While Providence St. Patrick Hospital prepares to break ground on a new six-story ambulatory wing and parking garage, it's also set to construct a new medical unit where staff can monitor patients outside the emergency room.

Joyce Dombrouski, CEO of Providence Montana, said the 10,000-square-foot addition, dubbed the clinical decision unit, will break ground in the coming weeks. It's set to open next year.

“It's by design a unit where we'd watch someone before we make a decision whether they need to be admitted fully into the inpatient world of the hospital, or if their condition stabilizes and they can go home,” she said. “It moves the patient out of the ER setting, but keeps them close enough to emergency where we can monitor what's going on with them.”

Dombrouski said the unit makes more efficient use of resources while offering potential savings to patients who may not need full admission to a hospital bed.

“Many patients that have been successfully treated in a clinical decision unit are those who might be suffering with some type of chest pain,” she said. “We know it's not an urgent heart attack, yet we're concerned enough that we don't want to send them home. We can safely monitor them in a clinical decision unit.”

The unit is planned just east of the hospital and the existing emergency room. The project will consume a handful of parking spaces, though St. Pat’s is taking steps to address that concern.

“The downside is that it does take some of our parking spaces that are contiguous to the ER,” she said. “Parking for us is always a challenge, and we're working to find acceptable numbers and location for substitute parking.”

Last week, the hospital held a ceremonial groundbreaking on a $126 million outpatient building. That project, planned for a vacant lot on West Broadway adjacent to the hospital, includes a six-story building with three floors of parking and three floors of clinical space.

That project is slated for completion in 2023.

Dombrouski said the clinical decision unit represents the hospital's Phase 1 expansion plans, while the new medical building represents Phase 2. Once the work is complete, Phase 3 would likely include back filling parts of the old hospital.

“I would call Phase 3 what we'd do with the space that gets vacated when the International Heart Institute moves to this new building,” she said. “We'll have a conversation about the best use of the space.”

Dombrouski said the hospital is also working with the city to create more of a medical campus, which could include the closure of McCormick Street. A sky bridge is planned between the new parking facility and the existing hospital.

The additions are driven in part by Missoula's growing population, changes to the health care industry, and an expanding service area, Dombrouski said.

“It's a result of the growth of the community and western Montana,” she said. “Our footprint of service really is the entire western part of the state.

“What we're also growing is that outpatient space, or that ambulatory space,” she added. “That's really where the world is moving in health care – that belief that a lot of things can be done without staying overnight in a hospital bed. It's really a more cost effective alternative than what we're able to do in our existing physical space.”