Dr Mark Waterman and Freda Lyon, RN, VP of Emergency Services at the WellStar Atlanta Medical Center hospital trauma center.
Photo: Phil Skinner for the AJC
Photo: Phil Skinner for the AJC

WellStar Trauma Centers unite

When WellStar Health System purchased five Atlanta-area hospitals from Tenet Healthcare in April of last year, it marked the beginning of a collaborative effort. As the one-year anniversary nears, the system’s three hospitals with trauma centers continue joining forces to amp up best practice. And it’s the patients who will reap the rewards.

Before the acquisition, WellStar Kennestone Hospital proved to be the busiest emergency department in the state. Since being designated a Level II Trauma Center by the Georgia Department of Public Health in 2012, the trauma team has served more than 7,000 patients.

The acquisition finds Kennestone teaming with WellStar Atlanta Medical Center and WellStar North Fulton Hospital. North Fulton, which also has a Level II Trauma Center, was the first trauma center in Georgia designated by the American College of Surgeons. Atlanta Medical Center has a Level I Trauma Center.

The difference between Level I and Level II is Level I centers must be participating in and conducting research to improve patient care. They also are required to have a surgical residency program. According to the American College of Surgeons, the clinical care provided at both Level I and II centers remains the same.

“Across the board in our emergency departments, we’re looking to standardize practices where we can,” said Freda Lyon, RN and vice president of Emergency Services for WellStar Health System. “We’re also looking to make sure we’re staying on top of all of the evidence-based practices. Emergency medicine just happens to be one of the areas that changes the fastest.”

A change in the new WellStar dynamic has resulted in a trauma task force that meets monthly from all of the trauma hospitals in the WellStar system. According to Lyon, they’re still in assessment mode.

“The next step for the task force is working on consolidating some evidence-based guidelines and best practices across the system,” said Dr. Amy Wyrzykowski, the medical director at WellStar Atlanta Medical Center. “So far we’ve been working with the state to make sure that our goals align with the state’s needs for trauma care in the state of Georgia.”

According to Lyon, the biggest change she’s seen in her two years with WellStar Health is the collaboration between the trauma centers. Although they’re still in the early stages, Lyon said she’s excited about the relationships.

“It’s really coming together,” she said. “We’re looking at our processes, searching out the evidence-based practices, and now it’s kind of a process of deciding what we need to roll out where. Who’s got the best practice and who needs to copy?”

Lyon said they’re considering taking Kennestone’s Trauma Nurse Fellowship program and possibly putting it in place elsewhere. This seven-week intensive program takes nurses new to trauma nursing and raises their skill level. When they walk out they’re able to be the primary nurse to trauma patients.

“We just had our first class,” Lyon said. “And we’re evaluating how that went. Our goal is once we’ve evaluated and gotten our research on the outcomes of the program, we’ll tweak and start sharing with other facilities.”

Another improvement recently took place at Atlanta Medical Center, modeled after a best practice from other WellStar emergency departments. It’s call door-to-provider, and it places an advance practice provider —either a nurse practitioner or a physician assistant— in triage to make sure the patients see their provider quickly. It helps kickstart the process and get things moving. Even if a patient can’t go straight back to a room, they can be seen by a provider and get labs, x-rays or other items started.

“That’s one of the best practices we’ve shared,” Lyon said. “Those are the kinds of things we’re doing. It’s something we can mobilize across the system where it makes sense.”

Another change that made sense was an increase in staffing. Each trauma center was examined, and Atlanta Medical Center had a need. Their staffing was recently increased by 20 percent. According to Lyon, they plan on having a total of a 45 percent increase in staff by summer.

“We were woefully understaffed, and now we’re up to capacity for nurses in the emergency department,” said Dr. Wyrzykowski, “which has resulted in a direct improvement in the quality of the patient care experience.”

If all goes well, the WellStar expansion should continue to further the quality of that experience. According to Dr. Wyrzykowski, there seems to be strength in numbers.

“We have the opportunity to be a trauma system within the Georgia trauma system,” Dr. Wyrzykowski said, “and share our resources within the system. This could help make us one of the premier trauma systems within the state.”

TRAUMA NURSING Q&A

Are you considering working in a trauma center? If so, we talked with Lisa Ulbricht, an RN who serves as the trauma outreach coordinator at WellStar Kennestone Hospital. She gave us a quick peek behind the curtain at the life of a trauma center nurse.

On what she likes most:

“Most people would say it’s an exciting specialty; exciting as in there’s a lot of adrenaline and things are happening fast. But there’s also a little bit of a variety. You don’t know what’s coming in. As an ER nurse, which is my background, we get bored easily. So having that variety helps to keep things interesting and different day to day. So there’s always something new to see and something new to learn.”

On the most rewarding part of working in a trauma center:

“I would definitely say when we see people come in, you really think that there’s no way they’re going to walk out of here. I’ve worked both ER and trauma ICU. So I have seen them come in looking terrible and then walk out of there. So I would say seeing them improve; going through that physical therapy; and then being discharged either back home or to rehab; and heading back to their normal life is very rewarding. Sometimes they come back, and we see even more improvement. It’s just nice to see that.”

On what it takes to be a good trauma nurse:

“I would say you definitely have to be flexible and have to be able to make quick decisions on your feet. Things change very rapidly with trauma patients. You need to be able to anticipate what’s to come. You need to know disease process of different mechanisms of injury, how to care for those patients and basically being one step ahead. You have to want to learn and continuously learn. Things are always evolving in the trauma world. There isn’t a lot of background in trauma history, so there’s a lot of new research happening and a lot of evidence coming out on the best way to deal with things. You need to be a leader and know how to delegate. Most of all, you need to know how to be a part of a team.”

On what working in trauma does for a nurse:

“I would say most importantly it gives you the base of critical thinking, because you have to think quickly and be able to recognize and detect what’s going on with a patient. If a patient is deteriorating rapidly, it will happen rapidly. So you have to be able to think quickly, critically and work fast. After that experience, you can use it anywhere you go. You’ll be able to be quick on your feet and be very knowledgable about really, really sick patients.”

On what helps the trauma center at WellStar Kennestone succeed:

I would say team work. Everyone works really well together. Education is important. We have a lot of internal education and a lot of people participate in that. There’s a lot of multitasking going on, and I think we have a great leadership team keeping everyone on the right track.

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