Hopes for Trauma Center Dashed

Efforts by communities in the eastern San Gabriel Valley to get a trauma center for the fast-growing region have hit a roadblock after a hospital considering the idea concluded that it couldn’t afford to provide the service.

The area, which includes Pomona, Diamond Bar, Walnut, Claremont and Glendora, has long been considered one of the most under-served regions in the county.

The decision leaves the 2 million residents of the San Gabriel Valley with one trauma center, Huntington Memorial Hospital in Pasadena, located on the western edge of the valley.

Huntington accepts only gravely ill patients, including those hurt in car accidents and by gunshots, from eight cities and one unincorporated area. Trauma patients in the valley’s other 23 cities and numerous unincorporated county areas are taken by ambulance to County-USC Medical Center in Boyle Heights or by helicopter to a rotating list of trauma centers, among them Long Beach Memorial Medical Center and St. Francis Medical Center in Lynwood.

Over the last few months, city leaders and officials from local fire and police departments have renewed efforts to get a trauma center, focusing on Pomona Valley Hospital Medical Center.

Those officials expressed frustration Thursday.

“There’s such a compelling need, and so often it falls on deaf ears,” said West Covina Police Chief Frank Wills. “We’re the richest nation in the history of the world, but we can’t provide quality medical care to our citizens. I’m surprised more people aren’t outraged by it.”

Wills said his department depends on trauma care services several times a week, with emergencies that include shooting victims and babies hurt in falls.

“Sometimes delays are significant,” Wills said. “When life is in the balance, it’s a matter of minutes.”

Bart Brewer, assistant chief in charge of emergency services training for the West Covina Fire Department, agreed.

“We would love to have a trauma center, but unfortunately the trend is to go the other way,” Brewer said. “Unfortunately, the trauma care service areas are covering a larger and larger area.”

Officials have no hard data showing that the lack of nearby trauma care has resulted in more deaths or serious complications, but they believe opening a trauma care center in the East Valley would strongly benefit the community.

Pomona Valley Hospital had a trauma center but pulled out of the system in the late 1980s because it could no longer afford to keep it open. The number of trauma centers countywide has declined from 22 to 13 in the last two decades.

Pomona hospital officials said this week that it was not only money this time that is keeping them from opening a trauma center but a combination of several factors:

* The 446-bed hospital would not have the capacity to accommodate the 1,000 additional patients that a trauma care unit would generate.

* A nationwide nursing shortage would make it virtually impossible to hire the additional 38 full-time nurses that would be needed -- on top of the openings the hospital already has. In addition, other in-demand staffers would have to be hired, including respiratory therapists and pharmacists.

* Regulations require that surgical specialists are on-hand at the hospital around the clock, seven days a week. The hospital would have to hire four or five trauma surgeons -- who are in short supply -- to meet that requirement, said Chris Aldworth, executive director of planning for Pomona Valley Hospital Medical Center.

“In our community, we already discovered in past studies that we’re under-covered in the area of general surgeons,” Aldworth said, noting that it is much more difficult for a community-based hospital unaffiliated with a university to attract such specialists.

* The hospital would lose roughly $7 million a year in operating costs, after an expected $1.7 million from Measure B was added in. Measure B is a property improvement tax passed in 2002 that provides $170 million a year for the county’s trauma system, but about 80% of the money goes to the four county hospitals for emergency room care.

“It would be great to have a trauma center out there,” said Mark Gamble, regional vice president of the Hospital Assn. of Southern California. “But the reality of the healthcare marketplace today is that’s not going to happen.”

Just before Pomona Valley’s recent decision, officials at Citrus Valley Medical Center-Queen of the Valley Campus in West Covina had also looked at the possibility of a trauma center, Gamble said. But they, too, deemed it impossible.

“In the short-term, we’re in good shape,” he said. “In the longer term, it’s hard to speculate.”

Carol Meyer, director of the county’s emergency medical services agency, said she was not surprised that Pomona Valley found it unfeasible to join the trauma network.

“Taking on both the financial and the physical responsibilities of being a trauma center are enormous,” she said. Pomona Valley officials “have to balance the fact that they’ve got a very, very overwhelmed emergency room already. Then you add trauma to it, and you are then going to take away basically from an emergency room that is already extremely busy.”

Trauma requires more personnel, and a hospital that is already having difficulty recruiting doctors and nurses will have additional problems finding these specialized staffers. The hospital also has to worry about having enough beds in its intensive care unit, which treats trauma patients after surgery.

“I can understand why the San Gabriel Valley would like to have a trauma center in the valley,” Meyer said. “But with the hospital not being able to take this on, this is basically how we’ve been functioning in the San Gabriel Valley since 1988, when Pomona and Queen of the Valley came out of the trauma system.”

She said that nearly all patients needing trauma care in the area get to a trauma center.

Without any plans for a new trauma center on the horizon, health officials and the San Gabriel Valley Council of Governments are working to bring 24-hour helicopter service to the east valley and updated equipment and training for city and fire agencies.

Currently, a single helicopter is stationed in Whittier from 10 a.m. to 6 p.m. every day.

About seven helicopters countywide fight fires, airlift trauma victims and perform other duties on a $2.6-million budget.