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NE Ga. Medical Center pursuing trauma care designation

POSTED: February 3, 2013 12:30 a.m.

For more than two years, Northeast Georgia Medical Center has been working to improve trauma care, an effort that could reduce the number of badly injured patients who must be flown to other hospitals.

The Gainesville-based hospital plans to seek a Level II trauma care designation, possibly by year’s end, making it the first such designated hospital in the Georgia Trauma Care Network Commission’s Region 2 that covers Northeast Georgia.

The nearest Level II centers to Hall are in North Fulton, Lawrenceville and Athens.

“I think (the designation) will save lives,” said Dr. Priscilla Strom, assistant trauma director at Northeast Georgia.

“The mortality rate from trauma in Georgia is 20 percent higher than other states and that’s due to the fact that right now there are ... regions without designated trauma centers,” said Dr. John H. Adamski II, trauma medical director for the hospital.

And with Northeast Georgia’s hills and valleys, making it difficult to reach some victims, “you’re already behind the eight ball in terms of transporting someone down to another facility,” he said.

Emergency responders decide “in the field,” after assessing injuries and the treatment needed based on protocols and guidelines, where to take trauma victims.

“For the most part, we try to get patients to the closest facility, but if you have a patient who’s severely injured, they need to go to the designated center that best treats them by resources and personnel availability,” Adamski said.

“Although we have a good number of that, if not all of it, here, in terms of expertise and resources, (responders) have to do what’s best for their patient.”

“That doesn’t necessarily mean that whatever (injury) that person has could not be taken care of here,” Strom said. “It just means that it might be better done in a place where you’ve got three or four orthopedic doctors on call rather than one.”

And time is of the essence, said Jack Moody, Habersham County’s Emergency Medical Service director.

People with a range of bad injuries “need to be in surgery within an hour to increase their chance of survival,” said Moody, who also serves as chairman of the Region 2 EMS Advisory Council.

Deb Battle, director of Northeast Georgia’s Trauma & Acute Care Surgery Service Line, said responders “can’t second-guess whether a nondesignated facility — if it’s us or any other hospital — has the resources available or not.”

Strom said movement toward getting the designation started about four years ago, when the hospital board “put together a study committee to look at trauma in the area.”

“Part of the mission of the (hospital) is to look at unmet needs,” said Melissa Tymchuk, spokeswoman for the Northeast Georgia Health System.

“Obviously, we had been meeting a lot of trauma needs ... so this was just continuing that ongoing look at what our region needs and what we need to provide.”

The committee, made up of board members, physicians and area residents, “came up with a recommendation ... that we should look toward improving trauma services,” Strom said.

“I’ve been here 18 years, and we’ve been doing trauma all along, but it’s never been a formalized program, and we’ve never had anybody dedicated to developing that program.”

About three years ago, the hospital tapped Strom — a general surgeon — to help with the program and hired Battle and a registrar whose job is to gather data. Later, it named Adamski as its trauma head.

The past couple of years or longer have been spent on refining standards and protocols.

“The difference has been getting rid of individual ‘silos,’” Battle said.

“Lots of good people here were doing lots of good things, but the (intensive care unit) was doing its thing and the (emergency room) was doing its thing. ... (We are) bringing all those players to one group, rather than staying in isolation of different departments.”

The challenge lies in “putting all that together to give the patient the best care experience and improve the outcome ... without having to be flown downtown or taken to another center,” Adamski said.

So, for the most part, Northeast Georgia needs to have its trauma procedures in place and flowing before it ever applies for the Level II designation, the doctors said.

Strom said she’d like to see the hospital apply for — and receive — the designation this year.

The application would go through the Georgia Department of Public Health’s Emergency Medical Services & Trauma office, which would send a team to check out the program.

“They would come and see if it’s the real deal,” Adamski said.

The designation, which would last for three years before coming up for renewal, could benefit other areas of the hospital in what is known as a “halo” effect, Battle said.

“If you can do trauma well, you can birth my baby well ... you can do other stuff well, too,” she said. “Not only are we going to impact trauma patients, but we’re going to improve care for other patients, as well.”

Even with a Level II designation, patients will still need to go to other hospitals.

For example, burn victims would go to a designated burn center and spinal cord-injury victims would go to the Shepherd Clinic in Atlanta.

The highest trauma care designation is Level I.

“To be Level I, you basically have to be an academic institution with research,” Strom said. “In the foreseeable future, we’ll never be a Level I.”

Grady Memorial Hospital and Atlanta Medical Center are the Level I hospitals serving North Georgia.

Emergency responders also will benefit from the move, Moody said.

“When you’re looking at it from an operational point of view, if we go out of our county to Grady, then that’s a four- to five-hour turnaround for us, and that’s four or five hours our county is without one of its advanced life-support units.”

Moody said the EMS council has supported Northeast Georgia Medical Center’s efforts to seek the trauma care designation.

“I don’t know that it will be a money maker for them ... but it’s just the right thing to do,” he said.


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