For the first time ever, Cape Cod has a trauma center.
Up until recently, if you were seriously injured on Cape Cod—badly enough to require trauma care—you sometimes had to travel at least 50 miles to the nearest trauma center in Boston or Rhode Island.
But now, Cape Cod Hospital has received verification from the American College of Surgeons as a Level III Trauma Center with neurotrauma care.
CAI's Gilda Geist spoke to Cape Cod Hospital's trauma medical director, Dr. C. Jeffrey Siegert, to learn more about what this means for patients on Cape Cod.
Gilda Geist Can you explain the different trauma center levels? And, just for our listeners, Level I is the highest.
C. Jeffrey Siegert So [for] Level III, you can take care of about 80 percent of the trauma. You can also stabilize those 20 percent of traumas that are really sick, and so when they get up to Boston or Rhode Island to a Level I center, they're going to have a much better outcome.
GG Cape Cod has long suffered from a shortage of health care providers, but I also understand that there are pretty specific staffing needs for a hospital to receive this kind of trauma center designation. How did you guys pull this off?
CJS There is a huge health care staffing crisis, especially on the Cape. But we had a lot of the pieces in place already. The difference was the communication between different services, like general surgery is talking to orthopedic surgery or orthopedic surgery is talking to general surgery. Because our patients, the trauma patient, touches so many different parts of a hospital and so many different nurses and techs and physicians, just in different specialties. You have to have a good way to communicate, to have a plan. That was the hard part.
So what we have now is when someone comes in with particular injury patterns, we already have the cookbook ready to go, and that was not in place before. And I think over the last three years, we've really been walking and talking and acting like a trauma center. We just haven't been advertising it because we weren't verified. But it's not like all of a sudden the lights go on and we're going to start doing that. We have been doing that and practicing that, and then seeing where our blind spots are and then going back every month, talking through with the whole team and saying, 'Okay, we're going to change this and update this guideline, and then that way we can do it better.'
GG So Betsy Henderson, trauma program manager for Cape Cod Hospital, who I spoke to last week, mentioned that you use this term 'medical desert.' Can you define that term for us and explain how it applies to us here on Cape Cod?
CJS Even though we're seem like we're pretty close to the big city—we're like only 60 or 70 miles away—from a logistical, medical standpoint, but especially after Covid, with the levels of staffing in the hospitals dropping precipitously, you can't just count on transferring a patient up to Boston and having a bed available on the other side of that. You really have to be able to stabilize these patients, take great care of them, even potentially do all the care on the Cape. Whereas before, ten years ago, it was a much simpler thing to get patients sent up to Boston. And that's why getting a trauma center together was important because it really enhances what we can do on the Cape, not just medically, but how fast we can do it.
We have basically one company that does a lot of the transport. If those ambulances basically are saturated, then you have to rely on the fire department. Well, when that happens, you send an ambulance with a crew up to Boston in the middle of the summer and all that traffic, you've definitely lost that ambulance. You've lost that crew for at least a shift, possibly two shifts. So what that does for the community is you call 911, your response time is worse.
GG Is there anything else you wanted to add?
CJS I'm just so proud of all the surgeons, the nurses and the techs. I mean, people have really sacrificed a lot. Everybody put in a ton of work. It's not just, like, paperwork. People are showing up at two in the morning, whereas before, they could just say, 'I'll just send it to Boston.' No, doesn't happen anymore. We come in, we take care of it. And I'm just so humbled by everybody's effort. We definitely were seeing better outcomes over the last year because we were able to take care of the patients on the Cape and we weren't just throwing them up to Boston. And by the time they get up to Boston, they're sick as a dog. So I was really proud of our teams.