pvh vs mcr

[dougbaker]

I am a bit confused. I understand the idea that you want to take a trauma pt to a hospital that has the correct level of care. I also know that PVH has been downgraded to a level 3 trauma center and the new MCR is a level 2 trauma center...
But explain this to me.

Here is a link
http://www.coloradoan.com/apps/pbcs.dll/article?AID=/20070327/UPDATES01/70327014

The location of this TA as mentioned in the article is on North Lemay and Poudre River Drive.

PVH is on Lemay ave and I used mapquest to locate Poudre River Drive.
PVH is perhaps two blocks away. I would bet you could see PVH from the accident site, but the person was transported to MCR, I did not check but at least 15 miles.

Why not transport to closest facility. It is not like PVH is closed or does handle any trama at all?



Here is the story:
Lemay open after accident
By Coloradoan staff


Northbound Lemay Avenue is open north of Riverside Avenue after an accident at Lemay and Poudre River Drive this afternoon.

It's unclear what caused the accident, but the driver of a Subaru was extricated and taken to Medical Center of the Rockies in Loveland with a broken femur.


It’s unclear if there were other passengers in the Subaru. It’s also unclear whether the driver or passengers in a Nissan Pathfinder involved in the crash were injured.

The accident happened shortly before 2 p.m.

See Coloradoan.com throughout the day for more

 

[jimmnn]

As was posted soon after MCR opened, all trauma patients are now transported directly to MCR by EMS.

The emergency department at PVH is of course still open but for medical patients the team that comprises a trauma center activation have all moved to MCR.

Not unlike all major trauma team activations in Denver transported by EMS go to DG even if they occur near University (a level 2) or SAC (a level 1) or especially near any of the non trauma centers like St Joes, PSL, Porters etc.

Jim<

 

[Spud]

Pvh - Mcr

I am a bit confused. I understand the idea that you want to take a trauma pt to a hospital that has the correct level of care. I also know that PVH has been downgraded to a level 3 trauma center and the new MCR is a level 2 trauma center...
But explain this to me.

The same type incident happened with the extrication TA at Shields and Drake yesterday evening. I believe that two patients were exported all the way out to MCR instead of just going to PVH.

It's all about money and control. For the last decade or so, PVH has been doing everything they can to prevent any competition from moving in on their turf. It will happen eventually as the area continues to grow but they are still going to try.

If they actually cared about providing the best chance for trauma victims to survive, they would have not downgraded the service available at the hospital on Lemay Av. With the financial abilities at their disposal, they could have easily maintained the level 2 status at PVH.

The story that you will get from them is certain to be different and will include politically correct excuses for the decisions that they made. I worked there for six years back in the 1990s and am familiar with the long-term strategy that they have. PVH (and MCR) are still relatively good facilities, but the PVHS system has been dollar driven for quite some time.

It will probably take loss of lives during transport to MCR that could have been saved by going to PVH before they will re-examine the decision to downgrade PVH from level 2 trauma.


The Spud

 

[edftc]

I have had the same concerns myself-you have probaly heard the units asking for the appropriate med facility,and yes, they drive by the Hospital(pVH) to get to MCR, but as Jim explains ,it is about the level of care that the patient receives-the trauma levels indicate this. Also, the medical equipt is superior,a lot of the pvh staff moved over to MCR. Pvh is moving into birthing units,etc. For critical heart care, I have been informed that I can expect to go to MCR.The ambulance turnaround, the coverage from loveland, and the transportation of EMTs (Firefighters) back to Ft Collins is all part of the change. I think the accident at Drake/Shields, split up the patients,the trauma to MCR and the less critical went to PVH. Also, ref the Lemay Poudre dr accident involved two to PVH, ( I beleive, not confirmed) and the femur pt to MCR.With all the CRASH team support, and the road closed for two hrs, I thought it was a fatal...Ed

 

[dougbaker]

Yes, and to point out that pvh and mcr are run by the same orgainzation. pvhs, runs both, so it is not compatiion but just the allocation of resources I guess.

