County agrees: Trauma centers needed

Dan Kulin

Tuesday, June 8, 2004 | 11:39 a.m.

A Clark County task force reviewing offers to open new trauma centers in the Las Vegas Valley agreed Monday that the area needs more centers as well as a system to coordinate trauma care.

The county Health District's Trauma System Assessment Citizen's Task Force did not decide whether it would support Sunrise Hospital and Medical Center's request to open a high-level trauma center or St. Rose Dominican Hospital's offer to open a lower-level trauma center at its Siena Campus in Henderson.

Now, the area's only trauma center is at the county-run University Medical Center. UMC officials support St. Rose's offer and oppose opening a trauma center at Sunrise out of fear it would be a financial drain to UMC.

The task force agreed to continue the discussion on June 14, and could make final recommendations then or June 22. The task force recommendations will go to a subcommittee of the county Board of Health, and then to the full board, which is scheduled to review the matter June 24. The Health Board will then submit its recommendation to the State Health Administrator, who has the power to designate new trauma centers.

Officials from the three hospitals again reiterated their arguments to the task force.

Sunrise Hospital officials were joined by former Sen. Richard Bryan who said the area needs a second trauma center in case UMC ever becomes overwhelmed or is forced to stop accepting patients.

Bryan said Las Vegas has been identified as a potential target for terrorists, and referred to a letter from Rep. Jim Gibbons, R-Nev., that said Las Vegas should have more than one trauma center for that reason.

But Dr. John Fildes, medical director at UMC's trauma center, said one more trauma center wouldn't help much in a "mass casualty event," which he said would require all area hospitals to work together to adequately deal with such an event.

Both sides also reiterated opposing predictions of the possible financial impact to UMC if Sunrise opened a trauma center.

Dr. Michael Metzler, director of trauma services at Sunrise, said he thought projections in a report from an independent consultant, the Abaris Group, were wrong. The report said the number of trauma cases are increasing much slower than population. Metzler said he thinks there will be enough of an increase in trauma cases to adequately support both trauma centers.

UMC officials said they agreed with the Abaris report, which recommended adding only a level III trauma center at St. Rose.

UMC officials also presented financial information that showed the hospital would lose $2.2 million to $2.5 million in revenue for every 600 trauma patients that went to another hospital. The Abaris report estimated Sunrise would take about 1,400 trauma patients from UMC. UMC treated 3,780 trauma patients on the fiscal year ended June 30.

Metzler also said Sunrise would draw patients from a smaller geographic area than the Abaris report showed.

Sunrise wants to open a level II trauma center, which, like UMC's level I trauma center, would have trauma doctors in the hospital around the clock. At a level III trauma center, which St. Rose is offering, trauma doctors are on call.

The UMC financial information also said that the UMC trauma center lost $11.9 million during the fiscal year that just ended.

Task force co-chair Robert Forbuss said that loss contradicted figures he's seen previously that showed UMC's trauma center posted a profit. UMC officials said the numbers presented Monday counted additional fixed costs, such as a portion of all the administrative costs at the hospital.

While task force members agreed in general that they should do whatever they can to avoid hurting UMC financially, they did not reach a consensus on what their final recommendation might be.

Task force member Dr. Max Doubrava said he thought his fellow members generally agree there should be a new level III trauma center in the area.

"The hang-up is on the level II," he said.

Doubrava also suggested they recommend Sunrise be given permission to open a trauma center on a trial basis, and end that program if it proves to hurt UMC.

But others disagreed.

"We can't do anything to hurt UMC," task force member Danny Thompson said, adding that he opposed letting Sunrise open a trauma center on a trial basis. "How would we put that back in the box?"

Several members also said that they think before a new trauma center opens, the area needs a trauma system.

A trauma system, which could be overseen by a committee, could set policies and procedures for all valley hospitals in areas such as disaster response, trauma care, and information sharing, officials said.