What is different about the disease of trauma other than the nature of the
injuries? Well, the disease happens 24 hours a day, seven days a week. In fact,
late night between 11 p.m. and 2 a.m. is the peak time for admissions to the
Trauma Center. Many patients who are victims of violence come attached with
security requirements. A percentage of trauma patients’ injuries are self-inflicted. Those with traumatic brain injuries require
specific protocols as
they begin to regain awareness and exhibit behavioral problems.
“The aggregation of these patients allows us improve clinical care, and to do
that in a scientific fashion. This is part of the mission of the enterprise,” Morris said.
Not only is clinical care improved by the aggregation of trauma patients, but by
treating all these patients in one place also significantly reduces cost. “What we have seen is that creating these efficiencies, which includes lots of
little efficiencies, if you aggregate them our length of stay is about 30
percent less now, and therefore we have lowered cost by 30 percent,” he said.
This increase in efficiency has so far allowed Vanderbilt to continue to treat a
growing population of uninsured or underinsured patients. “Under different circumstances this patient population might have led to a
reduction or the demise of our trauma program,” he said.
While systems and process for treating VUMC’s trauma patients may be routine by now, many of the patients’ injuries, and how they sustain them, are anything but ordinary. Things that
happen to trauma patients—Morris does not call these accidents—are myriad, and frequently hard to believe. The Trauma Center has a history of
treating a broadly diverse patient population from all walks of life.
Among the more visible patients in recent years: a rock musician seriously
injured in a motorcycle accident; a major country music star and a professional
football player, who were both critically injured in auto accidents; members of
Middle Tennessee’s law enforcement community injured in the line of duty; a real estate mogul
whose personal airplane went down in a cornfield; a rodeo cowboy gored by a
bull; a teenager who nearly had his head severed from his body as he was
garroted by a wire fence while riding an all-terrain vehicle; an elderly man
who suffered a traumatic brain injury after falling from a horse and then
having the horse, in turn, fall on his head, and a teenager who had both feet
severed by an amusement park ride.
“What I find most gratifying is that the Trauma Center has helped change the
culture of the institution as far as going out into the community. The Trauma
program has expanded the institution’s reach, and helped change the culture of the institution away from being known
only as a quaternary referral center,” Morris said. “We’re much more about meeting the community’s public health needs than we were years ago. The Trauma service, the Emergency
Department and LifeFlight have been fundamental catalysts in initiating this
change.”
