Supervisors Urged to Keep Trauma Care System As Is

San Diego County’s network of trauma care hospitals is working well and should not be changed, the county’s top administrator said in a report released Wednesday.

That recommendation, made by Chief Administrative Officer Clifford Graves, called for the county’s six trauma centers to remain in the system, and suggested that Tri-City Hospital’s application to join the network be rejected.

The Board of Supervisors discussed the highly charged issue in closed session Wednesday and will review the matter in public next week, when the board is expected to make the decisions that will shape the county’s trauma care system for years to come.

Trauma centers are hospital emergency rooms that have sophisticated equipment and a staff of medical specialists on hand 24 hours a day. Since August, severely injured people have been taken (frequently past a nearby emergency room) to a trauma center, where the increased level of care has been shown to improve the patients’ chances of surviving.

James Forde, director of the Department of Health Services, said the county’s recently completed evaluation of the trauma care system persuaded him to abandon an earlier suggestion that at least one of the five adult trauma centers be dropped.

Instead, Forde said on Wednesday that Mercy, Scripps and Sharp hospitals and the UC San Diego Medical Center should be given three-year contracts to serve as adult trauma centers. Children’s Hospital would also be designated for three years, while Palomar Hospital in Escondido would be given a conditional, six-month designation.

Under that arrangement, the number of patients treated at each trauma center would still fall short of the number that county health officials have said is needed for the trauma teams to maintain their skills.

But Forde said he is satisfied that the trauma network has provided excellent care despite inclusion of more hospitals than were originally considered necessary.

The hospitals themselves, all of which are losing money on trauma care, will have to decide if they are treating enough patients to make operating a center financially feasible, Forde said.

Ben Clay, a representative of Scripps Memorial Hospital, said Scripps would only be able to remain in the system if Oceanside’s Tri-City Hospital stops treating trauma patients. Although Tri-City has not been designated as a trauma center, it has fulfilled the county’s requirements in an attempt to win the status and has been used as a trauma center for some North County patients.

“If we go with five (trauma centers), we don’t want games in North County, with a hospital acting like a trauma center when it’s not a trauma center,” Clay said.

But Supervisor Paul Eckert, who has pressed for Tri-City to be included in the network, blasted the county staff’s report in an interview Wednesday.

“I think they’re stupid,” Eckert said of the recommendations. “The staff decided what they wanted and then they did the evaluation.”

Mark Havel, a spokesman for Tri-City, said he was still confident the hospital would be accepted by the county.

“We presume the trauma system is working because Tri-City Hospital has been involved,” Havel said. “Hopefully, the Board of Supervisors will understand clearly what we’re trying to say and make the right decision.”

Tri-City officials have argued that because of problems in transporting North County’s patients south to Scripps, the Oceanside hospital’s trauma center has treated more than half of the seriously injured victims in its area, even without the official county designation.

“It just amazes me how deaf the county staff has been,” Steve Karas, a Tri-City emergency physician, said. “I guess it’s because (the facts) don’t fit in perfectly with their vision of what a trauma system should be.”

The county staff’s report offered two other non-recommended options for the board to consider, one of which included Tri-City in the system along with the five existing adult trauma centers. The other option deleted both Tri-City and Palomar hospitals, leaving North County without a trauma center.