Warm Southern Breeze

"… there is no such thing as nothing."

Huntsville Hospital… all that AND a bag of chips? Wow! …NOT QUITE!

Posted by Warm Southern Breeze on Monday, March 22, 2010

Most folks don’t know it, but Huntsville Hospital is NOT, has not ever been, does not meet criteria for, and is not making any plans to obtain or become:

1.) a certified or verified Trauma Center;
2.) meet the a) American College of Surgeons, or, b) American Trauma Society qualifications for Trauma Center status;
3.) an Academic Medical Center;
4.) university affiliate;
5.) teaching hospital;
6.) research center; nor
7.) Nursing Magnet Hospital.

So what? What does that mean for you, your family, friends and others in this part of the Tennessee Valley?

Let’s examine these issues point by point.
1.) Huntsville Hospital is not a Verified or Certified Trauma Center.
On their website, Huntsville Hospital claims that “We provide the region’s only state designated Level I Trauma center.” (ref: http://www.huntsvillehospital.org/services/emergency/)

The University of Alabama at Birmingham Hospital’s website states “The Alabama Department of Public Health designates hospitals as trauma centers using modified ACS criteria, and three other state hospitals have met the state’s requirements; only UAB has ACS verification.” (ref: http://main.uab.edu/Sites/reporter/articles/64688/)

The Alabama Department of Public Health’s website states that, “Alabama is currently in the process of developing a statewide trauma system which will help save lives and reduce the burden of trauma. The system will improve the chance of survival, regardless of proximity to an urban trauma center. The trauma system is voluntary and all hospitals are invited to participate. Participating hospitals will be designated as levels one, two, or three, depending on their resources and services availability. Hospitals will be inspected to verify that they can provide the level of care for which they have applied.” -and- “In fact, 90 percent of injuries are minor and can be treated at a local community hospital. However, the remaining 10 percent who do have life-threatening injuries require quick, specialized care that can be provided by a trauma center. For these critically injured patients, the mortality rate can be significantly improved - if they are able to receive trauma care (in the operating room) within an hour of injury.” (ref: http://www.adph.org/ats/ -and- http://www.adph.org/ats/Default.asp?id=1954)

From: American College of Surgeons – http://www.facs.org/trauma/verifiedfaq.html
What is “trauma center designation”?
A facility earns the title of “designated trauma center” when it meets the requirements of government or other authorized entities. The ACS does not designate trauma centers. Instead, it verifies the presence of the resources listed in the book, Resources for Optimal Care of the Injured Patient.

What is ACS verification?
The ACS Consultation/Verification Program helps hospitals to evaluate and improve trauma care. It provides an objective, external review of a trauma center’s resources and performance. A team of trauma experts completes an on-site review of the hospital. The team assesses relevant features of the program. These include commitment, readiness, resources, policies, patient care, and performance improvement.

How can I find the list of ACS verified centers?
To see the list of verified centers, visit: http://www.facs.org/trauma/verified.html. The ACS lists only those centers that have successfully completed the ACS verification process.

We’re dealing with the meaning of three words, 1.) designate, 2.) certify, and 3.) verify. To designate means to appoint, to certify means to attest or confirm, and verify means to ensure or demonstrate that something is true, accurate or justified.

So, while the State of Alabama designates Huntsville Hospital as a “Level I Trauma center,” Huntsville Hospital does not meet the qualifying criteria as being verified by the American College of Surgeons to have the necessary “Resources for Optimal Care of the Injured Patient,” nor have they “successfully completed the ACS verification process.” Appointment to a position does not mean qualification. Essentially it comes down to this: When it comes to trauma care, do you believe Alabama’s legislature, or do you believe the American College of Surgeons?

The ACS guidelines: VRC Criteria Type I for Level I Trauma Centers (20K PDF) http://www.facs.org/trauma/vrc1.pdf

Point #2.) Huntsville Hospital does not meet the a) American College of Surgeons, or, b) American Trauma Society qualifications for Trauma Center status.

The American Trauma Society does NOT list Huntsville Hospital on their website as being either a Level I or Level II Trauma Center. “Find the nearest Level I/II trauma center to you: enter zip code” (ref: http://www.amtrauma.org/index.html)

A search of the American Trauma Society’s website for the Huntsville, AL area DOES NOT list Huntsville Hospital, and shows University of Alabama Birmingham Hospital in Birmingham, AL, Erlanger Medical Center in Chattanooga, TN, Floyd Medical Center, Rome, GA, and Hamilton Medical Center in Dalton, GA as Level I and/or Level II Trauma Centers nearest Huntsville, AL. (ref: http://www.amtrauma.org/atsandtrauma/zipsearch.jsp)

UAB is the University of Alabama at Birmingham, which School of Medicine is the Academic part, the research arm, and their hospital is Alabama’s ONLY ACS Verified Level I Trauma Center. (ref: http://www.facs.org/trauma/verified.html)

Point #3.) Huntsville Hospital is not an Academic Medical Center.
“But!,” some may ask, “What about UAB and their relationship with Huntsville Hospital?”

