Tufts Medical Center announced last month that its adult trauma service center has been designated a Level I trauma center, the highest level, by the Massachusetts Department of Public Health.
This designation is defined by a series of criteria set forth by the American College of Surgeons, which rates trauma centers based on their capabilities to treat seriously injured patients on three levels, according to William Mackey, professor and surgeon?in?chief at Tufts Medical Center.
"We had our site visit from the American College of Surgeons last year," Mackey said. "They assessed our program - they found no deficiencies at all and granted us Level I status - and we just found out about that now a little over a month ago."
"It's a big step for us: It'll mean increased volume, it'll mean increased severity, it's great teaching for medical students and residents," Mackey added. "It just opens up a whole new area of interest and excitement for us. Also another benefit is that it really upgrades all of the hospital's services."
To become a Level I trauma center, a hospital must treat over 1,200 trauma patients per year and conduct leading research.
"We have to build infrastructure for meeting all the requirements set forth by the American College of Surgeons, which means the clinical infrastructure and the research infrastructure, and there are many components associated with these," Reuven Rabinovici, professor and chief of the division of trauma and acute care surgery at Tufts Medical, said.
Tufts Medical had been designated as a Level II trauma center since 2009.
Rabinovici explained that there are a number of advantages that come with upgrading the hospital and that the speed necessitated by urgent trauma care improves efficiency and punctuality in all aspects of care. In addition, this new designation will enable Tufts Medical to more comprehensively train residents, fellows and nurses and better serve the community, he said.
"Many times we know, before we were a Level I trauma center, that even if other hospitals tried to transfer patients to other Level I trauma centers, many times they were basically fully booked, had no capacity and rejected the transfers," Rabinovici said. "So I think it adds capacity and expedites care of some of patients in the area."
"The criteria that differentiate a Level II from a Level I [trauma center] are primarily two different things: One is volume - volume of trauma patients - and the other is research activities," Brien Barnewolt, medical director and emergency physician?in?chief at Tufts Medical, said.
"So a Level II trauma center does not necessarily have to participate in research activities. We always have [participated in research] because we're an academic medical center," Barnewolt said.
"Patients who are injured in our immediate vicinity and who require the assets of a trauma center will no longer be driven past our medical center to some place that is actually more distant as has been in the past," Barnewolt said.
Barnewolt explained that it was natural for the Medical Center to seek this designation as it developed and progressed as an institution.
"As the volume grows, it makes sense to obtain the highest designation that you possibly can, and that's exactly what we did," he said.
The original motivation to increase the Medical Center's trauma level ranking was encouragement from former President and CEO of Tufts Medical Ellen Zane, but this initiative was continued by current President and CEO Eric Beyer, Barnewolt added.
Mackey said that this new designation - which also required confirmation from the Commonwealth of Massachusetts - was opposed by other institutions that were previously Level I trauma centers and were seeking to prevent a decrease in the number of trauma patients they saw.
"For us, we weren't really thinking about what the other hospitals or the city would gain," Mackey said. "We were thinking about making ourselves a better hospital and that clearly by going after this designation it makes us a better hospital."
In addition, Tufts Medical is already an approved Level I pediatric trauma center and is the oldest pediatric trauma center in the country. This new designation will allow families that are seriously injured to be treated in the same hospital, according to Mackey.
"This is a major achievement for the hospital because, to become a Level I trauma center, you need to have a Level I hospital," Rabinovici said.
After the Commonwealth approved Tufts Medical as a Level I trauma center, Tufts Medical became part of the rotation of local Level I trauma centers that offer immediate care and transportation to seriously injured patients, according to Mackey.
The other adult Level I trauma centers in Boston are Boston Medical Center, Massachusetts General Hospital, Brigham & Women's Hospital and Beth Israel Deaconess Medical Center.
"Patients who are not already associated with a hospital ... who are injured on the highway or in some kind of accident are taken to the five now adult Level I trauma centers in the city on a rotation basis, and we now have access to those patients as well," Mackey said.
