General Hospital in Calif. Wants in on Trauma Cases

Dec. 13--STOCKTON -- San Joaquin General Hospital has taken a step toward becoming a designated trauma center, a move officials said could shore up the county hospital's finances while giving local residents a better chance of surviving serious injuries.

The county Board of Supervisors last week gave the hospital the go-ahead to invest $2 million toward hiring staff and buying equipment in an effort to become the county's sole, designated trauma center by June 2013. From there, the idea is the county could further upgrade to handle even more types of traumatic injuries.

"It's a great opportunity for county residents to receive the best care, ... and it's a great opportunity for San Joaquin General Hospital to demonstrate its leadership in this area," hospital CEO David Culberson said. Studies show counties with both an organized trauma system and a designated trauma center give patients a greater likelihood of survival after being injured, he said.

San Joaquin County has neither.

And it is the only county in the state without such a plan, but officials are planning to develop one for approval by June.

Traffic accidents top the list of causes of traumatic injury in the county. The list also includes assaults, shootings and industrial and farming accidents, but many traumatic injuries are sustained in ground-level falls, particularly for the county's seniors.

If there is no trauma center when the plan is developed next year, the county's new system could require trauma patients to be taken to trauma centers in Modesto and Sacramento, officials said.

Trauma patients are taken out of the county now, too, but they are also taken to hospitals within the county. "Patients are generally taken to the nearest hospital," said Dan Burch, county Emergency Medical Services administrator.

A new, organized system would establish rules for when to bypass the nearest hospital and take a patient to a designated center set up to provide the appropriate level of care.

And there is no guarantee that San Joaquin General will be that hospital.

If more than one hospital in the county wants the designation, there will be an open and competitive process to determine which hospital will be the first choice to take trauma patients. Supervisors are scheduled to consider giving the EMS administration approval to develop a trauma plan at today's regular meeting.

There are different levels of trauma centers. Level I, the highest, includes a teaching-and-research element, according to the county. Level II is the hospital's desired goal. That would cost about $6 million in funding that could be recouped in three to five years, according to a report prepared by The Abaris Group, a consulting firm.

Hospital officials decided to take a more incremental approach, starting with a Level III center. Hospital staff estimate it would bring in about 800 trauma patients a year. With the volume and type of new patients, estimated increased revenue would be about $19.3 million a year, which is $2.5 million more than the anticipated $16.8 million increase in expenses to run the expanded operations.

Changes needed include buying more equipment, adding intensive-care unit beds and hiring more and specialized staff. Culberson said San Joaquin General is already on the right track, in part because its residency program brings general surgeons to the hospital 24 hours a day.

Doctors in the training program, along with the union representing other medical staff, helped cover the cost of the consultant's study.

The county's push for the trauma center designation marks the latest in a series of changes undertaken in recent years to fix financial shortcomings that has threatened to close the county hospital.

In recent years, the cost of operating San Joaquin General had officials wondering if the county could continue to afford subsidizing it. A dwindling overall county budget coincided with annual losses at San Joaquin General.

Hospital deficits exceeded $19 million three years ago and approached $16 million two years ago. Last year, the losses were down to around $9.7 million, an improvement that has pleased county decision makers.

"We're going from survival mode to considering bringing in a new line of business," said Supervisor Steve Bestolarides, who also is a member of the hospital's interim Board of Trustees.

"We've proven that doing something -- as opposed to doing nothing -- really makes a lot of difference."

Contact reporter Zachary K. Johnson at (209) 546-8258 or zjohnson@recordnet.com. Visit his blog at recordnet.com/johnsonblog.

Copyright 2011 - The Record, Stockton, Calif.