An Academic Medical Center is a part of a College of Medicine or Medical School. Huntsville Hospital is neither part of a College of Medicine or Medical School.

The exclusive extent of the relationship of UAB with Huntsville Hospital is merely as a clinical site (location where Students may practice their skills under the guidance of a clinical supervisor). That is the exclusive extent of UAB’s relationship with Huntsville Hospital. Those seeking to verify such information may call the Dean of the UAB Health Center Huntsville Clinical Programs at (256) 539-7757.

Point #4.) Huntsville Hospital is not a university affiliate.

Affiliate is defined as “officially attached or connected to.” Similar to Point #3.) above, Huntsville Hospital is NOT “officially attached or connected to” any institution of higher education.

Point #5.) Huntsville Hospital is not a teaching hospital.

The American Association of Medical Colleges website says that, “A “teaching hospital” refers to both individual hospitals and health systems and networks that deliver medical care to patients and are committed to educational activities in the health professions. Teaching hospitals provide clinical education and training to medical students, residents, and postgraduate fellows and are distinguished, in large part, by their clinical research programs, where drugs, medical devices and treatment methods are developed and tested. There are more than 1,000 teaching hospitals in the United States, 400 of which belong to the AAMC’s Council of Teaching Hospitals and Health Systems (COTH).” (ref: http://www.aamc.org/newsroom/presskits/teachinghospitals.htm -and- http://www.aamc.org/teachinghospitals.htm)

Further, Public Law defines precisely and exactly what a “teaching hospital” is.
42 C.F.R. PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS
Title 42: Public Health
PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS
Subpart D—Physician Services in Teaching Settings
§ 415.152   Definitions.
As used in this subpart—
Approved graduate medical education (GME) program means one of the following:
(1) A residency program approved by the Accreditation Council for Graduate Medical Education of the American Medical Association, by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association, by the Commission on Dental Accreditation of the American Dental Association, or by the Council on Podiatric Medicine Education of the American Podiatric Medical Association.
(2) A program otherwise recognized as an “approved medical residency program” under §413.75(b) of this chapter.
Direct medical and surgical services means services to individual beneficiaries that are either personally furnished by a physician or furnished by a resident under the supervision of a physician in a teaching hospital making the cost election described in §§415.160 through 415.162.
Nonprovider setting means a setting other than a hospital, skilled nursing facility, home health agency, or comprehensive outpatient rehabilitation facility in which residents furnish services. These include, but are not limited to, family practice or multispecialty clinics and physician offices.
Resident means one of the following:
(1) An individual who participates in an approved GME program, including programs in osteopathy, dentistry, and podiatry.
(2) A physician who is not in an approved GME program, but who is authorized to practice only in a hospital, for example, individuals with temporary or restricted licenses, or unlicensed graduates of foreign medical schools. For purposes of this subpart, the term resident is synonymous with the terms intern and fellow.
Teaching hospital means a hospital engaged in an approved GME residency program in medicine, osteopathy, dentistry, or podiatry.
Teaching physician means a physician (other than another resident) who involves residents in the care of his or her patients.
Teaching setting means any provider, hospital-based provider, or nonprovider settings in which Medicare payment for the services of residents is made under the direct GME payment provisions of §§413.75 through 413.83, or on a reasonable-cost basis under the provisions of §409.26 or §409.40(f) for resident services furnished in skilled nursing facilities or home health agencies, respectively.
[60 FR 63178, Dec. 8, 1995, as amended at 61 FR 59554, Nov. 22, 1996; 63 FR 26359, May 12, 1998; 70 FR 47490, Aug. 12, 2005]

Huntsville Hospital neither belongs to the COTH, nor is a university affiliate. Therefore, they are not a teaching hospital.

Point #6.) Huntsville Hospital is not a research center.

Simply put, a research center is a location where research is performed. Research is defined as “the systematic investigation into and study of materials and sources in order to establish facts and reach new conclusions.” Huntsville Hospital is not a research center.

Point #7.) Huntsville Hospital is not a Nursing Magnet Hospital.

