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Message from the State Health Officer

Donald E. Williamson, M.D.

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Alabamaís Statewide Trauma System Maximizes the Benefits of Rapid Intervention

Alabamaís statewide trauma system offers a unique opportunity to positively impact the lives of the citizens of Alabama. Trauma is a major problem in the state of Alabama, and is the leading cause of death in people under age 45 in our state.
After a traumatic injury, transporting the most severely injured patients to the closest, most appropriate hospital that meets their needs means lives can be saved and serious disabilities prevented. For the great majority of injured people, time isnít so important, but for the 5 to 10 percent of those with life-threatening or life-limiting injuries, this improved system can make tremendous positive changes in mortality, length of hospitalization, and quality of life.

Alabama has been on a nearly decade-long journey to address trauma by building a statewide trauma system. State leaders discussed the need for an organized response to managing and improving the care of severely injured people by implementing a trauma system. In 2007, the Alabama Legislature passed an act establishing a trauma system, and on August 21, 2014, we were happy to announce the activation of the final portion of the stateís 18-county southeast region, meaning the entire state is now covered.
Our system improves the chances of survival, regardless of the patientís proximity to an urban trauma center. This is the way the system works: After emergency medical services personnel arrive on the scene and evaluate a patient, the trauma communications center will be contacted. Most patients will be taken to the closest hospital for treatment; however, for those with severe injuries the system will centrally route them in real time to the closest and most appropriate trauma center. Minutes saved have been shown to reduce the death and disability rate in patients for whom prompt medical treatment can make a difference. Now patients needing rapid, specialized treatment go directly to a hospital with the capacity to provide definitive therapy.

Rather than having multiple dispatch locations, all Alabama cases are routed from a single site in Birmingham. The trauma system we use allows a hospital to inform us if they are overloaded with trauma cases, and whether the neurosurgeons, orthopedic surgeons, or other specialists are already occupied and are not available to care for the patient. Through improved communication, the patient then is routed to a hospital where care is available.

Alabama is the only state in the United States with the capability to constantly monitor the status of every trauma hospital and route the trauma patient to the right hospital every time. This system that matches the patient with the hospital in real time is the model for the rest of the nation.

In addition to providing the best care, this system makes the most efficient use of scarce resources. While other states have spent tens of millions of dollars to establish a trauma system, Alabama has enjoyed the voluntary participation of physicians and hospitals in the creation of the system.

Prior to the inception of the trauma system, the average hospital length of stay for trauma patients in Alabama was 5.72 days, compared to 5.15 days after the system began operation. This is approximately a 10 percent reduction in the length of hospital stays for traumas that have been reported to the Office of Emergency Medical Services. Reduced hospitalization times lead to reduced health care costs per patient and improved patient outcomes.

All hospitals are invited to participate and are designated as levels I, II, or III, depending on their resources and availability of services. Hospitals are inspected to verify that they can provide the level of care for which they have applied. Alabama has 6 EMS regions, 54 trauma centers, 1,166 ground units, and 12 air units statewide. In addition, 8 out-of-state air units are operating in Alabama.

We applaud the progressive hospitals of Alabama, emergency medical services personnel, Alabama physicians, and Alabama Trauma Communications Center partners for voluntarily working together to provide needed access to care. We look forward to the positive outcomes in saving lives and improving the quality of lives that will follow as a result of our statewide trauma system.

(September 2014)

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