Reprinted compliments of the Shelby Promoter, January 18th issue.

Last month, Marias Medical Center (MMC) director of nursing Julia Drishinski received the news she had been hoping for. The State of Montana’s Department of Public Health and Human Services (DPHHS) had designated MMC as a trauma receiving center.
A year-and-a-half of hard work and training had paid off for Drishinski and the hospital’s trauma committee, which is made up of employees from several departments of the hospital.
“You have to hold the standard of care to an exceptional level” to achieve the state’s designation as a trauma receiving center, Drishinski explained.
That includes instituting policies and procedures based on high levels of care and advanced trauma life support, which includes the hospital being certified in providing care based on the newest, evidence-based research. All doctors must be advanced trauma life support-certified and all nurses certified in the trauma nurses core curriculum, which train them to know how to react to injuries that may be traumatic.
Drishinski explained part of the program is based on performance-based improvement. The trauma committee had to send charts of patients to a DPHHS committee for review. “They would assess whether or not we’re giving care based on evidence-based practices,” she said.
“Trauma” can be anything from injuries sustained in a motor vehicle accident, a fall, or in the form of blunt or penetrating force. MMC anesthesiologist Dr. Tracy Lords said often trauma patients don’t come to the emergency room to be treated, either, so all nurses at MMC have to be prepared to treat a trauma patient.
Because a trauma injury may not be immediately obvious, all injuries that come into the hospital have to be treated as trauma. Drishinski said the hospital receives 300-400 accidents each year. Only several cases each month meet “trauma” criteria.
Still, everyone in the hospital needs to be ready.
“Every step is important. It starts with the first phone call,” said Lords.
Members of the EMS crew received certification to administer IVs and medications to patients on the way to the ER. They also received endorsements in monitoring patients and in airway management.
“That improves care markedly,” Lords said of the EMTs’ certification.
Drishinski pointed out the EMTs received training for the endorsements on their own time. “It speaks a lot to their commitment to the community,” she said. Even the basic EMS certification is a time-consuming process, said Drishinski. Adding the other endorsements meant a much larger time commitment.
The trauma committee, headed up by Dr. Chuck Marler, holds meetings monthly or quarterly, depending on need, said Drishinski. The committee discusses treatment of the trauma cases they treat and includes EMTs and EMS director Dr. Marc Adams, nurses, and representatives from the x-ray department, respiratory therapy and the operating room.
Drishinski said the purchase by MMC Auxiliary of a training dummy helped with training as well.
The designation also includes a community education component, so last year physicians held informational meetings on subjects including water safety, farm equipment safety and vehicle accident prevention.
The entire process, which took Drishinski and the trauma committee about a year and a half to complete, culminated in October with a visit from a DPHHS review team. MMC was not only certified as a trauma-receiving center, it did not receive provisional status, which most facilities do at first. Because of that, the hospital will not be surveyed again for three more years.
“For us, it puts us on a level of expertise I think that has been here,” said MMC CEO Mark Cross. “I’m proud of our staff for achieving this.”
Drishinski said because of MMC’s small size and its lack of a full-time surgeon, the hospital will probably not try for additional certification. Certification “is based on demographics and what type of physicians you can recruit,” Drishinski explained.
“We really focus on stabilize and ship,” agreed Lords.
Drishinski stressed it isn’t just the staff that works in the ER that has been involved in the designation. “The entire facility has worked hard for this designation. All departments are affected by the patients we bring into the ER,” she said.
“We’re privileged to be designated as a trauma receiving center,” added Lords.
Now that MMC has earned its designation, it will be subject to normal surveys.
“Next time they come, they’ll hold us to a higher bar,” Drishinski said. The state committee will assess the hospital’s equipment and policy and procedure, as well as conduct staff interviews and pull charts of trauma patients to make sure proper medication is being administered and the patients are being treated in a timely manner.
While the staff at MMC doesn’t want to see trauma cases, they want to be ready for them when they come. With their important new designation, they can be.

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The Sunburst Community Foundation-Non-Permanent of the Montana Community Foundation recently awarded Marias Healthcare Services, Inc $3958.00 toward the purchase of a Cardiograph to be used in the Sunburst Clinic. The Cardiograph will be used in the Sunburst Clinic to monitor the heart activity of North Toole County residents. The Cardiograph can detect heart problems and help identify solutions that can save lives. Patients suffering from chest pains can now be tested in Sunburst to determine whether the patient needs to be sent immediately to the hospital or cared for with alternate strategies. The Cardiograph can also be used for pre-surgery testing, DOT or similar physical, sports physicals, and/or general health screenings. The equipment is also compatible with the Marias Medical Center's electronic medical records. More information on the Sunburst Community Foundation check out their website at www.mtcf.org. The Toole County Health Foundation also contributed $500 toward this purchase.