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Medical care in Mesa notches up with Level I designation

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The wording on this sign at Banner Desert Medical Center will change to read "Emergency/Trauma" at 6 p.m. April 24. The hospital becomes a provisional Level I trauma center at midnight that day. (Courtesy of Banner Desert Medical Center)

Nearly a year of plans and preparations finally culminate at midnight April 24 when Banner Desert Medical Center in Mesa becomes a provisional Level I trauma center.

The provisional designation from the Arizona Department of Health Services Bureau of Emergency Medical Services and Trauma System allows Desert employees to provide the highest level of trauma care for people 15 and older. Teens who are at least 15 are considered adults in the realm of trauma care.

In a few months, when Cardon Children’s Medical Center is expected to gain its provisional Level I status, trauma patients of all ages can be taken to the joint Banner/Cardon campus.

Level I hospitals treat the “sickest of the sick,” and the most severely injured patients, according to Dr. Jeffrey Salomone, the trauma medical director at Banner Desert.

Patients at a Level I trauma center could be “bleeding to death,” he said, and “minutes count in these cases. We need to get people to the OR immediately.”

With 500,000 people living in Mesa and another 175,000 or so in Tempe, and no trauma center in either city, people are at higher risk of not receiving the best care in a trauma situation. Up until now, if a patient was deemed to need Level I care, he had to be taken to one of three Level I centers in the Valley — in downtown Phoenix, Chandler or Scottsdale, Salomone said.

Because Desert is basically located at the border of Mesa and Tempe, and is so close to U.S. 60 and Loop 101, emergency responders are expected to get patients from some parts of the East Valley to Desert faster than they could take them to one of the other Level I centers.

And, speed matters, Salomone said.

“Sometimes ambulances can travel faster on highways than city streets, so we may timewise be the faster hospital” to bring patients to, he said.

Emergency responders are trained to take patients to the closest appropriate trauma center, “and that differs by time of day. EMS crews make those decisions on a regular basis,” he said.

The addition of a higher level of medical care to Mesa is important to the city’s mayor.

“It’s very important that a city as large as Mesa have its own Level I trauma center,” Mayor John Giles said. “There’s no question it will be busy from day one and emergency care in Mesa will be both faster and better.”

Behind the scenes

Salomone has led the hospital’s effort for the last 50 weeks to prepare for the new designation.

“We’ve been working to transform the hospital to a trauma center,” Salomone said. He and five other trauma surgeons will lead the trauma program. Banner contracted with physicians from Advanced Surgical Associates of Mesa to care for Level I patients throughout their entire hospital stay, Salomone said.

The certification process took a year, Salomone said, because “there is a long, long list of stuff to be done” to gain the certification.

It was “definitely a complicated process,” Banner Desert CEO Laura Robertson said.

In spite of changes, evaluations and lots of work, the hospital staff is excited for the Level I designation, she said.

The list of tasks to accomplish included ensuring that the hospital’s labs, blood banks and imaging departments could all shorten their response times and ensure adequate supplies, equipment and personnel on duty all of the time, Salomone said.

“The two most important things,” for a trauma patient are “blood and surgeons,” he said. “That matters.” Trauma surgeons will be in the hospital 24/7. Two surgeons and two anesthesiologists will be in the building during traditional business hours. On weekends and at night, one surgeon and one anesthesiologist will be in the hospital and one of each specialty will be on back-up status, Salomone said.

Additional staffing levels in most therapy departments are also required. Nurses, technicians and child life specialists received additional training. Even the hospital security staff had to complete additional training to handle more major emergency situations than may have occurred at Desert in the past.

“We need to be prepared to handle potential victims of violent crime,” Salomone said. “We don’t see that much now.”

Hospital personnel have participated in drills “to look for bugs,” and adjust processes as needed, he said.

The prep work for Desert to become a Level I facility included input from EMS crews, Salomone said. “We talked with them about things they like and don’t like at other trauma centers and incorporated those things into our plan.”

It wasn’t only people who were trained and staffing levels increased, Salomone said. New equipment had to be added to the emergency department, the operating rooms and the intensive care unit.

Because Banner Desert is already a tertiary referral medical center for the East Valley, some of the necessary foundation for a Level I center was already in place.

“That made us perfect to become a trauma center,” Salomone said.

It’s also the busiest emergency department in Arizona, he said.

Currently, the Maricopa Medical Center in Phoenix is the only hospital in the state certified to treat trauma patients of all ages. So, Salomone explained, if a family is injured in a car accident today, the parents may be taken to the closest Level I center, but the children have to be taken to Maricopa Medical Center.

“We will be able to keep families together when Cardon becomes a Level I center this summer,” he said.

Cardon and Desert operate under the same license and the emergency department and trauma rooms are located “right between the two hospitals,” Salomone said.

Banner Desert will operate provisionally for 18 months as it works to meet the criteria established by the American College of Surgeons to be a Level I center. The hospital will undergo evaluations during that year and a half.

Desert officials have estimated they’ll treat 2,200 trauma patients a year, Salomone said.

Robertson, the Desert CEO, said the Level I designation is part of Banner Health’s plan to create an integrated trauma network. The network is expected to help emergency responders be better able to get trauma patients to the hospital best equipped and staffed to care for them.

“We will be able to care for the most seriously injured patients in-house,” Salomone said. “We don’t anticipate needing to send patients elsewhere.”

Banner Health has 12 trauma centers in Arizona, including two other Level I centers: Banner University Medical Center-Phoenix and Banner University Medical Center-Tucson.

Two other Level I trauma centers are located in the East Valley: Chandler Regional Medical Center and HonorHealth Scottsdale Osborn Medical Center. Nine facilities in the Valley have the Level I designation.

– Shelley Ridenour is a freelance reporter for MyNewsMesa.com.

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