Thansk for information. I guess I will plan on having my trauma needs near loveland
as if anyone can plan to need urgent medical care.

 

[jimmnn]

Ambulances bypass PVH
Severe cases going extra miles on way to Loveland
By KEVIN DUGGAN
KevinDuggan@coloradoan.com

People injured in car wrecks or other traumatic events in Fort Collins increasingly end up going to Loveland for medical treatment.

Since Medical Center of the Rockies opened in February, ambulances carrying seriously injured patients have bypassed Poudre Valley Hospital to travel to the new hospital even when PVH is closer.

In a recent case, a man who shot himself in the head while at the City Limits Lounge, about a mile from PVH, was taken to MCR more than 14 miles and 17 minutes away where he was pronounced dead.

The decision on which hospital to take patients is based on a number of criteria, said Lori McDonald, trauma program director for Poudre Valley Health System, which operates both hospitals.

The primary consideration is the severity of the injury and availability of the medical resources needed to treat the patient, McDonald said. A statewide system governs the ratings hospitals are given for handling trauma cases.

"The intended goal of the system is to get the right patient to the right hospital in the right amount of time," McDonald said.

MCR is rated a Level II trauma center. The hospital has trauma-trained nurses and doctors as well as surgeons immediately available when a patient arrives at the emergency department.

PVH had a Level II rating prior to MCR coming online, but now is considered a Level III facility.

Both hospitals have full functional emergency departments, McDonald said. The difference is the immediate availability of specialists such as neurosurgeons at MCR to deal with critical injuries, she said.

When paramedics arrive on the scene of a car wreck, they assess injuries and determine whether patients need to be taken to a hospital.

A patient with a serious injury to the head or neck, for example, would be taken to the closest trauma center with the highest rating, McDonald said.

Under state protocols, if travel time to a higher level trauma center is less than an additional 15 minutes, crews are required to go to the higher-rated center, McDonald said.

Patients can be taken to a lower-rated center to be stabilized if necessary, she said, but that adds time to “getting them where they ultimately need to go.”

Driving to MCR from the emergency department at PVH takes 20 to 23 minutes, depending on the route, without “lights and sirens,” according to a study by ambulance drivers. The drive from Harmony Campus at Timberline and Harmony roads takes about 14 minutes to MCR and just over 8 minutes to PVH.

MCR, which is near the interchange of Interstate 25 and U.S. Highway 34, was designed to be a regional hospital specializing in cardiac and trauma care. It has two landing pads for helicopters, including a rooftop pad accessible by an elevator that can carry a patient and trauma team directly to an operating room.

Follow-up care a patient would need also is a consideration when deciding which hospital he or she should go to, said Herb Brady, emergency medical services manager at PVH.

Medical expertise “cannot be concentrated on every street corner,” Brady said, so it makes sense to have trauma care focused in specific locations.

In some cases patients may choose which hospital they wish to go to, he said. But critically injured patients may not be able to make that choice and their families may not be aware of the resources available at different hospitals.

Having more than one hospital to choose from is not unusual for paramedics, he said.

“It has taken some adjustment now that we have two hospitals,” Brady said. “People in Fort Collins aren’t used to this. But for our paramedics who have worked in other cities, this is nothing new.”

 

[jeffreyinberthoud]

Hey for us guys up north,

I still keep hearing people refering to the other channel or channel 2 or tac
so keep looking for talk group Ive not found it yet

 

[rickak]

Hey for us guys up north,

I still keep hearing people refering to the other channel or channel 2 or tac
so keep looking for talk group Ive not found it yet

4070 is the pvh med tac1 talkgroup, if that is what you're refering to.

Rick

 

[jeffreyinberthoud]

med tac ??pvh

No rick I got that one also not sure what they are refering to Ill have to walk down and ask one of the TVA guys

 

[poltergeisty]

Ambulances bypass PVH
Severe cases going extra miles on way to Loveland
By KEVIN DUGGAN
KevinDuggan@coloradoan.com


Under state protocols, if travel time to a higher level trauma center is less than an additional 15 minutes, crews are required to go to the higher-rated center, McDonald said.

