Organizers and publicity referred to the May 18 meeting in Hattiesburg as a “town hall meeting,” but that’s not what the event was intended to have been or was!
The 6 pm gathering at the Family Y’s Center for Healthy Living – pure and simple – aimed to be and was a celebration of the success of Mississippi’s Trauma Care System, particularly Southeast Trauma Care Region (SETCR).
The people on the program represented hospitals, public health, the Region, their communities, and themselves as individual trauma survivors. Nobody debated or voted. But everybody learned how very personal and population-based traumatic injuries are. People who live and work in the 13 counties that comprise the SETCR expressed or gained a greater sense of value for the concept and reality of trauma regions.
SETCR hosted the event in cooperation with Mississippi State Department of Health, the regulatory agency for emergency medical services and administrative agency for the statewide, all voluntary Trauma Care System. The Region’s chief executive officer (CEO), Wade N. Spruill, Jr., set the agenda and orchestrated the process for community residents to learn and ask questions about trauma, the System, and the Region.
Spruill reminded, “Trauma leads causes of death among people from age 1 through 44 years. Trauma occurs without discrimination; this societal disease affects everyone — young, old, rich, poor, healthy, frail.”
With legal authority established in 1998, Mississippi designed a regional approach to developing the statewide trauma system. The Trauma Care Law gave Mississippi its first stable chance to improve those problems associated with severely injured people. Within a year, regions initiated active trauma programs designed to develop better methods for response and care of all traumatic injury victims.
Most people who attended work within or have had direct contact with trauma. Meeting participants already knew that severe trauma refers to a major injury to one or more body systems and requires immediate medical, and often surgical, care to prevent permanent disability or death. They’ve seen, heard, smelled, or felt the touch of trauma.
William Oliver, president of SETCR, Forrest General Hospital, and Mississippi Hospital Association, moderated.
From the Mississippi State Department of Health, Emergency Medical Services Director Keith Parker commended SETCR as “outstanding in its organizational approach. This region has been first in many things: it was the first region to be designated as a Trauma Region, and Forrest General Hospital was the first in the whole state to be certified a Level II Trauma Center. The Region and its leadership are known statewide, and you are seen as the model for doing things right.”
SETCR Vice President Doug Higginbotham – also CEO of South Central Regional Medical Center in Laurel – credited Marshall Tucker for jump-starting the region’s work.
“Marshall Tucker – now retired senior vice president of Forrest General Hospital – spearheaded the effort to get hospital leaders together with the state officials,” Higginbotham said. “We talked, and he reminded us, ‘It all boils down to how we work together to get any injured person to the right place in the right time.’ So we as a region became a tool to lower barriers among health care providers and throughout the 13 counties in this Region to assure trauma patients get the best care.”
The Region comprises 13 counties: Covington, Forrest, Greene, Jasper, Jefferson Davis, Jones, Lamar, Marion, Pearl River, Perry, Stone, Walthall, and Wayne.
“When each hospital functioned independently, different considerations played into whether an injured person could access the right care. Now it’s like we all have the same software and speak the same language; we have policies to streamline transfers from the injury scene to where an individual can get the best care,” Higginbotham emphasized.
“We’ve had some bumps in the road,” he admitted, “but we are standardized, and we’re collecting data to see how we’re doing, whether we’re doing it right, and how we can improve. Mississippi often gets credit for not being the best, but Mississippi is very much ahead of trauma systems development and with compassion for our fellow man.”
Jerry Howell, SETCR secretary and CEO of Marion General Hospital in Columbia, sadly recalled a traumatic event before creation of the statewide trauma care system in which a mother and five-year-old son suffered severe injuries in an all-terrain vehicle (ATV) crash.
“We did what we could,” he said, “but we were very limited. We were able to transfer the mother and she’s alive and doing well. But the system did not exist to allow us to save the boy.
“Now we have an amazingly good system,” Howell reported. “We have a very good Region, and we have hospitals and staff who really care. All factors and workers come together to save every life we possibly can.”
Physician George McGee, a trauma surgeon long-time on staff at Forrest General Hospital, recognized Dr. Kate Aseme as a colleague who pressed the hospital to become the first in Mississippi beyond University Medical Center to hire a full-time trauma surgeon.
Dr. McGee credited the regional trauma system approach and management for “death data having been reduced by 50 percent in just three years! SETCR has set a good example for our station and nation, particularly in light of our having a majority poor and largely rural population. I’m proud to be a member of this team.”
Finally, from her perspective as a family physician in Prentiss, Dr. Dianne Moran credited the trauma system for assuring she’s advanced-life support trained to give victims their best level of care within the right time.
“The best way to describe the Southeast Trauma Care Region from my perspective ‘borrows’ a popular advertising slogan,” she said: “’One call; that’s all!’
“Before the Region came to be, I would often make telephone calls to several specialty practitioners before I could even find the right one, much less get my patient to that often far-away physician or hospital,“ she compared. “Now we have established ways of whom to contact and protocols for transferring injured patients.”
Southeast Trauma Care Region (SETCR) in 1999 became the first region officially designated by the Mississippi State Department of Health (MSDH). The Department designated six more regions later that year.
“Unusual for most trauma systems,” recalled Spruill, who at the time was director of EMS with the Department of Health and primary designer with the Legislature of the system, “Mississippi established a special financial mechanism to assist trauma system development. A permanent funding source came via a $5 assessment on all moving traffic violations, creating the Trauma Care Trust Fund (TCTF); a portion of the Tobacco Settlement supplements the TCTF to nearly $8 million annually. The fund provides limited assistance for hospital- and physician-uncompensated trauma care.
“Real-life operations throughout the Southeast Trauma Care Region reveal facts that replace long-believed myths,” he said. “Two examples that deal with insurance coverage and access to care actually contradict the un-truths:
• Eighty-two percent of all trauma patients do have health insurance; indigent people comprise the minority among trauma victims.
• People now come to the hospital for emergency trauma care because they know the system, including triaged transportation, is available; without the system, many would have no way to get the care they need.
Spruill said that information the SETCR captures on trauma patients through its regional trauma registry (database) provides rich information that enables better decisions about system improvements, injury prevention, and research. The Trauma Report SETCR published in August 2004 – the first of its kind in Mississippi – is available on the Internet at http://www.aaaambulance.net/trauma_systems.asp.
“But the future of the statewide trauma system appears to be fragile,” Spruill warned, “and requires new strength through renewed commitment at all participants' levels: local, regional, and state.
“Failure or collapse of the system for any reason would result negatively on everyone,” he predicted. “Without a trauma care system, no one can be guaranteed the care they require for traumatic injury.”
About AAA Ambulance Service: AAA Ambulance Service, founded in 1965, created one of the first licensed emergency medical services providers in Mississippi. The community, tax-supported nonprofit organization’s mission is to save lives, prevent injuries, and reduce trauma-related personal anguish and health care costs. For more information, visit http://www.aaaambulance.net.
Contact: Christy M. Joy
PO Box 17889
Hattiesburg, MS 39404
207 South. 28th Ave.
Hattiesburg, MS 39401
(601) 264-0175 SND.Email
