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POINT OF VIEW County’s trauma system a model for state, nation


If you were to experience a traumatic injury in Palm Beach County today, you would receive care from one of the top trauma centers in our state. First responders would stabilize you and then transport you by air or ground to the Level 1 Trauma Center at St. Mary’s Medical Center, or the Level 1 Trauma Center at Delray Medical Center. There, you would meet at least 30 members of our trauma team, who would be there waiting for you, as they do every day, around the clock, ready to use their specialized training to make every attempt to save your life. And because your injury happened in the county, your chances of survival would be better than if this incident occurred anywhere else in the state of Florida.

Our current county trauma care system is widely heralded by national trauma experts as a model for the state and the nation. The system was developed more than 25 years ago with the formation of the Palm Beach County Health Care District. Today, both Delray Medical and St. Mary’s care for the most critically injured adults and children, and both have achieved Level 1 trauma status, the highest level of care available. Our mortality rate for preventable deaths is approximately 1.6 percent — the lowest in the state with the highest injury severity score.

Before we had a health care district, more than 50 percent of the trauma patients whose deaths were preventable did not survive. Each year, since 1991, the system has been further refined and enhanced in quality, efficiency, emergency response times, trauma surgery outcomes and post-operative care.

At every stage, from first responders to the emergency room to surgery and post-operative care, practice leads to proficiency. National standards for Level 1 trauma centers require treating a minimum of 1,200 patients per year with severe and/or life-threatening traumatic injuries. In Palm Beach County, there are about 3,000 such cases per year, so both St. Mary’s and Delray Medical have approximately 1,500 trauma activations each.

This fact is further established by the five-year plan adopted last summer by the Palm Beach County Health Care District. It concluded that the two current trauma centers are adequately serving the county’s needs, and that there is no need for an additional center.

Skilled trauma surgeons who want to work at a Level 1 facility would be inclined to go elsewhere. Also, diluting that volume could impact training programs at Florida Atlantic University’s medical school and other efforts to grow our own next generation of trauma surgeons.

Dr. Paul A. Taheri, CEO at Yale Medicine and Deputy Dean of the Yale School of Medicine, studied our system and concluded that “…by any metric this journey is a success, the trauma centers are well regarded, there is adequate capacity, the clinical care is exemplary and the system leadership is mature and sophisticated.”

Great trauma care depends on collaboration, cooperation and relentless practice. Criteria published by the American College of Surgeons say that another trauma center may be justified if it takes more than 60 minutes for a patient to get to a trauma hospital and receive care. Our average transport time is currently 8 minutes.

Our current trauma systems of care work exceptionally well for this community. We need to retain Level 1 trauma care in our county by protecting our current model. This trauma system has saved our community’s lives for decades; now it’s our turn to save our fast access to Level 1 care.

ROBERT BORREGO, WEST PALM BEACH

Editor’s note: Dr. Robert Borrego is medical director of trauma at St. Mary’s Medical Center.



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