The constant population growth in the North Texas area necessitates a need for more health care services, including access to facilities designated to treat patients with traumatic injuries.
Although there are 284 designated trauma care facilities in Texas that can handle traumatic injury situations such as severe car wrecks or gunshot wounds, less than a quarter of those facilities are in North Texas, according to the Texas Department of State Health Services.
Dr. Ronald Stewart, American College of Surgeons Committee on Trauma chairman, said population is one of the measures used to decide if a particular region needs more trauma care centers.
“Each region is different, but trauma care designation should be guided by population growth, the locations of existing centers in the area and geography,” he said. “Our goal is to always make sure that there are the right number of centers to take care of those trauma patients.”
Of those facilities in North Texas, Tarrant County is home to five trauma care facilities—one Level I trauma center, two Level II facilities and two Level III centers.[polldaddy poll=9187300]
John Peter Smith Hospital in Fort Worth is the only Level I trauma care center—the highest designation assigned—in Tarrant County. Other designated trauma care centers in Tarrant County include Cook Children’s Medical Center in Fort Worth and Texas Health Harris Methodist Hospital-Fort Worth, which are Level II centers. Baylor All Saints Medical Center at Fort Worth and Texas Health Harris Methodist Hospital-Hurst-Euless-Bedford are Level III facilities.
Soon, Grapevine, Colleyville and Southlake residents will have another trauma center nearby. Baylor Regional Medical Center at Grapevine on Nov. 1 notified the Texas Department of Health Services of its intention to pursue a Level II trauma designation and verification. The hospital hopes to achieve the designation in 2017.
“Baylor Regional Medical Center at Grapevine is pursuing Level II trauma designation in response to the needs expressed by our community, including local fire departments and emergency medical services agencies,” said Steven R. Newton, president of North Texas Division Operations with Baylor Scott & White Health. “Becoming a trauma center will allow us to bring new, comprehensive services to those who are critically injured in northeast Tarrant County.”
Trauma care centers are used to handle the most serious medical cases in which there is typically an issue of immediate survival, whereas a standard emergency room can handle anything from sprained ankles to heart attacks.
ACS is responsible for verifying trauma facility designations.
With its Level I designation JPS, which achieved Level I in 2010, is the best hospital for trauma care because no other hospital in Tarrant County has as much equipment and specialty physicians to handle trauma patients.
The highest levels of trauma centers have access to medical specialist and nursing care, including emergency medicine, trauma surgery, critical care, neurosurgery, orthopedic surgery and radiology, as well as highly sophisticated surgical and diagnostic equipment, according to ACS.
ACS estimates that one Level I trauma center is needed per 1 million people. Although there are three Level I trauma centers in Dallas County, there is only one Level I hospital to handle all of Tarrant County, which has a population of approximately 2 million people.
“A Level I trauma center has all the resources that you need from the very beginning to the very end of treatment,” JPS Trauma Outreach Coordinator Mary Ann Contreras said. “So the patient doesn’t have to go from one facility to another.”
People injured and needing treatment must be taken to the closest and most appropriate location for treatment, Contreras said. This can be difficult in some cases because there are only 17 facilities in Texas designated as Level I. While Dallas County has four Level I facilities, the nearest Level I facility to the west of JPS is 300 miles away in Lubbock.
Contreras said every year JPS sees more than 2,800 trauma patients.
Not much varies between the criteria of Level I and Level II as both require in-house, 24/7 surgeons, neurosurgeon Saeid Aryan said.
“The only difference between the levels is that Level I has some sort of research component,” he said. “Both levels require the same amount of care and response time. Within 30 minutes, no matter where I am, I need to be able to get to Baylor [Grapevine] and be able to operate on someone.”
Lower levels of trauma centers, such as Levels III and IV, may only be able to provide initial care and stabilization of a traumatic injury and arrange for transfer of the patient to a Level I or Level II trauma care facility.
BRMCG seeks designation
For residents in and surrounding Grapevine, BRMC at Grapevine earning its Level II trauma center designation means most trauma patients would no longer have to be transported to Dallas or Fort Worth.
“This will be huge for the community,” BRMC at Grapevine Stroke Coordinator Jamee Gatzemeier said. “In a trauma accident every second counts, and to be able to have doctors here that can be ready to operate within 30 minutes can really make the difference in saving someone’s life.”
BRMC Trauma Program Manager Danielle Sherar said the hospital has been working on the ability to pursue the trauma designation for years.
Sherar said she came aboard BRMC at Grapevine’s staff in 2013 with the plans to turn the hospital, which has no trauma designation, into a Level III, but she realized it could achieve a higher status.
“We started on a pathway looking at how Baylor Grapevine functions as a hospital in general—just mainly evaluating the infrastructure in the means of space, technology, education, physician specialty resources ... those type of things,” she said. “We came to a conclusion in about April 2014 that BRMC at Grapevine already has infrastructure in place that a Level II trauma center would need to have in place.”
Sherar said not only does the hospital have the resources to pursue designation, but it also already has a high volume of trauma patients—about 600 patients per year.
As a Level II trauma facility BRMC at Grapevine will have staff dedicated to trauma injury prevention and outreach to the community, Sherar said.
She said in order to obtain designation and verification the hospital will have ACS perform a verification site visit to verify the hospital is meeting expectations of a Level II.
“Verification is a national recognition that comes from ACS, and designation is state recognition, which is actually granted from the state commissioner,” she said. “So we will stay in active pursuit status for up to 24 months. So we are not official. We will not be official until the end of our active pursuit status, which will not come until sometime in 2017.”