Kokua Line
Kokua Line
Question: Queen's Hospital was advertising for emergency room nurses and termed itself a Level II trauma center. I have been under the impression it was the only Level 1 center in the state. If not, do we have a Level 1? Queen’s is ranked
Level II but still a
top flight hospitalAnswer: Queen's Medical Center is ranked a Level II trauma center nationally by the American College of Surgeons because it does not engage in research.
Otherwise, it has all the other requirements of a Level I center, including in-house trauma surgeons and 24-hour emergency services, said Susan Orr, manager of Queen's Emergency Room and Trauma Services. There are 26 Level I trauma centers and five Level II (including Queen's) centers certified nationally by the American College of Surgeons.
Queen's goal is to become more research-oriented and thereby achieve a national Level I rating within the next three to five years, Orr said.
Meanwhile, Queen's is rated a Level I trauma center -- the only one in Hawaii -- by the state Department of Health's Emergency Medical Services Systems Branch.
"Our standards really looked at having a hospital that has identified readiness 24 hours (a day) in-house," with trauma surgeons, neurosurgeons, anesthesia and all the support services necessary, Emergency Medical Services branch chief Donna Maiava said.
She explained that the state has developed an "integrated trauma system for Hawaii," with Queen's designated the lead trauma hospital.
Below the lead hospital, the state has designated "trauma support hospitals," which, on Oahu, include Straub, St. Francis, Kuakini, Castle, Pali Momi, Kaiser, Tripler and Wahiawa. For the neighbor islands, there may be only one hospital on an island, Maiava noted. So, for example, Maui Memorial is the lead trauma support hospital for Maui, she said.
Asked what it means if a hospital isn't classified Level I, Maiava said, "I don't think it means anything in the level of service between a I and a II. Certainly, the American College of Surgeons' classification for Level III and IV may mean they have only in-house emergency department physicians, but no other medical specialties in-house and readily available. That's really the difference in classifications."
For Hawaii, the state "chose not to use levels" (beyond Level I for Queen's). One reason: "Even if you were classified Level III and you're the only hospital on the island, what difference does that make," Maiava said. Instead, the state has worked out a system of networking hospitals, where patients can be rapidly stabilized at various hospitals, then transferred to Queen's.
"As an inclusive system, we then look to Queen's as the one that could best support the smaller outlying hospitals, to include neighbor islands," Maiava said. To that end, "We set up notification procedures that are very quick and not fraught with a lot of bureaucracy."
Mahalo
I've been back from Johnston Island nearly a month and was completely moved by the red, white and blue bows carefully tied to the fence on Moanalua Highway, from past Bob's Big Boy to the entrance of Moanalua Subdivision. Whoever did it should be commended for a great display of patriotism. -- General Ginny
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