JCH&L Looks to Obtain Trauma Designation

By Gordon Hopkins One of the priorities of Jefferson Community Health and Life's (JCH&L) new CEO, Holly Wolff, MHA, is obtaining a trauma designation for the facility.According to the American Trauma Society (ATS), “Trauma Center designation is a process outlined and developed at a state or local level. The state or local municipality identifies unique criteria in which to categorize Trauma Centers. These categories may vary from state to state and are typically outlined through legislative or regulatory authority.”In an interview with FJN, Wolff explained, “It's standardized processes across all states from the federal requirements. And so the trauma designation really is recognizing what level we are. Hospitals of this size are usually a level four or five, which are the smaller facilities. The level ones, that would be Omaha. I think Lincoln is a level one. But those are the ones that you send people out for a stroke or major trauma. Those are the ones that guarantee that they have all those specialists on site. They have the surgical coverage, all those things. So, the trauma designation, it really does help put into place the regulations of what constitutes a trauma.” The ATS recognizes five levels:Level IATS defines a Level I Trauma Center as “a comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level I Trauma Center is capable of providing total care for every aspect of injury – from prevention through rehabilitation.”Elements of Level I Trauma Centers include 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric and critical care. It usually serves as a referral resource for communities in nearby regions.Level IIA Level II Trauma Center is able to initiate definitive care for all injured patients including 24-hour immediate coverage by general surgeons, as well as coverage by various specialties. Tertiary care needs such as cardiac surgery, hemodialysis and microvascular surgery may be referred to a Level I Trauma Center.Level IIIA Level III Trauma Center must have demonstrated an ability to provide prompt assessment, resuscitation, surgery, intensive care and stabilization of injured patients and emergency operations, including 24-hour immediate coverage by emergency medicine physicians and the prompt availability of general surgeons and anesthesiologists.Level IVA Level IV Trauma Center can provide advanced trauma life support (ATLS) prior to transfer of patients to a higher level trauma center. It provides evaluation, stabilization, and diagnostic capabilities for injured patients.Level VPer ATS, a Level V Trauma Center provides initial evaluation, stabilization and diagnostic capabilities and prepares patients for transfer to higher levels of care.Wolff noted that JCH&L already provides the equivalent of Level IV or V care, “It's something that they were already doing, just didn't have it in those formal kind of processes of the decision making.”“How you incorporate EMS (Emergency Medical Services) in that trauma designation, because they can call it from the field,” said Wolff. “They would call and say, 'Hey, this is a really bad one.' That right there would be a perfect example. We're going to formally call this a trauma, and then we're going to make sure we follow those protocols.”Wolff said, “It follows best practice in the field, no matter what, so that is what you should be doing in practice and in policy.” Beyond having established policies and protocols, Wolff noted other benefits to the designation, “It really does encourage collaboration with the state. You then have access to their trainings. They usually have annual symposiums where you're getting those trauma coordinators together. EMS is oftentimes invited to all those things to, again, be on top of that best practice, if anything's changing.”JCH&L began working toward the official designation in October of 2024, shortly before Wolff's arrival. Chief Nursing Officer Erin Smith, RN, is heading up the effort.Wolff anticipates having the designation sometime in the next six months.

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