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South Side trauma center faces unexpected hurdle - Health Care News - Crain's Chicago Business

September 11, 2015

This hurdle could trip up new South Side trauma center



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Photo by Holy CrossHoly Cross Hospital at 68th Street and California Avenue

University of Chicago Medicine and Sinai Health System today announced plans to launch a long-awaited trauma center on the South Side. But first they must get permission from rivals.

In a bureaucratic twist in Illinois, a committee of representatives from the six Chicago trauma centers must approve the request to open one at Holy Cross Hospital in Marquette Park. At least two votes are secured.

U of C Medicine and Sinai each have a trauma center. Other centers include ones at Northwestern Memorial Hospital in downtown Streeterville and John H. Stroger Jr. Hospital of Cook County on the Near West Side. By giving their blessing, the latter two hospitals might lose patients who are now rushed to their facilities down the Dan Ryan expressway.

Read more:

• Editorial: South Side needs Level 1 trauma center, and U of C is the place for it
• Suburban hospital's offer to treat Chicago trauma victims gets cool reception
• U of Chicago examines opening an adult trauma center

Dr. Gary Merlotti, chairman of the surgery department at Mount Sinai Hospital, which is part of Sinai Health, said he has received support from nearly every trauma center director. The regional committee is expected to vote on the proposal next week.

"We will not have trouble with integrating into the system," he said.

He added that he expects Holy Cross' Level 1 center will be among the largest in the state given its proximity to neighborhoods with high rates of violence, such as Englewood and Lawndale. Holy Cross, at 68th Street and California Avenue, is part of West Side-based Sinai.

When asked if she was confident that competing trauma center directors would approve the request, Sinai CEO Karen Teitelbaum said: "We like to think that everybody is focused on what will be best for this particular area of Chicago."

She and Sharon O'Keefe, who leads U of C Medicine, deferred further comment on that topic to Merlotti.


The proposed center comes on the heels of persistent protests from activists who have singled out U of C Medicine to reopen its long-shuttered adult trauma center. Activists say the system hasn't done enough for trauma victims on the South Side. They've even tied the trauma center to the university's effort to land the Barack Obama Presidential Library and Museum.

There are only six state-designated Level I trauma centers in Chicago specializing in providing the highest level of care for patients who are shot or involved in horrific car crashes, for example. U of C Medicine's Comer Children's Hospital has a trauma center for children on its Hyde Park campus, while Lawndale-based Mount Sinai Hospital has a center that treats children and adults.

Trauma care is not a lucrative business. Many patients are low-income or uninsured. But it gives a level of cachet to a hospital. Stroger Hospital on the Near West Side, for example, is a famous training ground for trauma surgeons.

As part of the proposal, U of C Medicine will give Sinai $40 million to renovate Holy Cross' emergency department, which is among the busiest in the city, and to construct a three-story tower that would house the new trauma center, intensive care beds and operating rooms.


U of C plans to expand access to emergency care by moving its emergency department from an old hospital on campus to a site adjacent to its newest hospital, the Center for Care and Discovery. The current emergency department has long wait times, and more than 6,000 patients a year leave without being treated.

Both health systems will pay for their own physicians at the Holy Cross trauma center and hire more specialists and others to staff the center. But the $40 million is a one-time payment from U of C, O'Keefe said. It's not clear how Sinai, where 60 percent of patients are on Medicaid, will afford to maintain two trauma centers. Part of U of C's argument for not reopening its adult trauma center has been the cost, which can exceed $20 million a year, the Illinois Department of Public Health estimated in January.

"If that means reallocation of other resources to make it work, and I don't know what those are at this point, we will be doing that," Teitelbaum said. "But together we will use our resources to be able to bring this to fruition."

Both leaders noted their existing relationship. U of C medical residents train at Mount Sinai's emergency room, for example. They are exploring what else they might collaborate on.

O'Keefe cited Sinai's 27 years of experience in trauma care and Holy Cross' location near high-crime areas among the reasons for locating a trauma center there instead of in Hyde Park.

"They have a great deal to offer from their medical staffs," she said.

She added that because of this proposal, U of C Medicine no longer plans to raise the age of patients it treats at Comer Children's Hospital. It now treats patients up to 15 years old and was working to expand that to 16- and 17-year-olds.


The Cook County Health and Hospitals System, which includes Stroger Hospital, said the proposed trauma center would not affect the level of services the hospital provides.

"We will continue to serve as a regional pillar of excellence in trauma and burn care, providing full-service, expert care to our region's most critically injured patients, as we have for nearly 50 years," Alex Normington, a system spokeswoman, said in a statement.

That's a change in tone from March, when Maywood-based Loyola University Health System received a cool receptionfrom the regional trauma care directors for wanting to treat more Chicago patients.

Directors or media representatives of the three other Chicago trauma centers did not comment.


Dr. Marie Crandall, a former Northwestern Memorial Hospital trauma surgeon, has studied the connection between locations of trauma care centers on the South Side and mortality rates. She said Holy Cross was among several hospitals she and other researchers suggested to the state as a reasonable location for another trauma center.

"Time will tell if it changes outcomes, but I feel that it's a worthy effort," Crandall said of the proposed trauma center at Holy Cross.

Activists who have targeted U of C Medicine for years claimed victory.

"The new trauma center will save lives in neighborhoods on the South and Southwest side affected by gun violence and other traumas," they said in a statement.

But they still want the academic medical center to do more and say large swaths of the South Side will continue to be inadequately served.

Illinois regulators must approve the new trauma center, which is slated to open within two years.

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