St. Mary’s designated in top tier for trauma care
A six-year-long effort culminated Monday in an email that arrived in Jim Garvey’s inbox.
That’s how Garvey, administrator of Essentia Health-St. Mary’s Medical Center, learned that St. Mary’s had become the fifth hospital in Minnesota designated as a Level I trauma center.
The elevation from Level II to Level I — the top level bestowed by the American College of Surgeons — may make little difference to the average patient heading to the emergency room in the back of an ambulance.
But there’s more to it than a wonkish numbers game, Essentia officials say.
“It’s really about a different level of expertise,” said Dr. David Herman, CEO of Essentia Health. “So, for example, I do get letters that say, ‘I had to be flown down to the Twin Cities for this particular care. How come you don’t do that at Essentia?’ … Well, we do. … You don’t have to go down to the Twin Cities to get the care.”
St. Mary’s treats about 1,600 trauma patients each year, according to an Essentia news release.
Only a few of them still need to be referred out of town, officials said. A patient burned over 70 percent of their body likely would be transferred, Herman said. Transplants aren’t done in Duluth, Garvey added. Those were the only significant exceptions they could name.
The trauma designation system is designed to signify the level of care available at a hospital, according to the American College of Surgeons. They range from Level V, where a patient can be evaluated and stabilized before being routed to higher levels of care; to Level I, “a comprehensive regional resource center that is … central to the trauma system.”
Dozens of hospitals across the state are designated for trauma care by the Minnesota Department of Health, mostly at Level IV or V. But only 11 meet the additional requirements from the American College of Surgeons. As a Level I hospital for adult care, St. Mary’s joins Hennepin County Medical Center, Mayo Clinic Trauma Centers in Rochester, North Memorial Health Hospital in Robbinsdale and Regions Hospital in St. Paul.
St. Luke’s is a Level II trauma hospital for adult care, and St. Mary’s is Level II for pediatric care. For adult trauma, St. Mary’s offers what it has for some time, said Dr. Steve Eyer, adult trauma medical director. Board-certified trauma surgeons are not just on call but at the hospital 24/7, 365 days a year.
But to qualify as Level I, other factors are required, including research and teaching.
Essentia has a “robust” trauma research program, said Kate Dean, executive director of the Essentia Institute of Rural Health. In three years, their research has published 17 times in medical journals, she said.
On the education side, St. Mary’s is taking on one medical school graduate each year for a five-year residency in rural general surgery, she said. The first of the residents graduated in June.
St. Mary’s had been verified as a Level II trauma center since 1997, said Linda Vogel, trauma program manager. The hospital began working toward Level I six years ago, she said. The verification process takes place every three years, but the hospital didn’t seek the higher level until this year.
The American College of Surgeons sent a team of three surgeons to St. Mary’s in mid-September. They evaluated more than 200 criteria to determine whether the hospital could be upgraded to Level I, Vogel said.
Eyer said he was confident at the time that St. Mary’s had met the criteria. But the speed of the announcement was surprising. It usually takes two months before a hospital is notified, he said.
Eyer, Vogel and Garvey got the news via email on Monday, just over a month after the inspectors visited.
“We were not expecting it until mid-November,” Garvey said. “We were caught off guard a little bit.”
The St. Mary’s team is celebrating the accomplishment with a news conference today.