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Hospital seeks Level 1 trauma status

Thursday, June 15, 2006
Pioneer Press

When Merle and Melva Kingman were struck by a car while crossing Central Street in Evanston in September 2003, paramedics couldn't take the elderly couple to nearby Evanston Hospital, as they would have a few months earlier.
Because the hospital had elected earlier that summer to be downgraded to a Level II trauma center, paramedics took the elderly victims to St. Francis Hospital in south Evanston, where they later died of their injuries.
But Evanston Hospital may again become a destination for paramedics within the next year, transporting victims of serious blunt traumas, penetrating injuries and accidents suggesting the patient might lose a limb or be paralyzed.
Evanston Hospital President Raymond Grady announced Tuesday the hospital will reapply for Level I trauma status with the Illinois Department of Public Health.
When hospital officials elected to downgrade to Level II status in mid-2003, they said their trauma teams handled too few Level I cases to justify the high staffing costs and keep their skills sharp and well-practiced. At the time, the Evanston Hospital emergency room was handling about 30 patients with Trauma I injuries per year.
But hospital administrators say the number of trauma patients in the North Shore area has been larger than originally estimated.
"This decision, made after careful analysis and consideration, acknowledges the feedback we have received from patients, their families and elected officials in recent years," Grady said.
"Trauma victims deserve to have the option of being taken to the nearest Level I trauma center without further jeopardizing their already compromised health by having to be transported longer distances," he said.
Grady said the hospital has received commitments from four trained trauma surgeons to provide around-the-clock coverage, as required by the Illinois Department of Public Health.
To maintain a Level I trauma designation, a hospital must have a trauma surgeon on the premises 24 hours a day, seven days a week. Moreover, specialty surgical services such as neurosurgery, reimplantation and eye surgery must be available within 30 minutes from the time the patient is classified.
Glenbrook and Highland Park hospitals, which also are a part of Evanston Northwestern Healthcare, will maintain their Level II status. All three hospitals will continue to provide care to victims of heart attacks, strokes and serious automobile accidents with multiple breaks and fractures.
For the past three years, St. Francis Hospital has been the only Level I trauma center between Illinois Masonic Hospital, on Chicago's North Side, and the Wisconsin border. The nearest Level I hospital to the west is Advocate Lutheran General Hospital in Park Ridge.
Given that Level I trauma centers are far apart in many places, Evanston Fire Chief Alan Berkowsky said Evanston will be exceedingly fortunate to again have two such hospitals within its boundaries.
"It seems a little awkward to drive past a hospital such as Evanston to go to another hospital," Berkowsky said, "but it is really kind of amazing, because there are some places where people have to travel long distances to get to a Level I trauma center.
"Having one is an incredible resource for us, and having two is twice as good."
A group of medical directors from Region 10 Trauma Centers will consider the need for a Level I center on July 11. If a majority of the directors approves, the application will be submitted the following day to the emergency services division of the Illinois Department of Public Health, said Mark Schroeder, director of community relations for Evanston Northwestern Healthcare.
Schroeder said area hospitals have reported an increase in "bypasses" -- that is, times when paramedics bypass the nearest hospital because the hospital's monitoring systems are at capacity due to the volume of cases.
"We believe we can alleviate the burden," he said.
Restoring the Level I designation also makes sense at a time when Evanston Hospital regularly participates in crisis drills to practice for the possibility of a massive disaster with many victims, he said.

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