Jeff Kerby, MD, PhD has been named the first state of Alabama trauma consultant by the Alabama Department of Public Health. Kerby is a trauma surgeon at the University of Alabama at Birmingham and director of the Division of Acute Care Surgery in the Department of Surgery.
The position of state trauma consultant was created following a review of how Alabama handled medical response to traumatic injuries by the American College of Surgeons Committee on Trauma last year. The role will be to provide direction to the Alabama Trauma System and conduct periodic reviews of treatment and transfer protocols.
In 2007, Alabama developed a statewide system of trauma care based on BREMSS, the Birmingham Regional Emergency Medical Services System. The key piece to this system is the Trauma Communications Center, which provides the capability to constantly monitor the status of every trauma hospital and route the trauma patient to the right hospital.
"The Alabama Trauma Communications Center is the model for the rest of the nation and a resource only Alabama currently has in place," Kerby said. "The next step is to determine the appropriate role for each hospital in the system and establish quality assurance programs.
As part of his role, Kerby wants to collect data on outcomes from each participating hospital, but that requires funding. "We could have one of the best trauma systems in the country, but we are hampered by lack of resources and appropriate coordination throughout the system," Kerby said. The state legislature has formed a committee to examine ways to provide funding for trauma care.
There are four Level 1 trauma centers in the state: at UAB, University of South Alabama, Huntsville Hospital and Children's of Alabama. There are two Level 2 centers and 49 Level 3 centers at regional hospitals across the state. More than 15,000 patients a year enter into the state trauma system following traumatic injury.
60 percent of all trauma patients end up at one of the four Level 1 centers. About 30 percent of patients are transferred to a Level 1 facility after undergoing an initial evaluation elsewhere.
"In order to better serve the public, we need to strategically place Level 2 and high-functioning Level 3 trauma centers in the right regions, and we need to find ways to make sure they are sustainable for the long term," Kerby said. "A well-integrated, comprehensive system will provide better access to patients no matter where they are in Alabama. It should also reduce lengthy transfers to the few Level 1 centers in those cases where patients can be appropriately treated at Level 2 or 3 facilities."
Kerby hopes the state will be able to develop a quality collaborative that evaluates patient outcomes throughout the system.