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The journey to trauma center designation


Many people have been through a traumatic injury in their life. Whether from vehicle accidents, sports injuries, abuse, drownings, falls or natural disasters, traumatic injuries can occur at home, on the street or while at work and require immediate care.

The National Center for Injury Prevention and Control reports that unintentional injuries, such as vehicle crashes, falls and poisoning, are the leading cause of death in Americans ages 1 to 44 years old, with suicide coming in second. And the need for more trauma center locations is on the rise. According to the American College of Surgeons, Level III trauma-certified centers are especially essential for the care of patients in rural and more remote regions. 

Bothwell Regional Health Center has been working toward a Level III trauma center certification since Oct. 31, 2019, when the hospital submitted its application to the Missouri Department of Health and Senior Services (DHSS) after conducting a self-assessment to ensure the required critical care structure, trained workforce and equipment was in place to safely and quickly care for a trauma patient. 

According to Lynh Best, Bothwell’s Performance Improvement director, and member of the hospital’s certification team, obtaining a Level III trauma certification supports Bothwell’s mission, which is “working together to provide exceptional health and wellness services.”

“This certification will mean we provide prompt assessment, resuscitation, emergency operations and stabilization for patients experiencing a traumatic injury,” Best said. “We will know that we have the people and processes in place to treat patients quickly or that we can rapidly arrange for transfer to a higher level of trauma care if needed.” 

The trauma certification process has an extensive, seven-page criteria check sheet. Elements of this check sheet include having 24-hour immediate coverage by emergency personnel, a comprehensive quality assessment program, continued education for nursing staff and trauma team, transfer agreements for patients requiring more comprehensive care, and trauma prevention and community outreach efforts. 

Best said the next step in the process is that the DHSS will conduct a site survey and two or three reviewers will verify Bothwell’s compliance with Missouri’s regulation and standards for trauma center designation.

During the one- to two-day site survey, which is tentatively scheduled for July, DHSS will review Bothwell’s policies and procedures, perform chart reviews and evaluate quality and performance improvement plans. The team also will tour various departments, such as the Emergency Department, Radiology, Intensive Care Unit, laboratory and operating rooms to inspect and review equipment, review processes and interview physicians and leadership.

“Within 30 days after receiving the reviewers’ report, DHSS will finalize a summary report and provide a copy to Bothwell,” Best said. “We’ll know then whether we have met the criteria for trauma center designation or if we need to address certain criteria before receiving the designation.” 

Brenda Sprinkle, Bothwell Time Critical Diagnosis coordinator, and member of the certification team, said that while the process has been long and drawn-out for many multidisciplinary areas in the hospital, the hard work and wait will be worth it.

“This designation is the last in the wheel of a three-spoked effort to obtain several important certifications for Bothwell,” she said. “We obtained our Acute Stroke Ready Hospital certification in November 2019 and Acute Heart Attack-Ready certification in March 2021, both from The Joint Commission. These two certifications allow the DHSS to designate Bothwell as a Level III Stroke and ST Elevation Myocardial Infarction (STEMI) Center. A Level III trauma certification ensures our community that Bothwell Regional Health Center is a quality facility that is capable of caring for their loved ones in a traumatic emergency.”


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