Networking Hospitals to Improve Care

For better or for worse, we Americans live in a country that is generally suspicious of anything that smells even remotely of government interference in free markets. With that in mind, I came across an interesting article in the Wall Street Journal discussing how state governments are passing laws mandating a multi-tiered system for hospitals providing trauma care.

What is the problem that these laws attempt to address? To be blunt, you wouldn't want to be a trauma patient at a rural community hospital that lacks the staff, technology or care protocols to optimally treat your injuries. However, in many states there are few regulations mandating transfer protocols for severe cases.

In brief, these state laws attempt to address this problem by differentiating hospitals' trauma capabilities and ensuring that the most serious trauma cases get routed to the most advanced trauma center as rapidly as possible. If a patient arrives at a rural hospital with serious injuries, they are immediately transferred by ambulance or helicopter to the nearest level I trauma center.

There is an interesting ethical question here. If patients in states with trauma networks have substantially better outcomes than trauma patients in states without trauma networks, isn't there an ethical mandate to create these trauma networks in other states as well? And if the networks improve outcomes for trauma, might networks for other medical needs also improve outcomes? There is already evidence to suggest that stroke networks founded on the same clinical principles as trauma networks - rapid patient transfer to the best equipped hospitals - improve patient outcomes.

It will be interesting to watch if these trauma networks continue to proliferate among the states and serve as models for other clinical pathologies. There are certainly many hurdles left to clear - a distrust of government interference, resistance from hospitals and regulatory challenges in enforcement, to say the least.