As it prepares to open a shiny new hospital, Parkland Memorial is facing a steady decline in trauma cases due to increasing competition.

As it prepares to open a shiny new hospital, Parkland Memorial is facing a steady decline in trauma cases due to increasing competition.

The hospital’s board of managers at a Wednesday meeting encouraged a new marketing campaign that could draw more trauma cases from hospitals in rural areas of the state. Parkland would highlight the features of its new hospital and trauma center, which open Aug. 20.

"We’ve seen growth over the past 10 years, but over the past 24 months, we’ve seen a decline," said Kris Gaw, Parkland’s chief administrative officer. "It’s hard to predict what will happen with all these centers opening up."

The public hospital’s leaders are concerned that the decline could hurt Parkland’s efforts to train trauma specialists. Lost income also is an issue, estimated at $1.7 million for those services.

"Anybody can put their sign up and say they are a trauma center if they meet the criteria," Gaw told Parkland’s finance committee.

A decade ago, Parkland’s annual trauma caseload surpassed 4,000, and the number climbed to 7,800 in 2013. It should near 8,150 this year, the hospital said, but has fallen below 7,000 for the second year in a row.

The decline is alarming enough that a hospital committee is being assembled to try to reverse it, said Dr. Winfred Parnell, a board member. The committee will focus on building relationships with rural hospitals that might send trauma patients to Parkland.

Local hospitals offering trauma care say they saw a need to do more, especially in a state where 30 people die daily from traumatic injuries — nearly 10,000 Texans per year. That includes Methodist Dallas Medical Center, which was upgraded to a Level I trauma center in December.

"While more trauma centers have become available in North Dallas, demand for our trauma care remains consistently strong," said Chris Hawes, spokeswoman for Methodist Health System. Such access "is crucial to trauma patients, for whom every minute counts."

In 1987, Parkland was the first Texas hospital to win trauma verification by the American College of Surgeons. After a recent survey, Dallas County’s public hospital again was recognized as meeting the highest qualifications. Such centers offer 24-hour availability of specialists who can provide comprehensive emergency service to patients with traumatic injuries.

Four hospitals in Dallas and one in Fort Worth have Level I trauma designations. Three D-FW hospitals are Level II, four are Level III, and three are Level IV. Each level dictates the type and degree of injury the hospital is capable of treating.

In North Texas, only Parkland has a comprehensive burn center, one of the largest in a U.S. civilian hospital. Its new Rees-Jones Trauma Center will feature a rooftop helipad, custom elevator for the speedy transport of trauma patients, high-tech equipment and a unit specially designed to handle traumatic injuries.

"This institution has always been committed to this community," said Jorie Klein, Parkland’s director of trauma and disaster management. "We’re still in the upper echelon of trauma centers in the U.S."

The shifting of trauma patients to other hospitals also is a result of new standards for diagnosing injuries before a patient can be dispatched to a hospital. In 2013, the Centers for Disease Control and Prevention more clearly defined injuries that require treatment at a Level I trauma center.

Dr. Christopher Madden, Parkland’s former chief medical officer, said paramedics also are dispatching the injured to lower-level trauma centers, including those in Collin County and North Dallas.

"That whole northern corridor is cut off," he said of Parkland’s inner-city Dallas location. "There’s nothing we can do about it."


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