Vincennes hospital's trauma rating creates confusion in Daviess County

The designation and the law combined now requires ambulance services within 45 minutes of Good Samaritan to take some severely injured patients to the Vincennes hospital.

"This is a state law that went into effect on July 1 of this year and we are doing our best to comply," said Wayne Schuetz with Southwest Medical. "There are certain criteria we must look at and follow. We're not going to Good Samaritan because we like to buzz down the road. It's the law and if patients meet the criteria we are required to take them to a trauma center."

Because a large portion of Daviess County and even a small part of Martin County is within a 45-minute driving response to Good Samaritan the Level 3 Trauma designation is impacting local operations.

"It causes some confusion because it has that 45-minute transport tied to it," said Tina Durnil with the Daviess County EMS Advisory Committee. "We have never had a trauma hospital within 45 minutes for us to actually be affected by that rule. Now we do. The guidelines are very appropriate and specific based on the EMT's evaluation of the patient. The really critical stuff will still come here first to be stabilized."

The rule changes have ambulance services also looking at ways to be certain they maintain their complete coverage.

"It makes it more difficult for us to make sure we have everything covered in our own county," said Schuetz. "If we have a vehicle crash and we have to send people to a trauma center that takes those medics away from our own county making it a little more difficult for us."

Daviess County officials say Good Samaritan may have received a trauma designation, but the local hospital is still providing emergency services.

"We feel we do give good trauma care at Daviess Community Hospital," said Durnil. "It is something we've worked on for years and years and years. We are working toward our own designation. We started a year and a half ago down that road. It is going to get done and get us where Good Sam is now. They just got their paperwork in before we did."

For Daviess Community one of the hold-ups for a Level 3 Trauma recognition has been a turnover in staff.

"We need to get a medical director in place," said Durnil. "Once you do that you have to gather all of your medical data for a year, just like you were a trauma center. The medical director has to review all of those charts. The director has to be a general surgeon and they have to be certified. When we had a change in surgeons that put a bump in the road for us. Now Dr. Robinson is here and we can continue to get on board with it."

Daviess Community and Jasper Memorial Hospital and Health Care Center are both working toward the Level 3 Trauma certification but there is no firm time on when that work will be completed. Daviess County officials say that it is important to not only get the application in place, but also to make certain it will be accepted and approved. "If it is not approved then you have to wait two years before you can start the process again," said Durnil. "This may go on for a year or two until we get our Level III in process like Good Samaritan did."

Patients in Daviess County who still prefer to be treated at Daviess Community Hospital do have one additional option under the new law. They can request to skip the trauma center and go to the local hospital. "They have a right to request transport to Daviess Community as long as they can make a rational decision," said Schuetz. "They can say no to the trauma center and that they want to go to Daviess Community because their doctor is there. Anywhere they want to go they have the right to decide."

"They still have the choice that if they want to they can tell the ambulance service they want to go to Daviess Community," said Durnil. "Otherwise if they meet the guidelines and are within the 45 minute transport area they may wind up at Good Sam."

While the new rules and designations may be causing some problems now, local officials are convinced that in the long run the new trauma rules will produce better care. "It really is a good thing," said Durnil. "Indiana was one of the last states without a formalized trauma system. The state has been working on this and we've been involved with it for the last 12 years. It's going to provide better care for everybody in the state and we need to go down that road.

"We knew this was coming that eventually every hospital will be given a level designation."