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Published January 25, 2013, 10:54 PM

Sanford upgrading trauma services

FARGO – Sanford Medical Center is well along the path to seeking designation as the highest level of trauma service. If successful, the trauma center here would become the only top-level trauma center in the northern tier of states between Minneapolis-St. Paul and Seattle.

By: Patrick Springer, INFORUM

FARGO – Sanford Medical Center is well along the path to seeking designation as the highest level of trauma service.

If successful, the trauma center here would become the only top-level trauma center in the northern tier of states between Minneapolis-St. Paul and Seattle.

“There’s a huge swath of western Minnesota, North Dakota and eastern Montana that occasionally has to send their patients elsewhere,” said Dr. Steven Briggs, a surgeon and chairman of Sanford’s trauma department.

Sanford has been working for several years to provide the services required for the top-level trauma designation, and has many of the elements in place.

The recruitment of two more surgeons is the biggest remaining step before Sanford applies for verification as what’s called a Level I trauma center by the American College of Surgeons.

“Our goal is to have Level I before we open the new medical center in 2016, or sooner,” said Dennis Millirons, president of Sanford Fargo Medical Center. Sanford is planning a $494 million center in southwest Fargo.

North Dakota has six Level II trauma centers, including Sanford and Essentia Health in Fargo and Altru in Grand Forks, and others in Bismarck and Minot.

North Dakota does not yet have any designated Level II pediatric trauma centers, and Sanford also is moving to provide that level of care.

“We’re working toward that as well,” said Susan Jarvis, Sanford’s vice president of emergency, trauma and critical care services.

The difference between Level I and Level II trauma centers is not major, but the higher-level centers are able to treat the most complex and severe cases, which sometimes must be transported outside the region, health experts said.

The two most important distinctions are that top-level centers must conduct trauma research and demonstrate they can treat the most complex cases, said Dr. Randy Szlabick, who directs trauma medicine at Altru and serves as North Dakota’s trauma medical director.

Still, the designation matters in that it reflects a center’s recognized commitment to handle the most difficult trauma cases, he said.

“It does indicate that they have made a significant effort to raise the level of expertise and the level of care,” Szlabick said, adding that he regarded it as a “win-win” for the state’s network of trauma providers.

Also, to be eligible for top-level designation, a trauma center must meet certain patient volume minimums, a standard imposed to ensure a level of proficiency as well as adequate equipment and expertise, Szlabick said.

Sanford already is close to meeting those patient volumes, Jarvis said.

The emergency department, with 27 patient bays, last year had almost 60,000 visits, and volume continues to increase, she said. The new medical center will have 51 patient bays.

“We’ve added so many pieces, and the community has already seen the benefits,” Jarvis said.

Sanford’s intent is to fill a service niche, not to intrude on the service areas of other trauma centers, Briggs said.

“We’re not trying to take anybody’s business,” he said. “What we’re trying to do is fill the void so patients don’t have to go to Minneapolis unless they have a very particular need.”

Sanford estimates it will be able to treat 75 percent of the trauma patients now taken out of the state. That is important, Briggs said, because prompt treatment of life-threatening or life-altering injuries is crucial.

Complex orthopedic injuries, such as a crushed pelvis, or complex spinal injuries, are examples of the kinds of cases a top-level trauma center staff can treat, Briggs said.

Although North Dakota is very rural, the state’s network of trauma centers and emergency medical services gets high marks nationally, Szlabick said.

“North Dakota is considered to be quite advanced from the point of view of our trauma system,” he said.

Providers across the state and state health officials have been working for more than a decade through planning and training to raise the level of care, he said.

Trauma cases in western North Dakota have increased significantly in recent years, however, with oil field and highway accidents, according to health providers.

“They’ve been skyrocketing out west,” Briggs said. “It’s really been taking a toll across the state.”

Sanford has helicopter ambulances based in Fargo and Bemidji, Minn., and two fixed-wing air ambulances based in Fargo. It plans to add a helicopter ambulance in Bismarck in the near future.


Readers can reach Forum reporter Patrick Springer at (701) 241-5522

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