Medical City Plano CEO Charles Gressle said when looking at the state of Texas and the nation, a Level I trauma center is needed for about every 1 million people, meaning Collin County would need at least two Level I centers by 2040.

Until Medical City Plano received its designation, the population in the northern Dallas-Forth Worth suburbs had relied on Parkland Hospital in Dallas to serve as the lead trauma center in the region because it was the closest Level I facility. Trauma patients requiring the highest level of care would have been transferred to Parkland.

In addition to Medical City Plano, Collin County has three hospitals with lower-level trauma designations: Medical City McKinney and Texas Health Presbyterian Hospital Plano are Level III trauma facilities, and Texas Health Presbyterian Hospital Allen is a Level IV facility. Denton County has two Level III facilities—Medical City Lewisville and Medical City Denton.

Texas Health Presbyterian Hospital Plano is working on being designated as a Level II facility. The hospital has been increasing its capabilities since 2014 and has been operating at a Level II facility since September 2015.

Watson said the hospital hopes to be officially certified as a Level II facility by the end of June or mid-July.

From 2003-11—the latest data available from the Texas Department of State Health Services—trauma cases in Collin County increased by about 135 percent, and the county population increased by about 36 percent.

In Denton County, trauma cases increased by 76 percent from 2003-11, and the population increased by 34 percent during the same time period. 

Understanding trauma levels

Many injuries can be classified as traumatic, but hospital trauma levels vary, as does the level of care required for each patient.

The centers are categorized by level ranging from the highest level of care, Level I, to a Level IV facility. The requirements for the levels are designated by the state, and Level I and II facilities are also verified by the American College of Surgeons.

Level I and II centers provide the same level of care for trauma patients and have a full range of specialists and equipment available 24 hours a day. Level I trauma centers differ from Level II facilities because they have specialists in-house rather than on-call, and they also feature teaching and research.

The process to be recertified from a Level II to a Level I can take 18 months to three years. It took Medical City Plano nearly two years to receive its Level I designation from the state.

Although Level III facilities do not have the full availability of specialists that a Level I or II facility has, they still have the resources for emergency surgery and intensive care for most trauma patients. Surgeons and specialists are on call and are required to respond within 30 minutes.

The staff of a lowest level of trauma facility, Level IV, provides an initial evaluation, stabilization and diagnostics, but based on the severity of a case, it is likely to transfer the patient to the nearest trauma center with a higher designation.

How hospitals work together

In a trauma situation, paramedics determine the level of patient care needed, and the patient is subsequently transferred to the nearest trauma facility that can provide the needed care, Gressle said.

All nearby trauma centers work together as part of a regional trauma system, and representatives from each hospital take part in the North Central Trauma Regional Advisory Council.

In large-scale emergency situations, such as a tornado touchdown causing many injuries, NCTRAC members are able to use a computer software system to update other hospitals and trauma centers on the number of beds available and the hospital saturation—or capacity—level.

Plano editor Daniel Houston contributed to this report.