November 21, 2018

St. Francis hopes trauma status will boost recruitment, patient volumes

HBJ File Photo
HBJ File Photo
St. Francis Hospital has become a Level 1 trauma center, joining about 100 hospitals across the country with that status.
Photo | Contributed
Dr. Gary J. Kaml, director of trauma services at St. Francis.

Aiming to boost physician recruiting, patient volumes and its reputation, St. Francis Hospital and Medical Center in Hartford said it's earned the American College of Surgeons' highest-level status for trauma care.

Being "verified" by ACS as a Level I trauma center puts the 617-bed St. Francis in relatively rare company. Just over 100 hospitals in the U.S. are Level I, including Hartford Hospital, Yale New Haven Hospital and Connecticut Children's Medical Center, according to ACS.

St. Francis, owned by Michigan-based Trinity Health since 2015, has been Level II for the past 15 years.

In an interview Wednesday, Dr. Gary J. Kaml, director of trauma services at St. Francis, said the hospital had to meet a stringent list of requirements.

One of the costliest requirements that differentiates a Level II from a Level I hospital is the latter must ensure it has trauma surgeons and subspecialists available around the clock to operate on and treat patients who have been shot, in a car accident, or suffered various other serious injuries.

However, Kaml said St. Francis has already been offering round-the-clock trauma care to hundreds of patients a month, which is well over the ACS' Level I threshold for patient volume.

"I think we've been delivering level one quality care all along," he said. "We have all of the bells and whistles, and facilities and specialists."

"We were in a good position to strike, as it were," he added.

To ensure it was successful in achieving Level I, he said St. Francis had to negotiate a backup schedule for on-call doctors, in case one can't make it to the hospital when needed.

Kaml said area ambulance providers are already aware of St. Francis's trauma services, but he said the ACS' recent verification could further boost patient volumes.

He's also optimistic about being able to recruit high-profile trauma specialists. Many of the brightest surgeons coming out of medical school want to work in Level I centers, he said.

"That's where the action is, that's where the research is, and that's where they're going to be able to make their mark," he said.

To meet ACS' requirements, St. Francis also had to show that its physicians were taking on leadership roles in injury prevention and public education, as well as meet a certain threshold for trauma care research.

It's built up that effort in recent years, with trauma specialists publishing articles in medical journals and working with UConn School of Medicine surgery residents, Kaml said.

Across the country, there's been an uptick in recent years in the number of hospitals pursuing trauma-center status, according to Modern Healthcare, which reported that improved reimbursements and a higher insured rate spurred by the Affordable Care Act (Obamacare) have helped make trauma centers less risky investments for hospitals.

"The single biggest boost that Obamacare gave us is the fact that a good number of people are now insured," Kaml confirmed.

More insured patients means fewer unpaid trauma bills, which can be quite high. When a Level I or II trauma center "activates" its team of specialists to treat a patient, the hospital can charge a fee that can top $10,000 at some hospitals, according to Kaiser Health News.

The tradeoff is that studies have shown higher patient survival rates in higher-level trauma centers.

"It costs money to have a cadre of surgeons and other medical specialists available 24/7," Kaml said.

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