FRENCH CAMP — San Joaquin General Hospital has been put on notice that its official designation as a trauma center is in jeopardy if it does not comply with mandated standards by Oct. 10. The hospital’s top administrator said Tuesday everything possible is being done to meet that deadline.
The county’s only trauma center hospital has been found out of compliance with several staffing and management requirements established by state and federal law as well as the American College of Surgeons.
As a result of this notification, the local emergency medical regulator on Tuesday implemented a temporary change in trauma patient destinations that limits the geographic area from which major trauma patients in San Joaquin County will be sent to San Joaquin General.
Patients with major trauma, for example from a car crash, severe accident or gunshot wound that occurs within the area bounded by Eight Mile Road on the north and Highway 120 on the south along the Interstate 5 corridor will continue to be transported to San Joaquin General.
Adult trauma patients from the region north of Eight Mile Road will be transported to Kaiser Medical Center South Sacramento or the next closest trauma center. Trauma patients south of Eight Mile along the Highway 99 corridor and south of Highway 120/Interstate 205 will be sent to either Doctors or Memorial medical centers in Modesto or the next closest trauma center.
This temporary arrangement will expire at 7 a.m. Oct. 10, according to Dan Burch, administrator of the San Joaquin County Emergency Medical Services Agency.
“We’ve coordinated this with the EMS agencies in Sacramento and Stanislaus counties and they have agreed with the destination changes. If they get overwhelmed, we will reconsider,” Burch said.
Back in the summer of 2013, the 196-bed, county-owned public hospital was the first and still only hospital in the county to earn the designation as a Level III trauma center by creating a trauma-response team with a surgeon available 24 hours a day on 15 minutes’ notice.
To become a Level III trauma center, San Joaquin General had to demonstrate an ability to provide prompt assessment, resuscitation, surgery, intensive care and stabilization of injured patients and emergency operations, according to the American Trauma Society.
It was estimated at the time that the hospital’s trauma load would rise from an average of 50 patients a month to 115 patients a month.
That monthly average has now risen to about 200 patients. Of those, Burch estimates about 50 will be diverted to Kaiser South Sacramento in the next month while another 75 will be sent to the Modesto trauma centers, leaving San Joaquin General to treat an estimated 75 major trauma cases through Oct. 10.
“We felt that by reducing their workload, it would give them the best chance to achieve compliance,” Burch said Tuesday.
His agency is charged with monitoring San Joaquin General’s performance as a trauma center. Prior to issuing the formal notice of compliance, Burch said he met with hospital officials on several occasions to work on issues.
“It is our hope that San Joaquin General Hospital meets all standards and everything is corrected by October 10, and we can move forward,” Burch said.
Specifically, the hospital is out of compliance in the management of trauma patients in the intensive care unit, with nurse staffing and attending surgeon oversight in the emergency department, not adequately staffing the radio room with qualified personnel to communicate with paramedics in the field, and out of compliance with delays in taking major trauma patients to the operating room, according to Burch.
The EMS administrator said it was his desire to have adequate trauma services provided in San Joaquin County. To that end, he believes the county hospital can return to compliance.
“Yes, I think what is required can be achieved if they have the willingness to achieve it. It’s all a matter of leadership. It is our goal to see San Joaquin General Hospital succeed. This county desperately needs to have a Level III trauma center,” he said.
San Joaquin General’s chief executive officer, David Culberson, said Tuesday he has every intention of bringing his trauma center back into compliance, noting that the higher-than-anticipated patient load has been at the center of its problems.
“Sometimes trauma patients are coming in waves, six or seven in an eight-hour period, and that’s not too infrequent,” Culberson said, adding that it puts a considerable strain on hospital resources.
“We’re planning on maintaining trauma services here for many, many years to come, and planning on adding adequate staffing both on the physician side and the nursing side. We have two operating rooms available at all times, qualified nursing available and pre-hospital care is available at all times. And we’re still busier than ever,” Culberson said.
His goal is to ensure that appropriately trained and qualified personnel are available to take care of the number of patients expected.
In fact, he said San Joaquin General remains on track to rise to a Level II trauma center by September 2017, providing additional medical specialties including orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care, along with a dedicated magnetic resonance imaging, or MRI, scanner.
“We’re pretty excited about maintaining trauma services here,” Culberson said.
— Contact reporter Joe Goldeen at (209) 546-8278 or firstname.lastname@example.org. Follow him at recordnet.com/goldeenblog and on Twitter @JoeGoldeen.