main lobby, top hospital brass removed a tarp from the new ER sign
The atmosphere of excitement and pride among hospital staff Tuesday reflected the fruit of several years of planning and cooperation that involved hospital officials, community leaders and Sonoma Valley residents and philanthropists.
About 70 percent of the project's cost was paid for through bonds approved by voters in 2008.
The celebratory opening day stood in stark contrast to the acrimony that plagued a divided community eight years ago. At that time, hospital officials were pushing a plan to build a $148 million, 70-bed hospital on 16 acres of farmland that would have to be taken by eminent domain.
That plan was followed by another proposal that would have built a smaller, less expensive hospital on the southern end of the city's limits. The proposal drew fire from Sonoma Valley environmentalists who were opposed to expanding the city's urban growth boundary.
In the end, after considering a number of alternatives, hospital leaders and the local community came together on a plan that would expand the existing 83-bed facility and gradually modernize the rest of the hospital. For some, Tuesday's launch of the new wing represented a new era for Sonoma Valley.
"It's a healing hospital now," said hospital CEO Kelly Mather. "We've healed and now we're going to inspire healing."
At 6,586 square feet, the new ER is three times as big as the old department. The 5,657-square-foot surgery center is 20 percent bigger than the old operating department.
The ER has seven private treatment rooms and one area with two beds for severely ill patients. The department has a large waiting area, a triage room, consultation room and play area for kids.
From the larger nurse's station, medical staff have a clear line of sight to every patient room. The department is also equipped with tele-medicine capabilities that allow local ER physicians to consult with medical specialists in the Bay Area.
Dr. Robert Cohen, the hospital's chief medical officer, said more rooms means there will be less waiting time for patients. Hospital officials estimate that 90 percent of ER patients will be admitted to care within 10 minutes.
"The idea is to get to patients promptly so they don't wait," Cohen said, adding that the new ER rivals other local departments in design of patient flow and equipment.
"I think the public got a bargain," he said as he surveyed the new department. "I remember when this was a back-of-the-envelope design."
The new surgery center is also a departure from the old operating facility.
The old surgery center had separate areas for both pre-surgery and recovery stages of the surgery process. The new center brings pre-op rooms and and post-op recovery rooms to the same general area.
This allows surgery center nurses to be cross-trained in both areas for more efficient and complete care, said Dr. Allan Sendaydiego, director of surgical services at the hospital.
Consensus on the scope and design of the hospital did not come easy, said Bill Boerum, secretary of the Sonoma Valley Health Care District.
Eight years ago, Boerum helped lead the campaign to defeat Measure C, which sought to acquire a property owned by the Leveroni family through eminent domain. Other proposals followed and failed until the current plan was overwhelmingly approved by local residents.
Throughout the debate, there was one common goal, Boerum said.
"What the community has always expressed in polls as well as in any dialogue about what they want out of the hospital and health care district is a first-class emergency room," he said. "All constituencies and stakeholders have been dedicated to that."
Boerum said the new surgery center was necessary to attract doctors and surgeons to Sonoma Valley. The new surgical facilities "tells doctors that they can practice in a place that is absolutely first-class," he said.
The existing hospital, built in phases in the 1950s, had become outdated and inefficient by modern medical standards. Also, key buildings do not meet state seismic safety standards. The buildings had to meet those standards or close by last year.
By moving the surgery center and emergency department into the new wing, those requirements are now met, Mather said.
The 2008 bond measure approved by voters covered $31 million of the project cost and allocated $4 million to retire old debt. An additional $11.3 million was raised from the local community through a capital campaign.
Boerum said a significant portion of the donations came from large philanthropic gifts, including $3 million for the new emergency department from Gary and Marcia Nelson, longtime Sonoma residents who had previously made significant donations to the old emergency room.
Two other large donations came from Les and Judy Vadasz, who made a matching challenge grant of $2 million, and Sandy and Joan Weill, who contributed $1 million.
"When the community finally decided on the scale of the facility that it wanted, it gathered momentum and moved on," Boerum said.
Les Vadasz, a founding member of Intel Corp., Gary Nelson, founder of the Nelson Family of Companies, and Sandy Weill, the retired CEO and chairman of Citigroup, are all investors in Sonoma Media Investments, which owns The Press Democrat.
Mather said the next phase of modernizing the hospital includes creating an outpatient center that will utilize the entrance to the old ER. The old surgery area will be used for radiology, lab, special procedures and cardiopulmonary services.
Mather said that phase will require a separate capital campaign not expected to begin until 2015.
Fixing Sonoma Valley Hospital was the right choice for the local community, Mather said.
"Some hospitals can be around for more than 100 years as long as you keep them up," he said.