- Courtesy Memorial Hospital
- Memorial Hospital Central hopes to gain the Level 1 Trauma Center designation sometime next year.
Five years after the city leased the Memorial system to UCHealth under a 40-year deal, Memorial Central, at 1400 E. Boulder St., is slated to be surveyed by a team of experts in January for the Colorado Department of Public Health and Environment’s (CDPHE) Level 1 status, a step toward a designation that could come as early as April. Meanwhile, Penrose Hospital, at 2222 N. Nevada Ave., hopes to be surveyed in May, says Cecile D’Huyvetter, Penrose’s south state trauma and EMS director. Memorial Central, however, appears closer to meeting the 17 pages of criteria needed to make the cut.
Level 1 Trauma Centers, the top designation in a five-level system, offer the most sophisticated emergency treatment available due to a stable of specialists, including neurosurgeons. Memorial Central and Penrose Hospital now have Level 2 designations, which offer a high level of care but lack other components.
“When you’re the busiest emergency department in the state, this is about serving the community adequately, to meet the needs of the community who come to us for care,” UCHealth Memorial CEO Joel Yuhas says. “It is a social obligation that you are prepared to take care of whatever comes through your door.”
Both hospitals have been striving for Level 1 status for at least four years. While neither has formally applied to the state, Memorial plans to submit an application within days.
Three hospitals have earned Level 1 designations from CDPHE: Denver Health Medical Center, St. Anthony Hospital in Lakewood and Swedish Medical Center in Englewood.
Level 1 requires hospitals to have specialists in a wide range of disciplines, from neurosurgery to orthopedics, available round the clock, leading to a more rapid response to the critically injured. It also requires an academic and research component for trauma care that can translate the knowledge gained in treating patients into best practices and innovation, as well as draw the best practitioners available, UCHealth’s Yuhas says. In addition, a resident teaching program is required, along with publication of 20 peer-reviewed articles in medical journals within a three-year period.
Currently, Memorial Hospital Central and Penrose Hospital are among 13 hospitals in the state designated as Level 2 Trauma Centers, which provide fewer specialties, lack the academic and research element, and may choose to transfer patients requiring tertiary care, such as cardiac surgery and microvascular surgery.
When Memorial Central is inspected on Jan. 15 and 16 and Penrose in May, they’ll be reviewed by site teams composed of five members from the American College of Surgeons — three surgeons, an emergency room physician, and a trauma nurse coordinator — and one state observer from the Colorado Department of Public Health and Environment, says state Health Department spokeswoman Lorraine Dixon-Jones. The results of those reviews will be known about three months after the respective surveys.
In some ways, getting that sought-after designation wouldn’t change a lot for Memorial Central — Yuhas says the hospital currently transfers very few patients to Level 1 facilities. Julie Lonborg, a spokesperson for the Colorado Hospital Association, says that’s because Memorial already functions at a very high level. But while Memorial might offer the equivalent of Level 1 care, without the state designation, patients picked up from traffic or industrial accidents outside the region are flown over the Springs to a Level 1 facility in Denver.
If Memorial and Penrose secure Level 1 designations, they would become the destinations for air ambulances operating for hundreds of miles to the east and south, rather than a Denver hospital.
A key criterion for attaining Level 1 status is volume. The state’s rules require a hospital to treat a minimum of 320 patients a year who have the highest level of injury severity as determined by a pre-established scale. Yuhas says Memorial handles more than that number, though he didn’t provide a specific number, instead simply pointing out that Memorial Central’s ER is the busiest in the state. Last fiscal year, which ended June 30, the ER handled more than 107,000 patient visits, according to UCHealth Memorial data.
Yuhas says Memorial Central is also seeking verification of Level 1 capability from the American College of Surgeons, a scientific and educational association of surgeons with more than 72,000 members. The state designation, though, is the one that substantiates a hospital is a Level 1 Trauma Center.
Penrose, in a Nov. 27 press release, announced it had obtained ACS verification, which validated that Penrose had “demonstrated its commitment to providing the highest quality trauma care for all injured patients.” But the ACS’s criteria for minimum number of severely injured patients seen per year is 250. Penrose’s D’Huyvetter says Penrose meets that benchmark but currently falls short of the 320 required by the state.
But she says that requirement is “about the only standard” Penrose hasn’t achieved.
Dr. David Hamilton, medical director of Penrose Hospital Trauma Center, says via email, “Penrose Hospital is in constant collaboration with other hospitals throughout the Centura Health system and we have a residency partnership with Baylor School of Medicine’s surgery department. We are on track to meet all of the requirements, including medical research development and publication, for ACS and State verification.”