New Chandler trauma center is 1st of its kind in SE Valley

• Chandler Regional to become Level I trauma center
• First Level I center in the Southeast Valley
• Level I centers treat most severely injured patients

A trauma center equipped to treat seriously injured patients has come to the southeast Valley, and a similar facility could be in the West Valley soon.

Monday, Chandler Regional Medical Center is set to open the first Level 1 trauma center in the southeast Valley and the first in the metro area beyond a cluster in Phoenix and Scottsdale.

Meanwhile, West Valley Hospital in Goodyear is preparing an application and hopes to accept Level 1 trauma patients as early as this summer, according to CEO Stan Holm.

Level 1 is a trauma center's highest designation, requiring the hospital to be prepared at all times with medical specialists and equipment to immediately treat serious trauma injuries.

Proponents say the new and planned centers are long overdue and willhelp patients by reducing travel time when minutes can mean the difference between life and death.

"The chances for your outcome being good lessens with every minute I have to travel," said Keith Welch, battalion chief with the Chandler Fire Department. "It really is an advantage to have more trauma centers strategically located."

Chandler Regional expects to see more than 1,200 trauma patients annually. In the past, many of them would have been driven past the Dignity Health hospital to a Level 1 trauma center.

Leaders in the southeast Valley, which is home to more than 1 million people, have been calling for a trauma center for years.

There are five Level 1 trauma centers in central Phoenix and one in Scottsdale.

The Chandler facility also will serve Casa Grande and the growing Pinal County communities on the fringe of the Valley.

It is the first new non-pediatric Level 1 trauma center in the Valley since the state began designating them about eight years ago.

"The growth is out here. It's not necessarily downtown," said Forrest "Dell" Moore, trauma medical director at Chandler Regional. "We are best positioned to serve the growing needs of the communities we serve."

Adding Level 1 centers in the Valley has been controversial, particularly after a national trauma group suggested that the state hold off on designating any new centers.

"It may not change anything at this point, but I think we're going to have to be very wise with our resources," said Frank Mitchell, medical director of trauma and surgical critical care at Scottsdale Healthcare Osborn Medical Center, a Level 1 center.

Mitchell said that the system is working well in the Phoenix area and that more Level 1 trauma centers are not needed.

"It would be ideal that we would follow the recommendations of the American College of Surgeons," Mitchell said.

State officials asked that organization to conduct a review of the statewide system after a period of rapid expansion of Arizona's trauma system, according to the 2012 report.

Among the "priority recommendations" was requiring any new trauma center to demonstrate need before it could receive a trauma designation.

The ACS suggested a moratorium on trauma centers until the needs assessment was completed.

The Arizona Department of Health Services does not have the authority to dictate the number or location of trauma centers, said Terry Mullins, chief of the state Bureau of Emergency Medical Services and Trauma System.

The department studies statistics to determine whether the needs of patients are being met and whether patients are getting the right trauma care in a timely manner, Mullins said.

"It's not a methodology to say this facility should stay or this facility should go," he said.

More centers

The application process to become a Level 1 trauma center, while more detailed than in past years, determines whether a facility has the capacity to function as a trauma center.

It does not consider whether the center is needed to serve the population.

At the time of the ACS report, there were 25 trauma centers in the state.

With the addition of Chandler Regional, there are now 33, though not all are Level 1.

Urban Arizona has excellent trauma care, and the ADHS is managing the designation of trauma centers well, said Debbie Johnston, senior vice president of policy development for the Arizona Hospital and Healthcare Association.

"At the present time, I don't see the need to be changing how (the ADHS) manages the designation process," she said. "We're just not seeing any red flags."

The ADHS sees rural Arizona as an area that needs more help.

While the central region of the state, which includes metro Phoenix, has the largest number of trauma cases, it also has the lowest per capita rate of trauma cases in Arizona, according to the 2013 State Trauma Advisory Board's annual report.

Travel time a priority

The advantage of adding trauma centers is that it reduces travel time for patients, which medical officials say is particularly important for traumatic injuries.

"The sooner we can get that patient to that level of care, that increases their opportunity for a positive outcome," said Buckeye Fire Chief Bob Costello.

Costello added that a trauma center is needed in the West Valley.

"The trauma centers that we utilize routinely are excellent," he said. "The difficulty we face is just the sheer distance in getting a patient there."

Travel time from the scene of an injury to a Valley Level 1 trauma center is about 20 minutes, on average, in the southeast Valley and about 26 minutes in the southwest Valley, according to an ArizonaRepublic analysis of five years of ADHS data. That's compared with about 19 minutes in the northwest, 15 minutes in the northeast and about 11 minutes in Phoenix.

However, trauma centers must receive a certain number of patients to offset the expense of keeping staff and equipment constantly at the ready and maintaining the skills of medical staff who will handle those cases.

The ADHS requires Level 1 trauma centers to admit a certain number of trauma patients: about 1,200 per year. Chandler Regional and West Valley Hospital officials said they expect to meet or exceed that number.

Officials at both hospitals say their locations are better situated to provide strategic trauma care for more distant areas.

Chandler Regional expects patients from Pinal County. West Valley Hospital expects them from as far as the Arizona-California line.

"It really comes down to time. All else being equal, (patients will be taken to) the closest trauma center," Moore said.

Existing Level 1 trauma centers in the Valley each saw an average of 1,600 to 4,000 trauma cases per year from 2008 to 2012, according to ADHS data.

About a quarter of the trauma cases reported by Valley Level 1 centers came from southeast Valley cities.

Most of those patients went to Scottsdale for treatment.

Patient volume and outcomes should continue to be monitored to determine the impact of additional trauma centers, Mitchell said, adding that he could not estimate how many patients Scottsdale Healthcare might lose to a new center.

"Any of us could be in a car crash or have some event that needs to go to a trauma center, and our Number1 goal is that we have the resources in place to take care of patients when they're injured," he said. "The Number 1 thing is good-quality care for our patients."

The trauma center's opening is not expected to increase wait times for emergency-room
patients at Chandler Regional, Moore said.

Level I trauma centers in the Valley

A Level I trauma center is required to have a team of trauma physicians and surgeons on-site or minutes away at all times.

Chandler Regional will become the ninth state-designated Level I trauma center on Monday, March 24.

Arizona Level I trauma centers:

• Banner Good Samaritan Medical Center, 925 E. McDowell Road, Phoenix.

• Flagstaff Medical Center, 1200 N. Beaver St., Flagstaff (American College of Surgeons Level II).

• John C. Lincoln-North Mountain, 250 E. Dunlap Ave., Phoenix (American College of Surgeons Level II).

• Maricopa Medical Center, 2601 E. Roosevelt St., Phoenix.

• Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix.

• St. Joseph's Hospital and Medical Center, 350 W. Thomas Road, Phoenix.

• Scottsdale Healthcare-Osborn, 7400 E. Osborn Road, Scottsdale.

• The University of Arizona Medical Center-University Campus, 1501 N. Campbell Ave., Tucson.

Source: Arizona Department of Health Services and American College of Surgeons