An 89-year-old woman is airlifted to George Washington University Hospital (GW Hospital) suffering from degenerative disease — a gradual weakening of tissues and organs due to lifestyle choices and normal bodily wear and tear. “There didn’t appear to be a lick of trauma on this woman,” recalls Babak Sarani, M.D. ’97, RESD ’04. However, trauma, explains Sarani, is not always a case of car crashes or broken bones. In this instance, the patient had ruptured one of the main vessels that carries blood to her leg. “She was going to die,” adds Sarani, director of trauma and acute care surgery at GW Hospital and associate professor of surgery at GW’s School of Medicine and Health Sciences (SMHS). The woman was sent directly to GW Hospital’s interventional radiology lab. There physicians placed a stent across her ruptured iliac artery. Following a blood transfusion, the trauma team brought the patient to the ICU. She made a complete recovery and was released the next day. It’s the resources and infrastructure that come with being a Level 1 Trauma Center that saved this woman’s life, explains Sarani.
GW Hospital recently regained verification as a Level 1 Trauma Center, a distinction, says Sarani, meaning GW Hospital serves “a vital need in the District and in Northern Virginia for care of the injured patient.” Trauma centers are verified by various entities; the American College of Surgeons (ACS) is responsible for assessing trauma centers in Washington, D.C. They are ranked 1 through 3, with Level 1 being the highest, meaning GW Hospital is capable of providing around-the-clock evaluation and treatment for any injury — from prevention through rehabilitation.
“This region would have very poor trauma coverage if it wasn’t for us,” says Sarani. He adds that in 2013, GW Hospital’s trauma center treated 1,863 patients, while average mortality rates for the most severely injured patients entering the trauma center dropped to 22 percent. “If you look across the river in Northern Virginia, the next closest trauma center is Inova Fairfax Hospital in Falls Church. Therefore, if something catastrophic happens in Arlington, in Alexandria, or at Ronald Reagan Washington National Airport, you are looking at very limited resources available to patients in desperate need of proper care.”
In the District, GW Hospital is one of only three verified Level 1 Trauma Centers. GW clinical partner Children’s National Health System is the city’s only Level 1 Pediatric Trauma Center.
Verification brings accountability, says trauma nurse Lois Collins, R.N. “We are held to a certain standard. Every three years we have to answer to the ACS,” says Collins, who also serves as director of trauma services at GW Hospital. “The demands and mandates that are placed on us by the ACS actually allow us to make everyone on our team and in the whole hospital rise to the top.”
The Level 1 designation was critical for Sarani and his team. “The work that goes into making George Washington a Level 1 Trauma Center makes our residency programs better, and ultimately that makes the institution itself stronger.” Being a Level 1 greatly improves quality, he adds.
Collins credits Sarani for leading the charge. “You have to have the right person; you aren’t going to follow unless the right person is leading,” she says.
From an academic perspective, one of the most important aspects of being a Level 1 Trauma Center is research. A Level 1 Trauma Center has a firm number of original research projects that must be published annually, and it must have residency programs with education components built into them. “We have to publish a minimum of 20 papers every three years; that’s roughly seven papers annually,” Sarani says. Whereas a Level 2 functionally has the same capabilities as a Level 1 as far as providing care goes, it doesn’t have the added pressure of creating knowledge. “That’s why it’s so important. We are a university and creating knowledge is in our mission,” he adds.
A Level 1 Trauma Center provides open communication, transparency, and a shared commitment. For Sarani and Collins, it’s all about outcomes. “People are living and living better,” Collins says.
Related Content:
- Click to go to Faculty Profile of Babak Sarani, M.D.
- Click for link to George Washington University Hospital website
