Jan. 8, 2020 – “We are the support system for the frontline staff that takes care of our trauma patients.” That’s how Trauma Program Manager Matthew Derkrikorian described the responsibilities of the dynamic trauma services team during my visit with this group — my first passport stop in 2020!
First, I learned more about this seven-person team, including some fun facts about each member. One thing that stood out was the longevity of this group: Four members have been at Rady Children’s for more than 20 years, and Trauma Medical Staff Coordinator Berda Taylor has been here for more than 35! She met her husband here, and every one of her children and grandkids either used, worked or volunteered at Rady Children’s, or still do! There are also martial arts, bodysurfing and motorcycling aficionados on this team (Matthew Derkrikorian; Trauma Clinical Coordinator Kelly Wisegarver; Trauma Registrar Kevin Smith, respectively), as well as a former movie extra (Trauma Registrar Cindy Burgal) and a veteran with 24 years of service in the United States Navy (Trauma Medical Director Romeo Ignacio, MD).
As I learned more about the trauma department, it became apparent that this team is the gold standard for pediatric trauma care. Rady Children’s is the catchment area for all pediatric trauma (under age 15 years) in San Diego County, parts of Imperial and Riverside counties, and some areas of the Mexico border. It is also part of the San Diego County Trauma System, a successful partnership between the county and six designated trauma centers. In the system’s 30 years of existence, the rate of preventable trauma deaths has dropped from 21 percent to less than one percent. Very impressive!
In addition, the team works closely with the county’s trauma medical audit, pre-hospital audit and child fatality review committees, and with the San Diego Trauma Research and Education Foundation, which integrates with the trauma system. Within our own health system, they partner with clinical areas including the emergency department, the PICU and PICU CHET, 3East and surgical services. They also join forces with nonclinical entities, such as the Center for Healthier Communities on injury prevention projects and the Center for Innovative Learning on its trauma simulations with advanced manikins.
Another unique attribute of this team is its intense focus on process improvement and multidisciplinary and interdepartmental collaborations. They have weekly internal meetings, as well as monthly meetings with the county, to look for ways to make improvements that often end up having a positive impact on nearly all of our patients. The trauma team is also embracing new technology, employing a trauma narrator module in Epic to accurately document patients’ interventions and medications; operating upgraded cameras in the trauma bays so that interventions can later be reviewed; and using new monitors in the bays that allow for more informed care in real time.
We then headed down to the emergency department where the two trauma bays are located. Little did I know that Matt had sent out a page to the trauma team that a patient had been injured in a surfing accident and would be arriving soon — and that patient was me!
One of the CHET team members quickly put me in a neck brace while other medical staff laid me down on a gurney. They efficiently began monitoring my vital signs while Dr. Ignacio checked my extremities for any injuries. It was pretty realistic! Thankfully, the team decided that I would be okay and did not need to be admitted. While this was obviously a simulation, it was clear just how well this team would work together in a real emergency. With somewhere between 70 and 85 traumas every month, they get a lot of practice.
I left this visit with a fresh stamp in my passport, a Stop the Bleed kit (appropriately!) and another example of a team that is fulfilling our mission every day. This dedication to improving child health is woven into the DNA of our organization. I’ve said it before, but it’s worth saying again in the new year: With the right people and the right culture, we can get anything done!