March 23, 1995 in Washington Voices

Saving Lives Valley Hospital And Medical Center Seeks Designation As Trauma Center To Better Serve The Community

Emi Endo Staff writer

Valley Hospital and Medical Center has invested in new equipment to upgrade its emergency room. The hospital’s doctors have received special training and all nurses have been certified to handle trauma cases.

The hospital hopes to earn state designation this year as a trauma center - and to save the lives of seriously injured Valley residents for many years to come.

But if you’re shot, stabbed, badly burned or critically injured in an auto accident here in the Spokane Valley, it’s possible you’ll end up somewhere other than at Valley Hospital.

Instead, the ambulance might take you downtown to either Sacred Heart Medical Center or Deaconess Medical Center. Those two hospitals have applied to the state for a shared designation as a major trauma center - meaning they would treat the Spokane area’s most serious injury cases.

A Washington state law that aims to improve trauma care will limit the number of hospitals with trauma units. Health officials believe that surgeons and assistants at a smaller number of trauma centers would gain more experience and be better equipped to save the lives of the most critically injured people.

A network of trauma care providers would be established. Valley Hospital, as a trauma center, and the major trauma center downtown would play different but equally important roles within that network.

“I think it’s great for the community,” said Janet Griffith, director of the state Emergency Medical Services and Trauma System. “The patients are going to get the appropriate care - that’s the bottom line.”

Valley Hospital is seeking a lower level of trauma center designation than is proposed for the downtown hospitals.

The state plans to survey the Spokane hospitals in May and designate all the Eastern Washington trauma centers a few weeks later.

Jim Nania, emergency room director at Deaconess, said the new system will change where some patients are treated.

“Currently, major injuries go to the closest hospital,” he said.

But what if you’re horribly injured in an accident in the Valley? Weather and time permitting, Nania said, you would be taken to one of the downtown hospitals.

However, if there isn’t time, you might be transported to Valley Hospital. Or, if there is time, you might be taken to Valley Hospital to be stabilized by the trauma team there before being transferred downtown.

“We do not want to keep a patient beyond our scope,” said Edna Camp, assistant vice president of patient care services. “We’re very aware of unnecessary cost of duplicating services.”

As it is now, Valley Hospital sends the most seriously injured patients to one of the downtown hospitals, she said.

Valley Hospital is not equipped to handle patients who need a heartlung machine or acute dialysis, Camp said.

Spokane hospital officials say it is difficult to predict just how the change will affect the number of critically injured people treated at Valley Hospital or instead taken downtown.

In a typical year, as many as 20 of Valley Hospital’s most critically injured would-be patients might be taken instead to a major trauma center downtown, officials said. But because of the improvements in equipment and staff training at Valley Hospital, some trauma patients who now are being sent downtown could instead end up at Valley Hospital.

The effects of the new system won’t be seen until it has been in place for a couple of years.

“It really puts in synch - for our whole city - a process for trauma,” said Kay Lewis, Valley Hospital’s vice president for patient care services.

“Yes, we probably will lose some patients (to other hospitals),” she said. “That’s just something we’ll live with.”

Deaconess Medical Center’s Nania said, “The most severely injured patients will be directed toward the highest-level facilities. That might direct some patients away from Valley Hospital.”

On the other hand, Nania said, “If Valley Hospital is successful as a (lower-level) designation, that says a lot about their capability to serve.”

Valley residents who currently use to Deaconess or Sacred Heart may opt for their local hospital once they recognize the hospital’s commitment to improving trauma care, he said.

“Theoretically, as our Valley population grows, patients with significant injuries - maybe not the most severe - are going to more often go to Valley Hospital,” Nania said.

The state health department projects about 263 major trauma cases this year in Eastern Washington, and 554 moderate cases.

The downtown hospitals already receive a larger percentage of trauma patients, Greenberg said. That’s because of the location of the hospitals, the air transport system and the resources available there.

Whether Valley Hospital will lose revenue by losing patients remains to be seen.

Generally, the higher the percentage of penetrating wounds, such as stabbing or gunshot wounds, the greater the burden to the hospital, Camp said.

“Trauma isn’t a business to make money anyway,” she said.

While Valley and other hospitals are improving their trauma care, they’re also working to prevent the need for these services.

“The bottom line focus is, ‘We don’t want your business,”’ Greenberg said.

Valley Hospital plans to make prevention and education important elements of its role as a trauma center, Lewis said. The hospital plans school and community safety programs with an emphasis on trauma, she said.

All trauma centers will be linked by computer so hospitals can track trauma patients. Patients taken from hospital to hospital will have their records updated along the way.

State officials can then analyze the patient’s entire history, from emergency medical service response through rehabilitation. This analysis will also enable trauma centers to take a broader look what works and what doesn’t in the trauma system.

The state will survey the trauma centers every three years to make sure they meet the standards for their levels.

“For Valley Hospital, (the new system) is an opportunity for us to formalize and strengthen the care we’ve always been giving,” Camp said. “We’ve had a trauma team in place forever.

“The beauty of the system is: You get the patient to the right facility.”

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