.....................

The drive from Harmony Campus at Timberline and Harmony roads takes about 14 minutes to MCR and just over 8 minutes to PVH.

So this state protocol is right within the border line of bypassing MCR in favor of just going to the whole eight minute trip to PVH? DAMN! Common sense never makes sense in a bureaucracy anyways.

Now if the President where to visit Fort Collins and he/she has an emergency, where do you think the first hospital trip will be? I'm sure the blood will be on hand at PVH. :roll:

 

[jimmnn]

So this state protocol is right within the border line of bypassing MCR in favor of just going to the whole eight minute trip to PVH? DAMN! Common sense never makes sense in a bureaucracy anyways.

Now if the President where to visit Fort Collins and he/she has an emergency, where do you think the first hospital trip will be? I'm sure the blood will be on hand at PVH. :roll:

Actually no the presidents medical team does a pre-site visit of the highest American College of Surgeons (ACS) verified trauma center so MCR (level 2) would win over PVH (level 3).

I was involved recently in a pre-site visit in the South Metro area and Littleton Hosp (level 2) and Swedish (level 1) were both visited and the team reserved a surgical suite and kept the cross matched blood on hand at Swedish in Englewood.

Jim<

 

[mpg0515]

4070 is the pvh med tac1 talkgroup, if that is what you're refering to.

Rick

just to add another TG that Jeffrey might be thinking of is 4071 is being used/called PVH MED Tac-2 instead of "security" or whatever it is labeled with.

 

[skipshark773]

just to add another TG that Jeffrey might be thinking of is 4071 is being used/called PVH MED Tac-2 instead of "security" or whatever it is labeled with.

Yea, security operates off a UHF frequency, 461.975 PL 192.8. They have callsigns like Valley 1 ect. I havn't really been paying close attention to that frequency to see if MCR uses it for security too, but Ill give it a listen and see what comes up.

 

[mpg0515]

Yea, security operates off a UHF frequency, 461.975 PL 192.8. They have callsigns like Valley 1 ect. I havn't really been paying close attention to that frequency to see if MCR uses it for security too, but Ill give it a listen and see what comes up.

as a matter of fact they do.... 461.975 w/ a 203.5pl. There is also a link setup so that PVH can talk to MCR and that pl is 162.2. kind of funny when they are talking back and forth, I can hear both repeaters here and they kind of take each other out. Interesting they decided to use the same pair only different pl tones....

 

[skipshark773]

Interesting, I was unaware of that. Ill have to plug those PL's in and give it a listen. I'm interested in hearing how the 162.2 link is used.

 

[Halfpint]

Hmmmmmmm... Somehow I am not the least bit surprised that `new' money is again winning out over `old' money. In this case it's `new' investment money winning out over `old' already basically amortized investment money but, it's still the same old song and dance.

PVHS has gone and invested a whole bedpan load of `new' money into MCR and rather than invest a smaller amount of it into PVH to keep up the `service status' they have decided that they will let PVH `slow twist in the breezes' as a lesser facility so that they can use MCR as their new diadem to show off to their stockholders as an example of how `forward thinking' they are.

Years ago my father, an Orthopædic Surgeon, as part of a study he was one of the authors of for the Federal Government pointed out that this was going to be just one of the problems that were going to crop up in the future in areas where there was large explosive growth in population in relationship to existing services availabilites. He and his fellow authors noted that the existing facilities would tend to be marginalized down in favour of moving services they had historically provided over to the newer facilities mainly because of the perceived `new' = `best' syndrome even when it would actually end up meaning that both facilities would actually suffer because of variables like transit time increases among others. (Sounds kinda familiar doesn't it? {WAN GRIN!}) While I don't have a copy of the whole study handy I *do* remember that they had worked out a somewhat simple formula based on population densities that were such that, from what it sounds like if they had been followed, this particular situation we now have could have been avoided and both patient care *and* the facilitie's `bottom lines' would have actually benefitted in the long run with only a slight bit of `pain' on the facilitie's `bottom lines' whilst keeping patient care / service at at least the same levels if not a bit higher. *All* the authors warned about the approach of exchanging the goal of providing proper, timely, and quality patient care for maintaining investor `bottom line' `care' that was even then becoming visible in the healthcare industry.

