Trauma center efforts advance - January 15, 2014

Courtesy of NWI Times

At least three local hospitals are playing a role in the state’s effort to make trauma care accessible for all Hoosiers.

Hospitals with Franciscan Alliance and Methodist Hospitals are seeking trauma designation.

There are no trauma centers in Northwest Indiana. Those suffering traumatic injury, such as a gunshot or stab wound or blunt force trauma, usually are transported to hospitals in Oak Lawn, Fort Wayne or Indianapolis, all of which have trauma centers.

The American College of Surgeons recommends Indiana should have 15 or 16 trauma care centers. The state has 12, including provisional facilities, that are considered Level I, II or III trauma care centers, said Art Logsdon, assistant commissioner for the Indiana Health and Human Services Commission.

“There’s no question there’s a need for a trauma center in Northwest Indiana,” Logsdon said. “Probably multiple trauma centers could thrive.”

Aside from the gun and knife wounds that come to mind with the word “trauma,” the region also has a confluence of interstates that lead to accidents, he said.

“We anticipate receiving Level III Trauma Center designation at our Northlake campus in Gary the fall of this year,” said Jennifer Mullen, trauma program coordinator at Methodist Hospitals.

Level I is the most advanced level. Level III centers require general surgeons to be on staff and can provide, “prompt assessment, resuscitation, emergency operations and stabilization and also arrange for possible transfer to a facility that can provide definitive trauma care,” according to the American College of Surgeons.

Methodist Hospitals is working on its application to be considered “in the process of American College of Surgeon trauma verification.” When it submits its “in the process” application, the hospital will be legally recognized by the state to function as a Level III center, Mullen said.

The hospital established a trauma services department by appointing trauma fellowship-trained Dr. Reuben Rutland as trauma medical director, naming certified emergency nurse and trauma nurse specialist Mullen as trauma program coordinator and Latasha Taylor as trauma program data coordinator.

Franciscan St. Margaret Health hospital in Dyer and Franciscan St. Anthony Health hospital in Crown Point have applications pending that are expected to go in some time this month, said Franciscan Alliance Northern Indiana Region CEO Gene Diamond.

Terre Haute and Bloomington don’t have trauma centers, and other portions of the state handle traumas the way Northwest Indiana handles some, by sending them across the state line, Logsdon said.

Southern Indiana trauma cases go to Cincinnati, and those at the far southern end of the state are taken to Louisville, he said.

Cost is a hindrance, Logsdon said.

“To be a trauma center, you’ve got to have advanced equipment, you’ve got to have staff, and you’ve got to have them 24/7,” he said.

The Northwest Indiana Regional Development Authority accepted proposals from contractors interested in preparing feasibility studies gauging the need for a trauma center and academic medical center in Northwest Indiana.

The contract was expected to be awarded Jan. 3, but that has been delayed, said Dave Wellman, communications manager for the RDA. Senate Bill 585, known as the “Gary bill,” included funding for the feasibility study.

State officials toured Indiana in 2012 and 2013, discussing trauma care in each of the 10 health preparedness districts. Another state tour is planned for the summer, as are several educational outreach efforts, Logsdon said.

“Indiana really doesn’t have a trauma system,” he said. “We certainly don’t have an integrated trauma system.”

He said 42 other states have an integrated trauma system, meaning trauma and emergency medical services programs are housed in the same agency. In Indiana, the groups talk and attend each other’s meetings, but they are housed separately, he said.

The EMS function is done through the Department of Homeland Security, and trauma is handled through the state Health and Human Services Commission.

“We’ve been able to collect data from EMS providers,” Logsdon said. “We want to ultimately integrate EMS and hospital data to get a longitudinal picture of trauma data.”

A trauma registry rule that took effect in November in Indiana requires all EMS transport agencies, hospitals and rehab hospitals to report data to the state Health and Human Services Commission.

In 2012, the EMS triage and transport rule set the requirement that the most serious patients must be taken to a trauma center, unless the closest center is more than 45 minutes away.