Ventura County Star
By Steve Carroll
VENTURA COUNTY, Calif. — It is important to clarify the facts regarding the process and extraordinary measures taken to avoid any possible bias in the selection process for Ventura County’s trauma-designated hospitals. The county’s Emergency Medical Services Agency from the beginning embarked on a fair and impartial process that assured transparency through inclusion.
EMSA is mandated by the state of California to provide regulatory oversight and medical direction for the development, implementation and oversight of a sustainable trauma system, including the identification and designation of trauma centers.
Development of trauma system
More than 18 months ago, EMS convened the Ventura County trauma stakeholder group to provide discussion and input into the creation of the trauma system for Ventura County. This group included all Ventura County hospitals, ambulance companies, fire departments, law enforcement, air transport providers and EMS staff.
An economic analysis was conducted by Bishop and Associates, a well-known and highly respected trauma consultation firm. With consideration of geographic issues, population concentrations and fiscal sustainability, the stakeholders group concluded and unanimously agreed that the trauma plan would include two designated trauma centers, one in the east county and the other in the west county.
Hospitals agreed to process
The trauma Request for Proposal was created by EMS using California and American College of Surgeons criteria for trauma hospital designation. The RFP was then released to all the hospitals. The stakeholder group created a subgroup called the trauma work group to work on the remaining details.
This group had representation from all area hospitals, ambulance services and EMS. The hospitals through their work group representatives were able to critique the RFP and through consensus, it was modified to reflect these discussions.
The final document contains the procedures, list of requirements and selection criteria for trauma hospital designation agreed upon by EMS and the working group.
EMS received completed proposals from Los Robles Hospital and Medical Center, St. John’s Regional Medical Center and Ventura County Medical Center.
Unbiased reviewers
The American College of Surgeons provides the gold standard in the evaluation of trauma care and certifies hospitals nationwide. This organization verifies the presence of resources needed for optimal care of the injured patient.
To ensure an unbiased and professional review of the hospital proposals and with the unanimous consent of the trauma working group, EMS contracted with the ACS to act as an independent review panel.
The ACS has no affiliation with Ventura County government, Ventura County Medical Center or our EMS Agency. All members of the working group agreed that the ACS would provide impartial, unbiased review of the RFP applications and be qualified to perform site visits to each hospital for a physical inspection and interview of medical and other staff.
With the difficult situation of choosing between two west county applicants for one designation, we asked ACS to evaluate and score the two west county hospitals. An overall score for each hospital was to be included in its final report.
At the time of the ACS site visits, its representative confirmed that Ventura County Medical Center and St. John’s hospital representatives understood and agreed to the process.
ACS recommendation
The ACS recommended designation of Los Robles Hospital and Medical Center in the east county and VCMC in West County. Though the scoring was close, all five surveyors unanimously scored in favor of VCMC over St. John’s Regional Medical Center.
While the report states that all three hospitals met the minimum standards, it also includes an opinion that Ventura County might best be served by three trauma centers.
According to the state-approved trauma plan and agreed to by all members of the trauma working group, the designation of three trauma centers is not sustainable or medically appropriate for our county.
Based on this information, the EMS Agency intended to recommend to the Ventura County Board of Supervisors that Los Robles Hospital and Medical Center and Ventura County Medical Center be designated as level II trauma centers.
We planned to complete the necessary contracts, policy development and training in time for a June 1 implementation.
Status of trauma system
St. John’s has decided to appeal the decision, claiming the EMS Agency strayed from the written plan. The facts do not support that allegation. We are currently working to identify appropriate appeal panel members. EMS Agency believes it had achieved a fair and open process. This belief was confirmed by the Jan. 30 Star article, “Three hospitals vie to be county trauma centers,” in which then CEO of St. John’s Michael Murray stated, “I trust in the objectivity of the process”.
As the individual charged with managing emergency medical services, I feel an enormous sense of responsibility to the people of this county and take great pride in the care we provide. EMS’s goal is, and always has been, to ensure the safety and well-being of Ventura County’s residents.
It’s a commitment we take very seriously. We strive to provide an EMS system where patients receive excellent care at all of our eight quality hospitals and where those with the most serious illness or injury are directed to the one best staffed and equipped to treat them.
EMS will work as swiftly as possible toward the ultimate goal of implementing a high-quality trauma system for Ventura County. Our community deserves nothing less.
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