Yakima Valley residents Joel Cardenas and Lindsey Montes De Oca both see health care as their calling and have a passion for emergency medicine. They have 25 years of experience between them. 

When the opportunity to open a new emergency department to better serve people in the area came knocking, they jumped at it.

MultiCare provided that opportunity when it opened a new neighborhood emergency department in Union Gap in November, aiming to improve efficiency and care in the underserved Yakima Valley. 

“It was really exciting to have brand new equipment, and just create the culture that we want the community to see,” said De Oca, registered nurse at the emergency department. “And deserve.”

The Union Gap location, which opened at 38 Adelyn Way, is MultiCare’s eighth neighborhood emergency department in the state and is open 24/7. 

The seven other locations are in the Puget Sound region, where MultiCare had success with the model, said Cardenas, the emergency department nurse manager. 

In 2024, MultiCare Yakima Memorial Hospital’s emergency department had 87,000 visits, making it one of the busiest in the state, according to the hospital. 

The high volume of patients showed MultiCare that there is a demand and benefit for more health care services in the region.

“After doing the data analysis and looking at the places that it made sense to have a neighborhood emergency department, Union Gap seemed like the reasonable place,” said Dr. Tanny Davenport, chief medical officer for MultiCare Yakima Memorial Hospital.

Yakima used to have two hospitals and emergency departments until Astria Regional Hospital closed in 2020. Astria Health operates hospitals in Toppenish and Sunnyside.

Care for underserved communities 

The new neighborhood emergency department operates like a traditional emergency room, except it’s not attached to the hospital. 

Physicians can diagnose, treat and stabilize patients. If they need a higher level of care, they’re transferred to the hospital on Tieton Drive. 

“We look at it like an extension of the Yakima main campus,” Cardenas said. “We don’t have specialized services, but we will and do find those services and transfer you to a higher level of care.”

Since opening more than two months ago, the emergency department has seen around 4,300 patients. The department averages 80 patients daily, as expected, Cardenas said.

The department has 10 exam rooms, a triage room, a pharmacy, a lab, and on-site radiology services. About 4% of patients are transferred to the main hospital. 

The medical professionals are mostly seeing patients dealing with upper respiratory infections, urinary complaints and abdominal pain, which is average for emergency departments.

It’s also the peak of flu season, so they’re seeing a high volume of patients with those symptoms. The goal for average wait time is 15 minutes, Cardenas said.

Early data also suggest a decrease in patient load at the Yakima Memorial Hospital’s emergency department due to the presence in Union Gap. 

“That gives them more time and ability to treat and see patients,” Cardenas said.

Metrics and feedback 

Two significant metrics used to measure the success of the emergency department are wait times, patient volume and patient satisfaction. As time goes on, Cardenas said they will continue to optimize and study more data. 

Some early feedback from the emergency department has been overwhelmingly positive, Cardenas and De Oca said. 

“We’ve had patients call the next day saying, ‘I really appreciate the care that you gave my mother. I haven’t experienced anything like that since COVID,'” De Oca said.

Cardenas said he was shocked at how positive the feedback was, with the department scoring in the 92nd percentile in that metric. 

The emergency department has 12 nurses on staff at any given time and one physician at all times. During high-volume times, there will be more. Interpreter services and bilingual staff are available. 

The emergency department is considered a prime location due to its easy road access and proximity to Interstate 82. It is just off Valley Mall Boulevard, near Costco in Union Gap.

“Every time we identify something that we can stabilize, treat and get to a higher level of care, it’s really emphasizing we’re here for a reason,” Cardenas said.

Goals and next steps 

The next steps for the emergency department are to continue collaboration, especially with local emergency medical services and law enforcement agencies, Cardenas said. 

Further into the year, MultiCare and the emergency department will continue to identify barriers and gaps, and work to improve their processes. 

As time goes on and more people learn about the emergency department, they are expecting more patient visits.

“Every time that we diagnose and treat something, it really validates this process,” Cardenas said. “And this process is working.”