by Sarah Jane Tribble
Saying that emergency transport times are crucial, University Hospitals has announced plans to open a Level 1 trauma center on its main campus in University Circle.
The center, credentialed by the American College of Surgeons, will have a team of board certified trauma surgeons to treat the region’s most critically wounded – often those from vehicle accidents or gun shot wounds.
“It meets an acute need for high level trauma care on this side of town,” said Dr. Keith Clancy director of trauma services at University Hospitals.
Cleveland’s East Side has lacked enough emergency facilities since Huron Hospital closed in 2011, Clancy said.
University Hospitals had been considering a trauma center even before Huron Hospital closed, Clancy said. But since its closure the demand has been obvious: University Hospitals reports seeing about 700 trauma patients in 2014 up from 500 the year before.
Overall, the hospital reports a 40 percent increase in patients coming from the Huron market since the hospital closed.
Other reasons for University Hospitals to open an adult trauma center include the ability to keep families together after children have reported to the hospital’s Rainbow Children’s and Babies trauma center. Currently, if parents are also in need of top trauma care, they would go to another hospital.
In addition, Clancy said Northeast Ohio lacks trauma services compared to other large metropolitan areas. Toledo, for example, has three Level 1 trauma centers.
“The Greater Cleveland metropolitan area is the largest metropolitan area in Ohio that’s only got one adult trauma center,” Clancy said. “So, we certainly believe the size of the community would support a second adult trauma center.”
Shaker Heights Fire Chief Pat Sweeney was quoted in the hospital’s announcement as saying the trauma center “will be an important resource for residents who can rest assured that if the are seriously injured, the highest level of are is less than 10 minutes away.”
Cleveland's highest level of trauma patients currently go to MetroHealth Medical Center on West 25 th Street. That's a long way for an ambulance to travel from the east side.
Indeed, Cleveland city leaders raised questions about the transport times when Huron closed. And in 2012, those fears were proven true with when city officials released data showing that the average response time had increased.
Dr. Jeffrey Claridge, director of the Northeast Ohio Trauma System and director of the division of trauma, critical care and burns at MetroHealth, said Friday that response times for patients from the Huron market had increased on average by about 8 minutes. But, he added, survival rates have also increased.
“Those patients are surviving twice more likely than they were before,” Claridge said. “It’s getting the patients to a place that has done this … if anything trauma data supports that the more you do it, the better you get.
Claridge said he is concerned that having two trauma centers in the same region will hurt those survival rates.
“So, actually, having two centers doing the same volume will actually deteriorate outcomes,” Clancy said, explaining, “If I only fix two aortas all year versus four, I’m not going to be as good at that. And if our team only practices and does a 100 patients a month versus 200 a month, you get better with practice and repetition. Experience improves.”
Metrohealth serves an average of 3,000 trauma patients annually. To be certified as Level 1, a center must treat 1,200 patients annually.
Officials at University Hospitals said they are planning to work with MetroHealth to further improve survival rates. In addition, University Hospitals said it did not plan to take on burn patients, which MetroHealth has a special unit to treat.
At the MetroHealth annual meeting Friday, some did not welcome the news of an additional trauma center and instead feared what the competition might mean for the city's safety-net hospital.
Cleveland City Councilman Joe Cimperman said he hopes the proposal will “actually improve something (survival rates) that is already pretty outstanding.”
“Too often we take Metro Hospital for granted,” Cimperman said, then added that trauma is an important part of the county-funded hospital’s work in the community. “I'm hoping people are thinking about how we keep their entire continuum of care in place."
Near the end of MetroHealth's annual meeting, one staff member stood to ask the only question during the question and answer session:
“Metro is trauma,” MetroHealth Patient Experience Officer Dr. Sara Laskey said into the microphone. Then, she added, “what I want to know is, we do it so well, so why in the world is UH opening a trauma center?”
Dr. Akram Boutros, chief executive officer of MetroHealth, answered by telling the audience “we have been doing this for so long and we are one of the busiest trauma centers in the country and we do it so well, I don’t think that is the real question. I think we will be just fine,
“My concern,” Boutros said. “What I think all of our concerns should be is, what does this mean to the community?”
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