Newswise — CLEVELAND – The Level I trauma center at University Hospitals Cleveland Medical Center has received verification from the American College of Surgeons (ACS), the organization that establishes criteria ensuring trauma care capability and institutional performance.
The Level I trauma center opened late in 2015 and has been operating under provisional status, as is customary until the ACS could conduct its extensive review of the program earlier this year and issue its final verification, which was in May.
“Obtaining a Level I verification status indicates the institution’s capability of providing comprehensive care for every aspect of injury,” said Nathaniel McQuay, MD, Director of Trauma Services and Acute-Care Surgery at UH Cleveland Medical Center. “Level I trauma centers also have a major responsibility for providing leadership in education, research, and system planning thereby ensuring the continuing presence of adequate resources in order to provide efficient, high level care for the management of time sensitive injuries.”
When UH announced the creation of the Level I trauma center, it was part of an initiative to create a coordinated regional trauma network of UH hospitals. UH worked with local municipalities across Northeast Ohio to develop the Level I center, as well as its expanded trauma services across the region.
The Level I trauma center coordinates with an extended regional trauma system that includes four existing Level III trauma centers at UH Geauga Medical Center, St. John Medical Center in Westlake, Southwest General Health Center in Middleburg Heights, and UH Portage Medical Center in Ravenna. Additionally, UH Rainbow Babies & Children’s Hospital, on UH’s main campus, is the region’s only Level I center for children and adolescents. The UH Rainbow center has been a continuously verified Level I pediatric trauma center by the ACS for 25 years. The UH regional trauma network provides better coordinated care because participating facilities have the same electronic medical record system, shared clinical processes and consistent staff training.
“Traumatic injury is a major public health issue in the US and Northeast Ohio. It is the major killer of young people, ages 1 through 44, and results in the largest amount of years of productive life lost, more than cancer or heart disease,” said Glen Tinkoff, MD, the System Chief of Trauma and Acute Care Surgery at UH who also served for 18 years on the ACS’ Committee on Trauma. “By investing in comprehensive trauma care system-wide, UH is making a major commitment to providing all trauma victims the appropriate level of care they require and deserve and doing so efficiently and effectively.”
From Jan. 1, 2016 through April 30, 2017, the Level 1 adult trauma service at UH Cleveland Medical Center has evaluated 3,300 trauma patients, admitted almost 2,500 injured patients to the hospital, and responded to more than 1,900 activations of the trauma team to evaluate patients coming into the Emergency Department to determine their severity.
“UH Cleveland Medical Center also is taking a lead role in community outreach to curb violence and reduce returns to the Emergency Room,” said Dr. McQuay. “UH staff meet with patients and families in the hospital, as well as visit schools and church groups to identify and discuss economic, social and other issues influencing personal choices and behaviors. The goal is to confront, address, and prevent future violence to benefit the community.”
UH is a member of the Northern Ohio Trauma System (NOTS), which also includes MetroHealth Medical Center and the Cleveland Clinic, to ensure patients are rapidly triaged and taken to the appropriate level of care for trauma and other emergencies.
UH also is working with local emergency medical service teams to help equip community response teams with potentially lifesaving equipment to use before arriving at hospitals because time is of the essence in dealing with trauma and other critical emergencies. For example, UH has helped provide equipment and training that enables local EMS crews to treat heart attack and stroke patients en route to hospitals.
Level I trauma centers provide the highest level of total care for every aspect of injury – from prevention through rehabilitation. The new UH facility provides residents in Northeast Ohio – especially the east side of Cleveland – improved access to the highest level of trauma services.
Until the UH Level I trauma center, compared to many similarly sized and smaller cities, Cleveland was underserved. Greater Cleveland, with 2.1 million people, had only one Level I trauma center for adults on Cleveland’s west side. By comparison, St. Louis had three adult Level I trauma centers. Columbus and Cincinnati each had two. Greater Toledo, which is about one-third the size of Greater Cleveland, had three. Cleveland had no Level I adult trauma center on the east side.
According to a 2012 study by the City of Cleveland, travel times from Cleveland’s east side neighborhoods to a trauma center increased by an average of more than 5 minutes after Huron Hospital closed in 2011. These increased travel times impacted EMS transport times throughout the city.
The Level I center at UH Cleveland Medical Center coordinates care with UH’s Level III trauma centers and others in the area. Level III centers provide resuscitation and stabilization of trauma patients, can admit single-injury patients, and transfer patients with more complex injuries to the Level I center at UH Cleveland Medical Center.
The system recruited trauma surgeons Drs. McQuay and Tinkoff, along with six general surgeons, three orthopedic surgeons, a hand surgeon, an additional neurosurgeon, four additional anesthesiologists, and additional nurses in anesthesia and intensive care. Also, operating rooms and a dedicated trauma intensive care unit were added.
Elements of a Level I trauma center include: 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedics, neurosurgery, anesthesiology, emergency medicine, radiology, plastic surgery, oral and maxillofacial, and critical care. Level I centers also provide leadership in prevention and public education to surrounding communities, incorporate a comprehensive quality assessment program and operate an organized teaching and research effort to help direct new innovations in trauma care.
ACS is a national scientific and educational association of surgeons that maintains a voluntary verification program for trauma centers.
About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 18 hospitals, more than 40 outpatient health centers and 200 physician offices in 15 counties throughout northern Ohio. The system’s flagship academic medical center, University Hospitals Cleveland Medical Center, located on a 35-acre campus in Cleveland’s University Circle, is affiliated with Case Western Reserve University School of Medicine. The main campus also includes University Hospitals Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; University Hospitals MacDonald Women's Hospital, Ohio's only hospital for women; and University Hospitals Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, including cancer, pediatrics, women's health, orthopedics, radiology, neuroscience, cardiology and cardiovascular surgery, digestive health, transplantation and urology. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to Harrington Discovery Institute at University Hospitals – part of The Harrington Project for Discovery & Development. UH is the second largest employer in northern Ohio with 26,000 employees. For more information, go to UHhospitals.org.