Though the Hazel Hawkins Memorial Hospital Emergency Department announced on the hospital website last year it was working on becoming a Level IV trauma center, it has yet to receive certification.
The process to become a Level IV trauma center began in 2014, according to Michael Bogey, an emergency physician at Hazel Hawkins. Bogey briefed the hospital’s board of directors Jan. 24 on the current status of efforts to gain certification.
“We are operating as a trauma ER and we see plenty of trauma,” Bogey said. “This ER is fully equipped with three state-of-the-art trauma bays that can handle anything that’s thrown at it.”
Bogey said what the hospital normally cannot handle is “definitive care,” or what care the trauma patient must have after they’re stabilized.
Kris Mangano, San Benito County Emergency Medical Services Coordinator, told BenitoLink that certification won’t happen until San Benito County Medical Director David Ghilarducci approves it. Mangano said she and Ghilarducci met with Hazel Hawkins surgeons and anesthesiologists two weeks ago to address their concerns about what gaining Level IV trauma center certification would mean for them.
“Now it’s up to the hospital on how to proceed,” Mangano said. “Once they say they’re ready we do a walk-through with a check-off list provided by the American College of Surgeons. Then we give them our stamp of approval or recommendations for changes.”
Even though it is not certified as a Level IV trauma center, the hospital has worked to certify nurses and physicians who treat patients upon arrival at the ER. It also has agreements with regional trauma centers for when conditions warrant a patient transfer.
Because Hazel Hawkins is functioning as a non-certified trauma center, the staff can only stabilize a patient, then it must send them to a definitive-level hospital, Bogey said. He said even if Hazel Hawkins does become a certified Level IV hospital, he didn’t think it would see patients it doesn’t already see. He said that over time he hopes to be able to educate the entire medical staff on what it means to be a Level IV trauma center.
“We’re operating as a Level IV trauma center because that’s what we do,” Bogey said. “We cannot prevent the guy who flips a tractor and ruptures his spleen, or the drunk kid who broke his C2 and is paralyzed, or the gunshot to the neck that came in here two weeks ago. We have to see them because they show up at our doorstep.”
Bogey indicated that if the trauma patient cannot be stabilized in order to safely transport them to another hospital, they would be treated at Hazel Hawkins.
He explained the different levels of hospitals:
- Level I: Provides all services (Valley Medical Center in San Jose)
- Level II: Cares for most patients (Natividad in Salinas)
- Level III: Sends trauma patients to other hospitals
- Level IV: Keeps emergency room open 24/7, but sends trauma patients to other hospitals
- Level V: Operates only part of the day and sends trauma patients to other hospitals
Bogey said because the Hazel Hawkins ER is already operating like a Level IV trauma center, it raises the level of training throughout the hospital.
“The community gets to say they’ve got a trauma center,” he said. “I can’t change the fact that [patients] aren’t going to stay here. But we have the responsibility to provide that service as a trauma center. Because we’re the only hospital in the county, we do it.”
Dr. Joseph Ezer, a pulmonologist at Hazel Hawkins, wondered why there are not more Level IV hospitals in the area. Bogey told him it isn’t easy to be certified Level IV because every nurse has to be certified, a database must be maintained, and policies need to be updated, all of which has been accomplished at Hazel Hawkins, he said.
“We’ve met the standards, now we just need the team buy-in at this time,” Bogey said. “We don’t want to do it without the general surgeons and anesthesiologists because if they’re against it, I’m not going to force their hand.”
Surgeons and anesthesiologists represent the biggest barrier to certification, Bogey said, because their perception is if the hospital is promoted as a trauma center to the public then it will have to perform as one.
“The idea of trauma is it’s a team effort and if we don’t have everyone playing on the team, it’s not worth it,” he said.