Monday, April 23, 2018
Opinion

Column: New trauma centers saving lives in Florida

Dereck Welch nearly bled to death before arriving at the new trauma center at Ocala Regional Medical Center. Doctors say he likely wouldn't have made it if the ambulance had needed to drive farther.

After Nancy Romeo's son was hit by a dump truck, she says, the Ocala center saved her son's life.

Sarah Ziebro might have faced a difficult hospital recovery, with her family far away and unable to visit often, if not for the new trauma center at Blake Regional Medical Center, closer to home.

As we look at the benefits of Florida's new trauma centers, these are the voices we should listen to: our patients. (All the patients listed above were quoted in Florida newspapers after testifying at community trauma hearings.) The fundamental question does not involve the bottom line for hospitals. It's about the bottom line for patients: Are we saving more lives?

The evidence shows that the new centers are doing exactly that.

In 2010, USF Health teamed up with several HCA-affiliated hospitals to form a public/private trauma network in Florida. The network included one existing center, Lawnwood Medical Center in Fort Pierce, and proposed new trauma centers at Blake Medical Center in Bradenton, Regional Medical Center Bayonet Point in Hudson, Orange Park Medical Center in Orange Park, and Kendall Regional Medical Center in Kendall.

The state recognized the need and granted these centers provisional status in 2011, with Blake and Bayonet Point recently receiving fully verified status. Ocala Regional Medical Center joined the network and got provisional status last year.

Advocates for more established trauma centers have argued that smaller trauma centers may not match larger centers' safety records. But the data show that Florida's newest trauma centers are just as safe — and even perform better in some categories.

So far, the trauma centers of the USF/HCA Trauma Network have treated more than 7,600 patients. The survival rate among those patients is virtually the same — 96.2 percent compared to 96.4 at other trauma centers. The complication rate is significantly lower: 24.6 compared to 26.1 percent.

Having been the former CEO of an inner-city, safety net, academic Level I trauma center, I understand the burden of indigent care on hospital operations.

I also came to appreciate the necessity of having non-safety net hospitals assume their share of indigent care. All USF/HCA facilities have assumed a share of this burden to offset the impact on safety net hospitals. We're caring for a slightly higher number of uninsured patients, 17.8 percent compared to 15.2 percent at other trauma centers.

The network recognizes the need for experienced medical directors to lead these programs. We have successfully recruited highly qualified personnel, a number of whom have had over 20 years' experience at American College of Surgeons, Committee on Trauma verified Level I or Level II centers. All are board certified by the American Board of Surgery and have Certificates of Added Qualifications in Surgical Critical Care.

The new trauma network will also serve as a vital source of research data, so that we can learn more about what types of procedures provide the best outcomes. This is the benefit of creating a network with an academic medical center; the research gains may ultimately help people far beyond Florida's borders.

Finally, there is a clear need for increased trauma care in Florida. Since 2005, our state's population has grown by more than 3 million people. Unfortunately, that also has meant that more people need trauma care. Florida has gone from seeing 18,000 trauma patients per quarter to more than 32,000. The state's trauma centers have not kept pace; the percentage of trauma patients being seen at trauma centers, where they have the best outcomes and access to the most specialized care, has dropped by 5 percent.

Those numbers speak for themselves. Nobody ever wants to need trauma care. But when Florida residents do need emergency help, we hope that their chances will be better because we are here.

James M. Hurst, M.D., FACS, is the medical director of the USF/HCA Trauma Network and a professor of surgery at USF Health. He wrote this exclusively for the Tampa Bay Times.

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