Peterson Regional Medical Center in Kerrville has been designated by the state as a “Basic (Level IV) Trauma Facility” in the state’s Trauma Service Area – P.
The Texas Department of State Health Services notified Cory Edmondson, chief executive officer, in mid-December by letter.
This state designation is valid for a three-year period; and PRMC officials must reapply for this before July 1, 2024, if local hospital officials want to continue with this level of service to Hill Country residents.
The letter in mid-December said, “Your hospital is commended for its commitment to quality care and the commitment to achieve and maintain a Basic (Level IV) designation. Congratulations to you and your staff for the vital role the hospital provides to your community.”
Darin Smith, R.N., is PRMC’s “Trauma Program Manager” and has been directing their efforts at the local hospital to achieve qualification for this state designation.
The next nearest “Trauma Level” designated hospitals are in San Antonio, Smith said.
“We had to prove to the state that our care levels had improved to provide better and faster and safer care, to get each patient where they needed to go,” Smith said.
He said, “We’ve been working on better-identifying trauma patients; and that starts with prevention of injuries, which is connected for each patient back to their lifestyles.”
He described the whole process as starting with their “pre-hospital care” by the local Emergency Medical Services before they get to the Emergency Room. Then they improved their processes of following each patient through their “continuum of care” whether they are admitted here or sometimes sent all the way to a San Antonio hospital.
“If they stay here, the most common injury we see is hip fractures. And with our surgery options, many of those patients are up walking until they can be sent home or to another place for care,” Smith said. “The goal is to get them out the door of the hospital in a timely manner.”
He said he and Edmondson and the overall PRMC staff have been wanting to join the ranks of other trauma hospitals in this state-designated region of Texas.
Smith said he first had to attend classes starting back in October 2020; followed by hosting a “trauma surveyor” in the Kerrville facility who was here to track the PRMC processes in treating trauma patients; and answer the question, “Did the PRMC staff give the right care?”
“There were 26 ‘audit filters’ they considered,” he said. “Now after the past months of work, we also see what things can be changed and improved.”
He said now that they’ve won their initial designation, they will be sending fewer patients by Air Life or ambulance to San Antonio. And PRMC’s processes and programs will be surveyed again every three years after this.
“If Level IV is basic, we already aspire to improve to Level III,’ Smith said, “but we know by then there also will be new rules that will be harder to meet.
“The trend line of trauma admissions should begin to trend up; while the trend line of transfers should start to trend down.”
He said before the February 2020 Snow/Ice storm, they tracked 20-25 admissions; and in the main week of that storm alone, they cared for 22 trauma patients.
He said most people would think of car wrecks as major trauma cases. But in the Kerrville area, the number one cause of trauma cases is an elderly person who slips, trips or falls.
Motor vehicle collisions are actually number two on the list of major injuries, especially for the elderly.
Smith’s work at PRMC is now more “office-driven,” to keep “audit charts” about patients as current as possible. Now he’s officially “Trauma Coordinator” for the local hospital.
He said another factor they’ve improved is their “whole blood program” plus improvements in their “falls prevention program.”
The Emergency Room nurses not only send feedback to Smith after dealing with patients, but they also provide “real-time” education to patients while they’re treating them, without waiting until the next Falls Prevention class happens.
To improve that education factor, he said the hospital’s Falls Prevention class that was offered every other month will be offered every month in the near future.
“Now every injury that’s designated as a ‘trauma’ is seen by an ER doctor within 10 minutes; and also is announced over the hospital’s public address system.
He said the most frequent of those cases are seen in people over age 65 who fall, and strike their heads on something. And they’re taking medication that is a “blood-thinner.” So there’s a likelihood of a busted blood vessel and those patients can develop “a bleed” that must be treated immediately.
“These patients can get worse over time; and need immediate care,” he said.
He described it as a good thing that there are many resources in the major hospitals in San Antonio. But they’re also farther away than Peterson’s staff and resources.