It was a simple enough idea: Hospitals that treat the most trauma patients will have better outcomes. And those hospitals should have specialists, life saving equipment, and other specialty services immediately available to treat critically injured patients. This simple idea, realized as the Oregon Trauma System, has saved thousands of lives for 20 years.
Trauma is the leading cause of death and permanent disability in North America for people ages 1 to 44, and one of the leading causes of death in those older than 65. Approximately 175,000 accident-related deaths occur each year in North America.
More than 25 years ago, a landmark study showed trauma patients in the Portland area who had been taken to the nearest hospital had inappropriate outcomes based on the severity of their injuries. This proved a rallying cry to the Oregon Legislature, which called for the institution of a statewide trauma system. In 1985 then-Gov. Victor Atiyeh signed a bill creating Oregon’s statewide trauma system. The system that went into effect three years later created a coordinated, four-tiered network of trauma centers, a trauma registry, a state advisory board, and nine area trauma advisory boards to implement and monitor trauma system activities.
"Oregon not only developed one of the nation's first statewide trauma systems, it was also unique in its inclusion of smaller, rural hospitals," said William B. Long, M.D., medical director of Legacy Trauma Services. "We're proud that our system still stands as a model for other states."
Patients are identified at the scene of accidents by emergency medical services (EMS) personnel as having injuries serious enough to be entered into the trauma system. EMS providers then determine whether a patient needs to be taken to the nearest trauma center to be stabilized, or transported immediately to a Level 1 trauma center, and whether that is best accomplished by air or ground.
Legacy Emanuel Hospital & Health Center and Oregon Health & Science University are Oregon’s only Level I trauma centers, providing the most comprehensive, highest level of care for severely injured adult and pediatric patients with complex, multi-system trauma. Level 1 trauma centers are required to have an emergency physician, general surgeon, anesthesiologist, nursing and support personnel who can initiate immediate surgery in house and available to the patient upon arrival to the hospital. A broad range of sub-specialists, including a neurosurgeon, are always on-call and quickly available to respond.
The Oregon Trauma System established guidelines for continued education of trauma health care providers, and required OHSU and Legacy Emanuel to conduct research and provide community education about injury prevention. It also established the Oregon Trauma Registry, which provides information on characteristics, treatments and outcomes of trauma patients. The registry allows researchers to study the effectiveness of the trauma system and provide continual quality improvement.
Since its implementation, the Oregon Trauma System has treated 133,859 patients, including 21,474 patients who were transferred within the trauma system. A study in 1994 showed the implementation of the Oregon Trauma System resulted in a 35 percent reduction in the risk of death for severely injured patients. Another study in 1999 showed trauma patients in Oregon had better outcomes than trauma patients in Washington before that state implemented a statewide trauma system.
“As a community, Oregon rose to the challenge of lowering its unacceptable trauma mortality rate,” said Martin Schreiber, M.D., chief of OHSU’s trauma surgery (critical care section). “On the 20th anniversary of the Oregon Trauma System, we can look back and truly appreciate the advanced thinking of all those involved in creating it.”
The Oregon Trauma System is designed to provide prompt and efficient communication between health care providers from first responders through all levels of care at trauma hospitals. This ensures patients are taken to the hospital best equipped to treat their injuries. Oregonians can feel confident they will receive the best possible care should they ever sustain a traumatic injury.
Oregon Health & Science University is the state’s only health and research university, and Oregon’s only academic health center. OHSU is Portland's largest employer and the fourth largest in Oregon (excluding government), with 12,600 employees. OHSU's size contributes to its ability to provide many services and community support activities not found anywhere else in the state. It serves patients from every corner of the state, and is a conduit for learning for more than 3,400 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to every county in the state.
About Legacy Health System
Legacy Health System is an Oregon-based nonprofit, tax-exempt organization and, with more than 8,500 full- and part-time employees, is one of the largest private sector employers in the Portland metropolitan area. The Legacy system provides an integrated network of healthcare services, including acute and critical care, inpatient and outpatient treatment, community health education and a variety of specialty services. Legacy’s hospitals include: Legacy Emanuel Hospital & Health Center, Legacy Emanuel Children’s Hospital and Legacy Good Samaritan Hospital in Portland, Ore.; Legacy Meridian Park Hospital in Tualatin, Ore.; Legacy Mount Hood Medical Center in Gresham, Ore.; and Legacy Salmon Creek Hospital in Vancouver, Wash. Also included in the Legacy system are a hospice agency, a full-service research facility, and specialty and primary care clinics.