Ga. hospital's trauma call faulted; DeKalb Medical defends exit from state network - @ JEMS.com


Ga. hospital's trauma call faulted; DeKalb Medical defends exit from state network


 
 

Chandler Brown | | Monday, June 25, 2007


ATLANTA, Ga. The decision by DeKalb County's lone trauma center to opt out of the state trauma network will have deadly consequences, the doctor who oversees it said Thursday.

"People are going to die in the back of the ambulance on the way to Grady, that's the bottom line," said Dr. William Hardcastle, DeKalb Medical's chief of trauma.

On July 1, DeKalb Medical will no longer be part of the state's trauma network, which means DeKalb paramedics will send most patients with traumatic injuries such as gunshot wounds and broken bones to hospitals outside the county.

Driving to the nearest trauma centers --- Grady Memorial Hospital and Atlanta Medical Center --- will cost precious time for critical patients and keep DeKalb paramedics out of the county and unavailable for other emergencies, Hardcastle said.

"Patient care is going to be affected, no matter what they say," said Dr. Don Siegel, DeKalb Medical's assistant chief of trauma.

Hospital administrators counter that trauma cases account for about 1 percent of visits to the emergency room and that trauma care will continue.

On Thursday, DeKalb Medical CEO Eric Norwood met with concerned residents who have urged the hospital board to reconsider, and the DeKalb County Commission recently passed a resolution urging the hospital board to reconsider its decision.

"This affects everyone who lives or does business in DeKalb County," said Gloria Lee, a Decatur resident who was at Thursday's meeting.

DeKalb Medical's board of directors made the decision this spring. Administrators said the hospital would have an easier time recruiting doctors because they increasingly want to work at non-trauma facilities where they are likely to have fewer emergency department shifts.

Dr. Patrick O'Neal, state EMS medical director, said it's too early to know what impact DeKalb Medical's decision will have. He would not address Hardcastle's concerns other than to say, "all lives are in greater danger as we see facilities that have been designated as trauma centers drop out of the system."

As a general procedure, DeKalb Fire and Rescue does not deliver trauma patients to hospitals outside the trauma network unless the patient is alert enough to specifically request it or is in immediate danger of dying before reaching another hospital, O'Neal said. DeKalb Medical will treat those patients as well as patients who arrive by car, hospital administrators say.

Norwood could not be reached for comment Thursday. However, the hospital released a statement insisting that the level of trauma care at DeKalb Medical will not change, reiterating what Norwood said in an interview last month.

"We will continue to offer the same care that we always have," he said then. "This is a manpower issue, nothing else."

DeKalb Medical is the only trauma center for adults in DeKalb County. Children's Healthcare of Atlanta at Egleston treats traumatic injuries in children. Besides Grady and Atlanta Medical, other trauma centers near DeKalb are North Fulton Regional Hospital in Alpharetta and Gwinnett Medical Center in Lawrenceville.

DeKalb Medical treats about 500 to 600 trauma patients a year at its Level 3 trauma center, according to Cheryl Iverson, the hospital's vice president of business development and marketing. About 150 of them have been severely injured, she said.

The decision to get out of the trauma network comes in the wake of losses in revenue and staff cutbacks at DeKalb Medical.

For fiscal 2006, the hospital posted a $1.3 million net loss; for fiscal 2005, the net loss was $15 million. Losses also are expected for fiscal 2007. The hospital has laid off 157 staffers in the past year.

Norwood and Iverson said the decision to opt out of the trauma network is not unusual. Piedmont, Northside and St. Joseph's hospitals did the same thing in recent years, choosing to focus on specialized areas such as orthopedics and cardiovascular care. All three still operate emergency departments that can accommodate trauma cases.

"DeKalb Medical is this area's only place to receive top-notch trauma services," said Hardcastle, who helped open DeKalb's trauma unit in 1989, "and that needs to continue."

CORRECTION

A story about DeKalb Medical Center opting out of the state's trauma network stated that Northside Hospital also recently opted out. In fact, Northside was never in the network.




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