Nursing Magnet status refers to “an award given by the American Nurses’ Credentialing Center (ANCC), an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. A Magnet hospital is stated to be one where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. Magnet status is also said to indicate nursing involvement in data collection and decision-making in patient care delivery. The idea is that Magnet nursing leaders value staff nurses, involve them in shaping research-based nursing practice, and encourage and reward them for advancing in nursing practice. Magnet hospitals are supposed to have open communication between nurses and other members of the health care team, and an appropriate personnel mix to attain the best patient outcomes and staff work environment.” The ANCC website states that, “”Recognizing quality patient care, nursing excellence, and innovations in professional nursing practice, ANCC’s Magnet Recognition Program® provides consumers with the ultimate benchmark to measure the quality of care that they can expect to receive.” (ref: http://www.nursingadvocacy.org/faq/magnet.html -and- http://www.nursecredentialing.org/)

In Alabama, the only Nursing Magnet Status Hospitals are UAB University Hospital and Children’s Health System, and achieved that status in 2002 and 2007 respectively. (ref: http://www.nursecredentialing.org/)

Huntsville Hospital is NOT a Nursing Magnet Hospital.

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6 Responses to “Huntsville Hospital… all that AND a bag of chips? Wow! …NOT QUITE!”

  1. Elizabeth said

    Actually, your citings are incorrect. There are different credentialing groups for trauma centers, as you likely inadvertently noted in your citings. While Huntsville Hospital is not verified by the ACS, it does meet the criteria for a state level I and national level II trauma center. It is a teaching hospital in that there are medical students and residents present in the hospital at any given time. It is a rare day that at least one of these are not present in the ED at some point in time. While Huntsville Hospital does not wear the badge of UAB or call itself a “university affiliate”, it does work in concert with UAB in providing teaching experience for medical students and residents.

    A little closer research into the operations of Huntsville Hospital will also lead you to realize that it is, in fact, a research center. For more information, may I direct you to the Heart Center and the work it does with Huntsville Hopsital.

    If you are involved in a trauma, you would certainly be better served being transported to Huntsville Hospital than to Decatur General or Crestwood Medical Center. In fact, these two hospitals often divert their traumas to Huntsville Hospital.

    • Warm Southern Breeze said

      First off, thanks for reading, and writing!

      From your reply, it would seem (to me) that you did not thoroughly read, nor perhaps comprehend some of the material. My citations are wholly, completely and entirely accurate as of the date of publication – and to the best of my knowledge, as of the date and time of my reply, have not changed. I cited my sources, with links, and gave direct quotations, whereas in your reply there are no references of any kind.

      Regarding trauma, for example, you assert that HHSys “does meet the criteria for… national level II trauma center,” however fail to mention any reference, accrediting, or credentialing agency. You wrote that I “inadvertently noted,” (inadvertent means “unintentional,” “inattentive,” or “characterized by lack of attention”) however, I precisely and exactly cited references and sources, again, whereas you did not.

      I wrote that “Point #2.) Huntsville Hospital does not meet the a) American College of Surgeons, or, b) American Trauma Society qualifications for Trauma Center status.” Those are TWO accrediting organizations/agencies. I wrote that what “We’re dealing with the meaning of three words, 1.) designate, 2.) certify, and 3.) verify. To designate means to appoint, to certify means to attest or confirm, and verify means to ensure or demonstrate that something is true, accurate or justified.

      I encourage you to re-read the points – (what the hell… since you can’t don’t or won’t… here is my citation AGAIN – “What is “trauma center designation”? A facility earns the title of “designated trauma center” when it meets the requirements of government or other authorized entities. The ACS does not designate trauma centers. Instead, it verifies the presence of the resources listed in the book, Resources for Optimal Care of the Injured Patient.

      I cited the federal legal source and definition of a “teaching hospital,” which HHSys does NOT meet.

      To be blunt… well, I shan’t be blunt, but I shall write that your assertions need more attention, for they are fully uninformed.

      There is ONE POINT upon which we agree, and it is that trauma victims “...would certainly be better served being transported to Huntsville Hospital than to Decatur General or Crestwood Medical Center.

      I could go on point by point in your reply, but I shall stop at this point and (presuming you are) – colleague-to-colleague – encourage you to MORE THOROUGHLY re-read the entire entry.

  2. Adalbert, zahnärzte…

    [...]Huntsville Hospital… all that AND a bag of chips? Wow! …NOT QUITE! « Warm Southern Breeze[...]…

  3. x said

    Looks Like Someone Is Either Mad They Got Fired Or Mad They Got A bill

    • Warm Southern Breeze said

      Hi x, and thanks for writing! No, neither of your assertions are correct. For I have NEVER been in the employ of Huntsville Hospital, neither is it the case of “Mad They Got A bill.” In fact, I’ve never been admitted to that, or any other hospital. Cheers to you!

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