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Home / Washington Business - March/April 2005 / Harborview Trauma Center: Providing the Best Care to Everyone |
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Harborview Trauma Center: Providing the Best Care to Everyone |
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Written On: March/April 2005 |
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Written By: by Shawn Sullivan |
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An elderly couple heads from Seattle to Yakima to visit relatives. Near the top of Snoqualmie Pass, they encounter a deer on the road and lose control of their vehicle while trying to avoid an accident. Their vehicle rolls over several times, and, as a result, the couple sustains major injuries.
The paramedics arrive at the scene and attempt to stabilize both people for transport to the only level-one trauma center in the Northwest, Harborview Medical Center in Seattle. The medics at the scene give the couple a 50 percent chance of survival. But the Harborview helicopter lands to pick them up and their odds for survival suddenly increase.
At Harborview Trauma Center, the trauma team receives a call that two people were involved in a serious auto accident. For the highly trained staff at Harborview it is just another routine night on the job.
The helicopter lands and the trauma team assesses the situation and prepares to save the elderly couple. Fortunately, these types of injuries are commonplace in the trauma center. The doctors at the hospital see thousands of these injuries every year, and the survival rate stands at 96 percent.
That number testifies to the professionalism and skill of the physicians that staff the trauma center. Harborview prides itself on its ability to care for every patient that comes through the emergency room doors with the best and most current techniques available.
“Harborview Trauma Center’s primary objective is to care for critically ill and injured patients,” says Harborview’s chief of trauma services Dr. Gregory Jurkovich. “It is also to have the most advanced resources available 24 hours a day, seven days a week and 365 days a year to allow us to care for any injuries that occur to any patient.”
Doctors at the trauma center normally see 6 to 7 seriously injured patients every shift, and a shift normally lasts 12 to 14 hours. Long hours and the unpredictability of the work is a testament to the dedication of the doctors and nurses in the trauma center.
Not only do they see trauma victims daily, they are also responsible for several other important tasks during their entire shift, sometimes keeping them past their scheduled time. On a typical day, a resident surgeon’s shift starts at six o’clock in the morning. Between six and eight, surgeons make rounds to see patients. The operating room schedule begins at eight o’clock and the surgeons will remain busy all day long taking care of either elective surgeries or urgent surgeries from the night before.
Surgery will be interspersed with a half a day of clinic, seven days a week, where surgeons see patients without critical injuries or patients that come back for follow-ups. One or two hours of each day is also spent in educational conferences where doctors review the latest in technological advances and surgical procedures.
Every doctor must work a 24-hour shift two or three times each month. After the physician completes the shift, he or she usually stays at the hospital for another four to six hours to complete paper work. When the paperwork is completed, he has the next day to rest before another next shift begins.
On occasion doctors in the operating room need to conduct emergency surgery, which causes changes in the operating schedule. “The nature of work here is not very predictable,” says Jurkovich. “It is very disruptive, very unscheduled, and you have to be willing and flexible to deal with that disruption. Doctors in the trauma center often are required to shift gears and focus on an emergency. That is one of the biggest challenges our doctors face.”
A constant need for quick reaction times and a commitment to patients who need immediate critical care is another part of the challenge. “These are patients who, anywhere else in the country, even at other major trauma centers, would have died,” says Johnese Spisso, Harborview’s chief operating officer. “That is why we say we are ‘practicing perfect,’ because of how well we set up the trauma center. We are committed to getting the right patient to the right part of the hospital at the right time.”
The fact that 30 percent of the indigent patients in Washington come to Harborview for charity care illustrates a commitment to the treatment of any patient, regardless of financial situations. “We provide the lion’s share of charity care in the state,” Spisso says. “Changes in the economic status of the state and the loss of the state’s medical indigent program cause a steady increase in the number of charity care cases.”
King County residents have responded to this crisis by approving a bond initiative to fund improvements at the hospital. The county agreed to make the oldest buildings on campus earthquake safe and expand the Intensive Care Unit capacity. The ICU expansion will help increase the trauma center’s ability to treat every person in need, a significant step in reaching Harborview’s goal of caring for any injuries that occur to any patient.
Harborview also conducts research through the University of Washington, and applies successful research technology to the trauma center. The Gamma Knife Center is one of the advances that successfully limited the invasiveness of major surgery. The Gamma Knife is a laser used for operating on brain tumors and other difficult surgical problems. The laser allows the patients who undergo difficult surgery to recover quickly. In most cases, Harborview releases these patients the same day.
The Gamma Knife Center is only one of the many advances in technology that have assisted Harborview in becoming the medical powerhouse it is today. The trauma center is always looking for ways to improve, and Harborview is always looking to improve the level of care.
Where Did It All Begin?
In 1887, King County made an agreement with Dr. H. B. Bagley to provide medical treatment for the county’s poor. The contract lasted one year, and Bagley received $300 for his services. Soon after King County signed the contract, a six-bed, two-story county welfare hospital emerged in Seattle’s Georgetown neighborhood. This small county hospital turned into the nationally recognized Harborview Medical Center that sits at the top of Seattle’s First Hill district.
Today, Harborview Trauma Center is the largest trauma center in the state. King County still owns the buildings, but the University of Washington has total management control. At any given point during the year, Harborview employs approximately 4,000 employees, not including the interns and medical students that rotate through the facility each year.
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