Leveling Up

Every second counts when a trauma patient enters the emergency room – a fact CoxHealth’s trauma program manager Jami Blackwell knows all too well.

“In the past, a surgeon would be at home or in their office and it could take up to 20 minutes to respond, but not anymore,” Blackwell said of Cox South’s new Level I Trauma Center status from the Missouri Department of Health and Senior Services. “We have at least one trauma surgeon in house 24 hours a day.”

Announced Oct. 23, Level I is the highest ranking available from the MDHSS and the hospital is equipped to handle any injury that walks, crawls or rolls through its doors. But service that swift comes at a high price.

“The Level I designation cost us about $52 million,” said CoxHealth Vice President of Clinical Services Tyler Hedden, “because that’s how much our new emergency wing cost.”

Complete with a 24-hour laboratory, radiology suite and surgery center, the 78,000-square-foot facility at 3801 S. National Ave. is the hospital’s crowning jewel. Financed by 2008 bonds and a donation by the Lipscomb family, the two-year-old addition houses seven trauma bays, including one dedicated pediatric trauma bay, a 26-bed cardiac monitored observation unit, a pharmacy, two psychiatric safe rooms and doubles the hospitals trauma bed count to 56.

CoxHealth joins Mercy in Springfield and 8 others across the state who hold Level I status. CoxHealth’s Hedden said the new wing was just the first – and largest – hurdle CoxHealth had to jump before meeting Level I requirements. While the hospital had been operating at Level I status without the official designation since April, he said, the hospital made additional upgrades to areas such as its research facility.

“The biggest expense and ongoing expense we have is in staff,” Hedden said of the hospital’s new operating procedure. “Additional trauma surgeons around the clock and more research staff add up in payroll and other expenses.”

Hedden declined to disclose the trauma department’s operational budget. According the Springfield Business Journal research, CoxHealth had an operating revenue of $1.05 billion in 2012, up slightly from $1.02 billion in 2011.

The recognition comes after a team of surveyors conducted extensive review of CoxHealth’s program in late September. This review included touring all areas of the hospital involved in a patient’s trauma care, from surgery to radiology, laboratory to pediatrics and the intensive care unit. Surveyors also reviewed the program’s process improvement measures, patient outcomes, physician and nursing education records and more.

“We have the highest level of care for our patients,” said Blackwell, a 22-year CoxHealth veteran. “We have reached the benchmark others strive for and we will maintain that status and level of care for years to come.”

Caring for about 70,000 emergency room patients a year at the 563-bed Cox South facility, Hedden said the hospital is equipped to handle 120,000 at capacity. With another 40,000 patients a year at Cox North, 1423 N. Jefferson Ave., Hedden said the health care provider has no plans to upgrade the 72-bed facility on the original 1906 Burge Hospital site.

Despite much recent recognition for its new designation, CoxHealth isn’t the only Level I trauma game in town.

Situated between the two Cox hospitals at 1235 E. Cherokee St. sits Mercy Hospital Springfield, an 886-bed facility with Level I trauma status for more than a decade.

“We’ve been Level I for 12 years in Springfield,” said Velvet Shoults, Mercy director of trauma services. “As a Mercy system, it’s important to us to provide the community the best care possible.”

With a hospital total operating revenue of $8.6 million in 2012, up from $8.1 million in 2011, the Mercy emergency room handled 85,024, according to SBJ research.

Like Hedden, Shoults said “the cost isn’t in obtaining the status, it’s in maintaining it.”

“Running a trauma unit at full staff 24 hours a day is an added cost, but cost doesn’t matter when it’s for the best of the community,” she said.

Shoults said despite the perceived public competition between Springfield’s two major hospitals, she welcomes Cox South’s Level I status, saying she isn’t worried about any patient shifts in the near future.

“If there is a need, then we are happy to have them on board,” she said. “There is no competition there; I think we all just want what’s best for the community.”