Unfortunately I have this awful sinking feeling that we are going to see things get even worse than they cautioned against and scenarios like this are going to be played out more and more often before someone says "Enough is enough!" and we have to pick up the pieces and try and put things aright. In this case they *might* be able to do something about what is coming *if* they can perform the necessary `craniorectomotomy' quickly enough and bring PVH back up to the sufficient standards and use more realistic boundaries. Heaven knows that MCR is going to be gaining a lot more density to supply it fairly quickly given how the sprawl is growing even with all the supposed `slowing down' we keep hearing talked about. To sacrifice at one to try and gain an `instantaneous?' ROI at the other is doing both the clientel and the investors a `grave' disservice in more ways than one. I suppose that my growing up in a medical family has probably somewhat tinged my outlook but, I always have felt that it was the patients that were the important people. Sadly it is looking more and more that they are having to `take hind teat' to others these days. I guess I should be happy that my father and mother, who was an RN and a RPT, aren't around to see what is happening.

Oh, well... Just an `Olde Fart's' 2¢ worth... {FROWN!} Still... It *would* be nice for the `sheeple' to wake up and realize what is happening...

 

[Spud]

The level of care...

I suppose that my growing up in a medical family has probably somewhat tinged my outlook but, I always have felt that it was the patients that were the important people. Sadly it is looking more and more that they are having to `take hind teat' to others these days. I guess I should be happy that my father and mother, who was an RN and a RPT, aren't around to see what is happening.

Oh, well... Just an `Olde Fart's' 2¢ worth... {FROWN!} Still... It *would* be nice for the `sheeple' to wake up and realize what is happening...

Your message is well stated. I also grew up with my mother being an "old school" RN (complete with cap and gown), my Mother-in-law a CRNA (career gas passer) and my wife who retired after working for over 20 years at PVH.

The patients still matter to the majority of the "hands-on" employees but do not think for even one minute that this attitude is existent amongst the hospital administration or the stockholders. At that level it is all about money and control. The words that they speak are consistently trumped by the actions that they take with regards to treatment of both the patients and the employees.

It will take a significant loss of life and public pressure to get the mistakes that they have made rectified, if it can be done at all.

The spud.

 

[Thayne]

All I know is that the apparent level of a caring attitude that I have witnessed both as a patient in 1978 and a patient in 2003 has declined dramatically.
Even with all of the advances in medical technology, going to a hospital nowadays is Very scary. If you don't stick up for yourself or your family when hospitalized you have a very good chance of having a negative outcome compared to 30 years ago.IMHO

 

[jimmnn]

Larimer County: AirLife 911 in Rist Canyon currently on a scene flight, 3 y/o child run over by a vehicle awake but has a flail chest and major injs checking now MCR for stablization or a direct flight to Children's.

JIm<

 

[Halfpint]

Larimer County: AirLife 911 in Rist Canyon currently on a scene flight, 3 y/o child run over by a vehicle awake but has a flail chest and major injs checking now MCR for stablization or a direct flight to Children's.

JIm<

I've caught bits-n-pieces of that call and as a parent my prayers go out to all concerned. Amazingly enough I hope that they actually take the `stabilization' option and keep the chopper `hot' to eventually get him down to Children's as it sounded like they weren't having a good time aboard the chopper the last transmission I caught. As a parent calls like this scare the beegeezus out of me. On top of that I also remember all the troubles that occured when *I* was a major trauma, spinal @ C5/C6, patient back in 1966. (The first ambulance sent was involved in a TA, about 2 -3 miles from where I was, and they had to dispatch a second.)

Just an `Olde Fart's' 2¢ worth. {WAN GRIN!}