‘Rural’ Status for Santa Monica : Hospital Joins Trauma System

Santa Monica Hospital Medical Center has been granted limited status as a county trauma center in a compromise worked out with UCLA officials, who for months have opposed the hospital’s trauma center application.

Under the plan unanimously approved Tuesday by the Board of Supervisors, Santa Monica Hospital will be granted “rural” trauma center status.

The new status allows the hospital to treat critically injured and ill victims transported from outlying areas--particularly in Malibu and Venice--that are beyond a 20-minute ambulance ride from the existing Westside trauma facilities at UCLA Medical Center in Westwood and Daniel Freeman Hospital Medical Center in Inglewood.

County officials said the Santa Monica hospital is not expected to begin the program for several weeks because the board must review and approve details of the hospital’s trauma contract.

Officials of the two existing Westside trauma centers had fought Santa Monica’s application for full trauma center status, arguing that its designation would siphon patients from their facilities.

The UCLA and Daniel Freeman trauma centers treat victims from within a 20-minute radius, while victims from outlying areas are generally taken to the nearest emergency room.

UCLA officials Tuesday repeated their claim that losing a large number of patients to Santa Monica would put a financial strain on their trauma center and would deprive trauma surgeons of badly needed experience.

Dr. Jonathan Hiatt, director of trauma and emergency surgery services at UCLA, said he was pleased by the compromise, noting that UCLA will lose few patients under the agreement.

Loss of 100 Patients

Hiatt told the board that trauma teams at UCLA need a high volume of patients in order to maintain their emergency room skills. Granting full trauma status to Santa Monica Hospital would have caused UCLA to lose about 100 of its 300 trauma patients each year, Hiatt contended.

In contrast, allowing Santa Monica Hospital to take victims from outlying areas will result in the loss of only a handful of patients from UCLA or Daniel Freeman, county officials said.

Although Santa Monica may treat only a few dozen patients the first year, Dr. Brian Johnston, an emergency room physician, said that the facility will not require a high volume because it will be staffed by veteran emergency care personnel, not physicians in training. Medical experts vary on this point, with the American College of Surgeons contending that constant practice is necessary to maintain trauma care skills.

Although Tuesday’s agreement allows Santa Monica Hospital to join the county’s prestigious system of 20 trauma center hospitals, it is a far cry from the Level 2 trauma center status sought by hospital officials since late last year.

Better Survival Rate

Level 2 and Level 1 trauma centers must provide a 24-hour team of skilled trauma surgeons, nurses and technicians, a requirement that medical experts say increases the odds of survival for critically ill or injured victims.

Under the new agreement, Santa Monica Hospital will be allowed to simply activate a team of trauma experts already employed in emergency services at the hospital, said Leon Vargas, Santa Monica Hospital assistant vice president.

In contrast to Level 2 and Level 1 hospitals, Santa Monica’s trauma team will not be present 24 hours a day, but will be on call and able to arrive by the time trauma victims from outlying areas reach the hospital, he said.

Vargas said the rural trauma center status, while falling short of Level 2 status, “at least gets us into the trauma system and allows us to begin providing the care we need to provide.”

Support From Supervisor

Douglas Ring, an attorney representing the hospital, said he was “very happy with the agreement” and praised Supervisor Deane Dana for supporting the compromise.

Dana had warned the board that with the approach of summer and the expected increase in accidents at the beach, “we cannot afford to wait any longer to move Santa Monica Hospital into the trauma care system.”

Ring noted that paramedics and ambulance drivers “will now be aware that Santa Monica can handle trauma victims,” while in the past they may have traveled about five miles farther to UCLA.

Although county officials estimated that only about 10 trauma patients from outlying areas of Malibu or Venice were treated at Santa Monica Hospital last year, Ring predicted that number will greatly increase once paramedics become aware of the hospital’s new status.