Prepping for Trauma
October 8, 2011 · 1 Comment
Twenty years ago, NorthBay Medical Center was the defacto trauma center for Northern Solano County. Back then, physicians were required to handle emergency calls 24/7, in addition to their regular practices. It just went with the territory. Because the burden was so great, many doctors didn’t mind when helicopter companies offered to swoop in and deliver trauma patients to bigger, metropolitan hospitals.
But not Pete Zopfi, D.O.
NorthBay Healthcare’s new trauma medical director has always thrived in urgent situations. He trained at a large hospital in Dayton, Ohio, and saw more than his fair share of tractor and hay baler accidents, as well as motor vehicle accidents and the "knife-and-gun club" variety. He learned to be ready for anything at any time.
But one doctor does not a trauma department make. Other changes on the medical landscape had to occur in the past decade to bring NorthBay Healthcare to where it is today: Poised to answer all except the most extreme trauma calls.
Now a team of trauma-trained community surgeons, backed by a full field of hospitalists, stand at the ready to deal with everything from broken bones and dog bites to gun shot wounds and industrial accidents.
"Many of the advanced services we already provide, from our Chest Pain Center to our Stroke program, make the transition in trauma planning seamless," says Daman Mott, director of Emergency Services and Trauma.
Actually, NorthBay’s Emergency Department staffs have always handled any trauma that arrived at their doors. Some patients just walk in, while others are driven to one of the local facilities.
But when 9-1-1 is called, and patients are picked up by ambulance or helicopter, emergency medical service workers follow protocol, and some conditions require that patients be sent out of the area for help.
NorthBay has been in the planning stages for several years now to become a Level III trauma center, which means that all but the most serious neurological cases can be handled locally.
"It’s going to make a big difference to the people of Solano County," says Dr. Zopfi. "When you have to leave the county, the travel time alone may take 30 to 40 minutes away from the golden hour of treatment time. We’re developing a system in which people will receive high quality trauma care quicker and more efficiently."
Dr. Seth Kaufman agrees. As NorthBay’s Emergency Department Medical Director he sees a strong benefit for Solano County trauma patients.
Because We Care
"A protocol-driven, well-trained trauma team will improve care by decreasing the ‘door-to-operating room time’ and expanding the available services to the trauma patient," he says. "The hospital is fulfilling its mission of creating excellent, comprehensive trauma care in a county that needs it. We are taking the lead because we care about the community and therefore believe that long transport times do not benefit the patient."
Developing the system has involved a number of mock drills, involving real people playing the role of patients, and simulated patients or mannequins, which are programmed for the exercise. "It may be a mannequin, but it can be as realistic as the real world. You have to think on your feet and respond quickly or you’ll lose your ‘patient,’" says Zopfi.
Even though the Level III trauma facility will only exist at NorthBay Medical Center, at least in the beginning, Mott wants his entire Emergency Department team—52 staff members at VacaValley Hospital and 70 at Fairfield—to be fully trained and capable of stepping in. "If someone gets hurt and has to be taken to VacaValley Hospital because it’s the closest, I want them to receive definitive care and appropriate, timely transfer to the closest trauma center," he says.
The training, he admits, will probably never stop. "Trauma is like a highly skilled dance; the choreography is essential, so you drill and practice
to develop muscle memory and get everyone in synch, so they anticipate their next move because they all have the experience."
"We’re really coming together as a team," says Dr. Zopfi. "We’ve always handled trauma and we’ve done it really well, but now the focus is on making sure everyone knows what to do and when to do it. We’re getting even more efficient as we all understand our roles."
That transformation is a familiar sight for Vice President and Chief Nursing Officer Kathy Richerson. She joined NorthBay in 2000, after helping Mercy San Juan in Sacramento become a Level II trauma center. She knows the challenges well.
First, NorthBay had to make certain that becoming a trauma center was in the best interest of everyone: the patients, the community, staff, physicians and for the nonprofit NorthBay Healthcare.
Fiscally Responsible Decision
"Trauma has to be a fiscally responsible decision for the organization. We have to weigh the mission to the community and our ability to sustain an intense, highly technical program," she explains.
A study made a number of years ago didn’t support the plan, but when it was revisited in 2009, not only was there a need, but a vast deficit of appropriate care in Solano County. "We see trauma patients now," says Richerson. "But many get sent out to other centers, far away from their families. We want to be able to help them here. We are responding to the needs of our community."
In fact, NorthBay Healthcare was the first hospital in the area to declare an interest in establishing itself as a trauma center.
The decision to use a team of hospitalists—doctors with a variety of specialties, from intensive care to orthopaedic and general surgery—proved vital, says Richerson. "We are cutting edge in our use of these specialists," she says. "These physicians are getting the chance to do the kind of work they love and we’re getting the coverage we need to ensure all patient needs are met."
Combine those trauma-trained community surgeons and hospitalists with Emergency Department physicians, nurses, techs and support staff who have now all been trained to handle trauma cases and you have a team that’s not only excited about the prospect, but capable to respond at a moment’s notice.
"Trauma is a reality," says Richerson, "not a new line of business for us. We see it every day. But by meeting the requirements of state and national trauma standards, the patients will be able to stay here and we will deliver the very best and most current treatment."