Current Trauma Status Report - Southern Nevada Health District

Trauma Stakeholder Interview Results
The Abaris Group conducted greater than 100 interviews with trauma stakeholders in Southern
Nevada. This included one-on-one interviews and a series of focus groups. The following are brief
synopses of each type.
Interview Synopses
All synopses are presented in the stakeholder aggregate (all EMS providers were aggregated, all
hospitals with EDs, etc.) except for UMC Trauma Center.
Hospitals with EDs
The most commonly reported strength of the trauma system among ED respondents was the quality
of care at the UMC trauma center, which was described with words such as excellent, well-located, well
known, respected, and possessing committed resources and efficient and high quality care.
Respondents also cited as strengths UMC’s location and the fact there is no confusion in the
community about where to take trauma patients. The triage criteria were also cited as strengths by
some respondents (see triage criteria effectiveness survey results).
The most commonly reported weakness of the trauma system was acceptance of transfers at UMC -
mostly those patients that did not meet defined trauma triage criteria but that UMC was perceived to
have the resources to treat. Other weaknesses reported during some interviews were the community’s
sole reliance on UMC and a lack of competition, collaboration, or back up system due to UMC being
the only trauma center. There was also concern that growth had overwhelmed the system and that
UMC was an overly political or politically-connected institution. Over-triage was a reported concern as
well.
There are at least two hospitals willing to be added as trauma centers in the community. There is the
possibility of others in the future as the new hospitals mature and their product line needs become
identified. Of the original two new hospitals, their perspective is that their individual locations provide
the ideal site for a new trauma center.
All hospitals are impacted by capacity problems and subsequent ambulance diversions. There was a
level of frustration from the EDs and in some cases a belief that the EDs had done all they could to
improve flow and capacity but that not all had been done throughout the hospital to solve the
problems. Four hospitals admitted during the inventory process that they did not have a written
diversion policy. Several hospitals, though, were implementing an “adopt a boarder” program to assist
with ED flow which is considered to be a best-practice inpatient flow strategy.
Hospital CEOs expressed concerns about the on-call specialist challenge in the community with the
number of subspecialty issues varying from hospital to hospital. At the time of the interview one
hospital had no on call orthopedic coverage, one did not have general surgical coverage and many had
issues with neurosurgeons, ENTs, plastic and hand surgery coverage. The CEOs in general expressed
an interest in further studying this issue and coming up with common solution strategies.
Responses varied as to the need and preferred location of additional trauma centers. Sunrise Hospital
and Medical Center and St. Rose Dominican-Siena were the hospitals suggested most often, although
there was concern about the location of Sunrise from a traffic standpoint and whether St. Rose
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