[caption id="attachment_38341" align="alignright" width="288" caption="NorthBay Healthcare Medical Center in Fairfield will be the first trauma center in Solano County."][/caption]

SOLANO COUNTY -- Solano County has never had a hospital designated as a trauma center, a rarity given its size, but it could have two by the end of this year.

Both NorthBay Healthcare in Fairfield and Kaiser Permanente in Vacaville have filed plans with the county to open level III trauma centers, each with the stated intent of providing first-rate emergency care while lessening the need to send seriously injured patients out of county.

NorthBay Healthcare, which operates the 132-bed NorthBay Medical Center in Fairfield and 50-bed VacaValley Hospital in Vacaville, first announced the trauma center plans in September 2010.

The initial plan called for the Fairfield hospital to open as a level III center, with the eventual goal of opening a level II center at VacaValley, which will soon undergo a $118 million renovation and expansion.

[caption id="attachment_38343" align="alignleft" width="288" caption="Kaiser Permanente's Vacaville hospital "][/caption]

But shortly after NorthBay’s announcement, Kaiser announced that it too intended to make its 64-bed Vacaville facility, just built in 2009, a level III trauma center, with the intent of making it a level II center in the near future.

NorthBay, which has planned for the trauma center for three years, expects its Fairfield hospital to be given final county approval for a level III by the end of September, said hospital spokesman Steve Huddleston.

Kaiser anticipates its approval for level III by the end of 2011, according to Max Villalobos, senior vice president of hospital administration for Kaiser's Napa-Solano region.

There is no limit on how many level III centers can be in the county, but state law stipulates a county can have only one level II center, unless a specific exception is granted, said Ted Selby, emergency medical services administrator for Solano County.

Currently, Solano County sends about 42 percent of seriously injured patients to either UC Davis Medical Center in Sacramento, a level I center, or John Muir Medical Center in Walnut Creek, level II. Having a level III center would reduce that number significantly. A level II center is better equipped to handle severe head and spine injuries, while a level I center is required to have a research or teaching component.

NorthBay estimates its Fairfield hospital would see about 500 trauma patients a year, while Kaiser Vacaville put the number at about 300. The majority of traumas in Solano result from car accidents and falls.

A needs assessment is currently being conducted to see if Solano County could sustain a level II center. Which hospital would get the designation remains to be seen, Mr. Selby said.

“That’s when competition would come into play,” he said, adding the assessment should be completed sometime in 2012.

Mr. Huddleston said that, upon learning of Kaiser’s plans in Vacaville, NorthBay would be open to the idea developing its level II center in Fairfield, where it could ostensibly draw patients from Southern Solano, which includes Vallejo and Benicia.

“We expected Kaiser to open in South County,” Mr. Huddleston said. “When they announced it would be Vacaville, we planned in turn to collect the trauma in South County. We’re now being flexible to either case.”

Mr. Huddleston said NorthBay has seen a recent increase in trauma cases, likely a result of the Fairfield hospital’s coordination with first responders and its ability to treat level III type trauma. He also said Solano County could likely support two level III centers.

Mr. Villalobos said Kaiser chose the Vacaville facility for several reasons.

“One reason is geography,” said Mr. Villalobos, who headed up Kaiser’s level II trauma center in South Sacramento for 15 years. “The growth is really happening in North County, and it’s next to Highway 80. With trauma, time is of the essence, so it’s critical of the location. And having a brand new hospital, with the ability to provide trauma care with the best technology, it made sense” to choose Vacaville over Vallejo, where Kaiser has another hospital.

For now, both Kaiser and NorthBay said the focus will remain on a level III center, and that any decision on a level II would have to wait until the county announced its guidelines.

Mr. Selby said Solano County is requiring that any trauma center plan meet guidelines spelled out by the American College of Surgeons.

“That’s something that is not mandated by state code, but it’s something that we are mandating in Solano County,” Mr. Selby said.

In preparation for any trauma center designation, both hospitals have had to significantly boost staffing levels, bring on additional surgeons and generally ramp up all departments, like intensive care units and even labs and blood banks.

“Trauma is not just an emergency department,” Mr. Huddleston said.

Mr. Villalobos echoed that sentiment.

“It literally impacts everyone who works in the hospital,” he said.

Both Kaiser and NorthBay said they’re ironing out details with first responders throughout the county.

Mr. Huddleston said a certain level of prestige comes with being a trauma center.

“We certainly believe there will be a halo effect. You do stand out from other hospitals,” he said.

The county, Kaiser and NorthBay Healthcare agreed that the ultimate goal was to determine what works best for residents of Solano County.

“What I’m really focusing on is trying to build the best trauma system for residents of Solano County and have the best medical outcomes and the most saved lives,” Mr. Selby said.