Wednesday, June 18, 2025
Years of incremental construction and quiet logistical maneuvers have the Long Island Jewish Valley Stream Hospital entering the final phase of a $31 million renovation to its emergency department.
The conceptual work at play is to move patients through the system faster, with fewer and greater clinical precision. The centerpiece of the overhaul is a redesigned emergency department lobby and a novel intake system known as split-flow.
While most emergency departments rely on triage nurses to prioritize patients before they wait—sometimes for hours—to see a doctor, Valley Stream’s new model flips the process.
Patients will now encounter a physician in the waiting room, who will direct care at the point of entry. In short: medical decisions begin immediately.
“People don’t come to the hospital to fill out paperwork. They come to see a doctor,” said Dr. Salvatore Pardo, Chair of Emergency Medicine at LIJ Valley Stream. “This model gets care started faster and, more importantly, gets the right patients to the right place without unnecessary delays.”
The new emergency room will serve a projected 55,000 patients annually—up from 44,000. The redesigned space doubles the department’s square footage, adds three dedicated intake rooms, and integrates directly with Valley Stream’s broader hospital infrastructure. Though it remains physically constrained by its urban footprint, the hospital has navigated the challenge by constructing in phases, without disrupting daily operations.
Some upgrades—such as a CT scanner installed in 2020 and new X-ray suites added in 2022—are already in use. But the forthcoming opening of the lobby marks the project’s most public-facing transformation. Pardo emphasized that the full integration of split-flow—rebranded internally as “Super Track”—will define the new patient experience. “It’s not just architecture,” he noted. “It’s operational redesign.”
The approach is not entirely untested. Northwell Health, the hospital’s parent system, has piloted similar models in other facilities. But Valley Stream’s build is the first in Nassau County constructed specifically with this intake strategy in mind.
Beyond triage, the new design includes three isolation rooms—crucial for infectious disease containment—and a dedicated ambulance triage area, slated for completion by 2026. These features, while less visible, are essential in a post-Covid healthcare environment where adaptability and containment remain core concerns.
Dr. Pardo is quick to remind that Valley Stream is not a tertiary-care center, but a community hospital. It treats a broad swath of ailments—from fractures to heart attacks—with one common denominator: urgency. “Our patients are sick. They need timely care. This redesign is about meeting that need more intelligently.”
But implementation demands more than good intentions. It requires retraining staff across all levels of care; a challenge Ramirez has taken seriously.
“We’ve mandated simulation-based training for all emergency department personnel—from nurses and techs to even non-clinical staff,” she said. “We’ve partnered with local high schools to act as simulated patients. This isn’t a drill—it’s real prep.”
Roughly 60 percent of the department’s 125-person staff has already completed training, with additional sessions underway. The inclusion of licensed practical nurses — a new feature under this model — is aimed at maximizing the efficiency of registered nurses, who will be freed to focus on more acute cases.
The changes are not only structural and procedural but also environmental. “This isn’t just a new coat of paint,” said Ramirez.
“We’re talking about a completely new infrastructure—air quality, piping, ventilation—all of it rebuilt.” The aged bones of the building necessitated a phased approach to avoid shutting down services entirely. Combined with pandemic slowdowns and surprise setbacks revealed behind demolition walls, the multi-year effort often felt Sisyphean. Yet Ramirez is quick to note that the result justifies the grind.
For a facility that once contended with overcapacity and understaffed triage, the improvements are long overdue. “We’ve seen an increase in both volume and complexity—more strokes, more sepsis, more pediatric cases,” said Ramirez. Much of the patient load now comes from Southeast Queens—working-class families who often arrive in crisis.
“The emergency department is often the first point of contact with our patients and we have designed this space to ensure that every individual who walks through these doors receives the highest level of care, compassion, and urgency they deserve,” said Jason Tan, RN, president of Long Island Jewish Valley Stream Hospital. “This $31.3 million project has transformed our emergency services with cutting-edge technology, increased capacity and put a focus on patient experience.
The work, now nearing completion, reflects a broader shift in emergency medicine: toward faster decision-making, more flexible infrastructure, and an unapologetic focus on operational efficiency. In a field where time is often the most valuable commodity, Valley Stream is betting that speed, not size, is what counts.
