Expansion to provide responsive health care services that meet the needs of a growing community is a fact of life at Alice Peck Day Memorial Hospital in Lebanon.

But, that doesn’t necessarily mean tearing down and building anew. Such is the case with the Robert Mesropian Center for Community Care. To say it “opened” in March is a misnomer because it was business as usual (well, within reason) through the winter as craftsmen under the direction of Trumbull-Nelson, the construction manager, completed work on an expansion and renovation that more than doubles the size of a health care resource that opened more than 20 years ago. The facility will be dedicated in early May.

When Alice Peck Day died in 1927, she bequeathed her home and estate “to establish a cottage hospital.” The Peck Homestead was the site of the original hospital and still is one of several converted homes along Mascoma Street that have been retained for use by various hospital services. But, over the past 60 years, APD has grown to be much more than “a cottage hospital” and those original buildings set a tone, on arrival, that APD is, indeed, an integral part of the Lebanon community, just as Mrs. Day envisioned.

If it weren’t quite so big, the sparkling white clapboards of the Mesropian Center for Community Care would look like they had been part of the neighborhood for a long time. In addition to its fundamental role as a center for patient treatment, it’s a building that, by nature of its design and location, says “welcome” to the main hospital and Harvest Hill, APD’s independent and assisted living retirement community (another Trumbull-Nelson project), that occupy much of the rolling hillside that Alice Peck Day called home a century ago.

The original Community Care Center, a 6,500-square foot facility, opened in the early 1980s. It has been completely renovated to blend with the 8,000-square foot addition. The expanded center is named to honor the memory and leadership of Robert Mesropian, APD’s chief executive for 14 years, who died in 2001.

At the groundbreaking ceremony in April 2004, Dr. Peter Mason, a member of the APD staff, said, “Bob Mesropian was the creative force behind the Community Care Center as it exists today. Bob said, ‘Just provide the best care you can, the kind you would wish for your own family.’”

“Bob Mesropian was the creative force behind the Community Care Center as it exists today. Bob said, ‘Just provide the best care you can, the kind you would wish for your own family.’”

The center is the latest project in APD’s ongoing campus master plan that Harry Dorman, the hospital’s current chief executive, says, “…responds to the continually growing needs of the community for primary care.”

“Continually growing” is obvious at APD: Over the past eight years, the Community Care Center has experienced a 50 percent increase in volume. Last year (2003), more than 20,000 patient visits were made to the primary care clinic. The hospital anticipates that this trend in demand will continue.

“The necessity of an expanded facility cannot be overstated,” said Dr. Douglas Williamson, medical director of the Community Care Center in APD’s current annual report. “The building changes will eliminate the patient flow gridlock of the old building and allow us to add new providers.”

Built originally as the APD/Dartmouth Family Practice Center, the facility was designed to train medical students and family practice residents while providing primary care services from four providers. Currently there are eight primary care providers (two new physicians will be added) and a support staff of nearly 20 who deliver a variety of primary care services and minor outpatient procedures.

The Community Care Center has been designed for efficiency. As Krista Merrihew, the Center’s clinical manager, notes, “It’s engineered for privacy.” This will be possible through the availability of 26 examination rooms (double the previous number) that are situated around two nursing station pods.

To appreciate what this means: The Center’s doctors and nurse practitioners usually have three exam rooms in use simultaneously, sometimes four for pediatric patients (3-4 rooms is the ideal industry standard). While a provider is seeing a patient in one exam room, the next patient is being prepared in another and the preceding patient is completing activity in a third.

Exam rooms now can be coordinated for each service provider, a virtually non-existent availability in the old facility when providers had 1-2 rooms that created serious gridlock in patient flow.

In addition to the exam rooms and nursing stations, the Center’s new resources include:

• An expanded waiting room and a three-station reception area (further ensuring privacy);
• Two nurse triage areas;
• A central office for 10 providers;
• A patient education room and a multi-purpose conference room;
• Two procedure rooms;
• An expanded medical records office (APD will also bring a state-of-the-art electronic medical records system on line this year);
• Improved equipment and supply storage areas;
• The Center will have an upgraded air conditioning system and the parking area will be expanded to accommodate additional patients.

“APD is growing rapidly and we have a dire need for more space,” says Jan Thibodeau, the hospital’s director of development and community relations, about the $2.6 million project that has been funded entirely through donations. “The Center has been designed to retain the flavor of the neighborhood and is another step in APD’s response to growing health care needs in this region.”

When it’s fully operational, the Mesropian Center for Community Care will have the ability to provide service for an annualized patient volume that is expected to increase to more than 28,000 visits.

That’s a lot of patients of all ages who are expected to visit the Center in coming years but, if it works as Krista Merrihew and her associates envision, the waiting room will be warm, welcoming—and empty, reflecting the value the Mesropian Center for Community Care brings to health care in the Upper Valley.