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Accord revived trauma center

October 04, 2002|by LAURA ERNDE

laurae@herald-mail.com

Surgeons and administrators at Washington County Hospital say they are putting past disagreements behind them and are committed to keeping the trauma center open for the long term.

Agreements finalized Wednesday allowed the trauma center, downgraded to Level III, to reopen late Wednesday afternoon after a four-month lapse in service during which patients were sent to the Baltimore-Washington area for treatment.

The hospital closed its Level II trauma center June 1 after communication broke down between hospital administrators and the surgeons whose part-time work at the trauma center was crucial to the operation.

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Since then, the two sides have worked through issues of pay and working conditions.

"We're ecstatic. It's a necessary service and it's what the community deserves," said Deb Addo, the hospital's vice president for patient care.

The hospital agreed to spend more than $1.5 million to reinstate the trauma program, she said.

A key to the agreement was downgrading the center to a Level III center, which allows surgeons to be on call instead of being at the hospital 24 hours a day, as required by a Level II center. Some surgeons had complained they were getting burned out by the trauma work on top of their busy private practices.

Both surgeons and administrators said they are confident the change will not hurt patient care.

"It will be seamless for the patient," Addo said.

The rest of the emergency department trauma team, including doctors and nurses, will be there to meet patients at the door, said Dr. Marc Kross, the program's new surgeon-in-chief.

In 98 percent of the trauma cases, the on-call surgeon will also be there. In the rare cases that's not possible, Kross said he's confident that patient care will not be compromised.

"My wife and children live in this community as well and it could be me on that table," he said.

Kross said he and the program's nurses and doctors are glad to get back to their specialty.

"It will improve morale greatly," he said.

Dr. Karl Riggle, who was the primary negotiator for the trauma surgeons, will serve as the trauma center's administrative director.

Riggle will chair an in-house trauma committee that is being formed to monitor the program and deal with outstanding and future issues.

The hospital sees an average of two trauma patients a day.

Riggle said the contract represents a long-term solution to the problems that had plagued the hospital's trauma program.

When asked how long the contract with surgeons will last, Addo said: "We're expecting this is a lifetime contract. And if it's not, I will personally shorten their lives."

Emergency services workers on Wednesday expressed relief that the trauma center reopened. Maryland State Police medevac helicopters and area ambulance crews were taxed because they had to deliver critically injured patients to trauma centers in the Baltimore-Washington area.

"We're grateful for the state police and local EMS providers who did a great job," said Dr. Robert Bass, director of the Maryland Institute of Emergency Medical Services Systems (MIEMSS).

Bass said he gave the hospital the go-ahead to reopen the trauma center late Wednesday, immediately after receiving documentation that the on-call schedule was filled.

MIEMSS is about to begin a more comprehensive review of all the state's trauma centers.

Meanwhile, his attention turns to solving the problem on a statewide bases.

Trauma centers statewide are suffering financially because of the high cost of treating uninsured patients and their inability to get reimbursed by the state and federal government for the cost of paying surgeons, he said.

House Speaker Casper R. Taylor Jr., D-Allegany, and other state lawmakers have called for more state funding of trauma centers.

Options include a surcharge on traffic tickets or vehicle insurance premiums to raise the estimated $20 million to $30 million it would cost to subsidize trauma centers statewide.

A study panel of state lawmakers is scheduled to visit Washington County Hospital on Wednesday as part of its research into the funding problems, Addo said.

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