WDBJ7 EXCLUSIVE: Carilion Clinic transforms trauma patient care for 40 years

Published: Jul. 26, 2023 at 11:42 PM EDT
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ROANOKE, Va. (WDBJ) - Carilion Clinic is two years from opening its newest addition, The Crystal Spring Tower, right next to Roanoke Memorial Hospital. That expansion will have more resources to care for an increasing number of patients.

For 40 years, Carilion Clinic has been Southwest Virginia’s only Level One trauma center, the only hospital within a 150-mile radius to handle every level of injury. The healthcare institution is also certified as the region’s only Pediatric Level One Trauma Center.

But before the $500 million Crystal Spring Tower expansion, it was Roanoke’s main hospital.

“Community hospitals wanted to be able to say, we can do everything, we are your community hospital, we can do everything,” Dr. Carol Gilbert said. “It took awhile for people to realize that it’s a lot easier and can be a lot faster and more efficient and effective if you have a trauma service where everything is focused towards the trauma patient.”

Dr. Gilbert was Carilion’s first official medical director of trauma services in 1983. She paved the way for Carilion to become a Level One trauma center.

“I had no previous experience running a trauma center,” Dr. Gilbert said. “Because things hadn’t been done in any single way before, we could develop our own protocols and our own plans.”

In the program’s initial years, Carilion saw fewer than 200 trauma patients a year. In 2023, they see close to 4,600 a year from a larger population, more accidents and more violent crime.

Carilion’s current medical director for trauma services explained that the number is increasing.

“It’s almost commonplace every day or every other day to have two or three trauma patients that present to us at the same time, which means you need to have more than one room to see these patients,” Dr. Bryan Collier said.

Roanoke Memorial Hospital has only two trauma bays adjacent to the emergency department.

“A patient will go to a standard emergency department room that’s not equipped to take care of the trauma patients on a routine basis,” Dr. Collier said. “Therefore you’re changing your work flow which isn’t optimal for patient care.”

Almost half of Carilion’s trauma patients are flown in from the surrounding area, like West Virginia, Tennessee and North Carolina. The trauma center serves the largest geographical area in the state, so Carilion is adding five trauma bays to take care of patients.

The Crystal Spring Tower will have four adult bays that are all attached and one pediatric bay. Carilion Clinic’s senior director of trauma programs explained the new bays prioritize efficiency.

“We wanted to be as efficient as possible, so our strategy was to understand the human factors piece of this and how we could maximize not only the room, the storage and more importantly, the flow of people and equipment during a trauma,” Dan Freeman said.

After years of planning, Freeman explained the team is finishing up equipment designs and policies for the bays.

“We are finalizing some equipment such as blood storage in the emergency department that we currently do not have,” Freeman said. “We look to have some storage within the department so we can get the blood to the patient even sooner than what we would originally.”

As Carilion staff looks forward to working in the new tower, registered nurse Sandy Hubbard is making sure her nurses caring for trauma patients are ready to go.

“Nobody wakes up and goes to work and says, ‘I’m going to be in a car accident today’,” Hubbard said. “But sometimes that happens, and then their whole life is changed in an instant.”

The trauma team is learning the designs of each trauma bay, like how to maneuver between equipment and each other. Hubbard explained how she hopes her nurses learn what can’t be taught in a textbook.

“[I hope] to develop them into strong nurses so they can have the confidence and the experience that they need to really care for these patients on the worst day of their life,” Hubbard said.

For founder Dr. Carol Gilbert, the future is brighter than anything she could have imagined when she started the program four decades ago.

“I felt when I left Baltimore, we should have a trauma system for rural people, too. I spent most of my career taking care of trauma patients, and kind of herding this little program along until it’s a nice size program with a lot going on,” Dr. Gilbert said. “It’s probably one of the proudest things in my life.”

All still photographs featured in this story are courtesy of Carilion Clinic.