Methodist sees 60 percent increase in trauma cases - January 8, 2016

Courtesy of The Post-Tribune

By Christin Nance Lazerus • Contact Reporter • Post-Tribune

January 8, 2016, 5:49 PM

The emergency room at Methodist Hospital Northlake has always been a busy place, but since becoming an “In the Process” Level III trauma center in 2014, it’s seen a 60 percent increase in trauma cases.

Trauma coordinator Jennifer Mullen said the increase — from 540 patients in 2014 to 840 patients in 2015 — has meant an increase in staffing in the emergency department.

“In general, we’re a busy ER, but when you add trauma on top of that, that’s a lot of health care,” Mullen said.

Methodist attained the designation in August 2014, which allowed it to receive patients beyond its typical reach of Gary and within a 45-mile radius. Previously, many patients outside of Gary would be transported Illinois, South Bend, or even Indianapolis because they had designated trauma hospitals.

Mullen said 40 percent of Methodist’s trauma patients come from outside Gary, sometimes as far south as Jasper County and as far east as LaPorte.

“We’ve definitely seen more interesting mix of blunt injuries,” Mullen said. “Before it was mainly motor vehicle injuries, now we see ATV accidents, a patient that was kicked by horse, and farming accidents.

“This summer was particularly busy, with a lot of motorcycle crashes and pedestrian vs. car injuries.”

The proximity of a trauma center can matter immensely as patients can have up to a 30 percent better survival rate if taken to a trauma center rather than a regular hospital.

Under Level III status, Methodist must follow certain requirements, such as patients must be seen by a doctor within 30 minutes of arrival and must have a surgeon on call.

Becoming a verified trauma center

The state started expanding its trauma network in 2013 with the “In the Process” Level III designation. Currently, Indiana had 11 verified trauma centers and eight “in process” Level III trauma centers, including Methodist Northlake and the newly approved Franciscan St. Anthony Health in Crown Point.

Hospitals have two years from the date that the EMS Commission grants them “in process” status to become a verified trauma center by the American College of Surgeons. Methodist had its consultation visit — a practice run where ACS staff observe the program and give recommendations — in October, but the final visit and approval won’t likely take place until the second half of 2016, Mullen said.

Art Logsdon, Assistant Commissioner at the Indiana State Department of Health, said the program is going well so far, but three hospitals did have to withdraw from the program.

“At the one-year mark, hospitals go through another review — submit a call sheet, list who is responding, stuff like that,” Logsdon said. “That review resulted in three of the hospitals withdrawing.”

Logsdon said the state serves as a resource for hospitals that are interested in becoming a trauma center, by connecting them with a verified trauma center to answer questions or analyzing trauma data in a specific community.

“There’s nothing we can do to require a hospital to become a trauma center,” Logsdon said. “But there are clearly parts of the state where citizens live beyond a 45-minute trip to a trauma center. We’re aware of those and we offer education opportunities, like our statewide trauma tour each summer.”

Improvement and community outreach

Hospital staff meet monthly as part of the hospital’s Trauma Quality Program to review trauma cases and determine if they can improve any processes, Mullen said. The program started about eight months before Methodist received its trauma designation, and Mullen said it’s helped the hospital write new regulations.

“It’s really the foundation of how we use data to progress,” Mullen said. “You don’t know what you don’t know. Once we started measuring how long it takes to get to the operating room, we looked at faster movement.”

Each trauma center is required to have a Performance Improvement and Patient Safety (PIPS) program, which uses data from the hospital’s trauma registry to identify areas of improvement. The state’s performance improvement subcommittee, which is made up of members from all of the trauma centers in Indiana, has several goals for 2016, including increasing the number of hospitals reporting data to the state trauma registry and decreasing the time that it takes for trauma patients to receive definitive trauma care.

Analyzing the most common causes of injuries seen at Methodist — motor vehicle crashes, falls and gunshot wounds — also presents opportunities for community outreach. Mullen has done distracted driving presentations at local high schools and talked about how to avoid falls at the YWCA. Emergency department director Dr. Mike McGee — through his Project Outreach and Prevention (POP) on Violence program — has talked with teens at the Lake County Juvenile Center about the importance of turning their lives around, and Mullen said they hope to reach out to more groups on that topic.

Mullen said patients have provided good feedback on their experience and the hospital has built good relationships with Northwest Indiana EMS providers.

The process of becoming a verified trauma center presents its challenges, but Mullen said that Methodist is always looking at ways to improve.

“It’s definitely a growing process,” Mullen said. “How you start out is not always how you end up. I feel like we’re on a great track, and I’m always pushing and asking ‘Is this best can do?'”