FEATURED: Jeffrey Skubic, D.O., Medical Director, DHR Health Trauma Center, on Friday, June 11, 2021, announces the creation of a trauma resuscitation unit – a first for the Rio Grande Valley – which provides dedicated space and medical personnel for the most seriously-ill cases that come to the emergency room. (https://trauma.dhrhealth.com/templates/home.aspx)
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What DHR Health’s Level One Trauma Center achievement means for South Texas: “No trauma patient should have to be transferred north any more.” – Jeffrey Skubic, D.O., Medical Director
By DAVID A. DÍAZ
[email protected]
South Texans who suffer major physical trauma – serious injuries such as from falls, motor vehicle collisions, stabbing wounds, and gunshot wounds – no longer have to be transferred away from the Rio Grande Valley and deep South Texas hospitals to San Antonio medical facilities.
As a result of the Level One Trauma Center designation for DHR Health announced on Wednesday, September 8, 2021 by Gov. Greg Abbott, the hospital system, which is anchored in Edinburg, has met the ultimate life-saving emergency medical care standards required by Texas and the American College of Surgeons, which means DHR Health now provides the highest level of surgical care to trauma patients.
DHR Health’s Level One designation is valid for three years.
Hospitals seeking verification must undergo intense scrutiny by reviewers from the American College of Surgeons Committee on Trauma every three years. To be verified, the hospital must demonstrate its ability to provide a broad spectrum of trauma care resources to address the needs of all injured patients.
Trauma centers are ranked by different levels – Level One (comprehensive service) to Level Five (basic care).
The different levels refer to the kinds of resources available in a trauma center and the number of patients admitted annually.
A Level One Trauma Center provides the highest level of surgical care to trauma patients.
Being treated at a Level One Trauma Center increases a seriously injured patient’s chances of survival by an estimated 20 to 25 percent. It has a full range of specialists and equipment available 24 hours a day and admits a minimum required annual volume of severely injured patients.
https://www.utmbhealth.com/services/uc-er/level-1-trauma-center
Jeffrey Skubic, D.O., Medical Director, DHR Health Level One Trauma Center, provided more information to journalists and the public about what the hard-earned, well-deserved Level One Trauma Center designation means to everyone in the Rio Grande Valley, Corpus Christi and Laredo.
“It’s a huge difference. We have a lot of hospitals here, but the big capstone (most important), the main player for really severe traumas was University Health in San Antonio. We were always dependent on them,” Skubic said. “No matter what happened when something got really bad, the patients (in Rio Grande Valley hospitals) had to be sent all the way there.”
University Health System is the public hospital district for the San Antonio metropolitan region. It is also San Antonio’s only health system recognized by U.S. News & World Report, regarded as one of America’s Best Hospitals.
Owned and operated by Bexar County, it is the third largest public health system in Texas. The system is based out of University Hospital, a 716-bed teaching hospital located in the South Texas Medical Center.
https://en.wikipedia.org/wiki/University_Health_System
Although it too often had to be done, transporting the most seriously-injured by ground ambulance or air ambulance almost 250 miles to University Health was more than a desperate trip for the patient and their loved ones in the Rio Grande Valley.
“It’s ironic that it would be the worst, sickest patients who were sent there, who maybe could or could not tolerate the journey there. And it was always very expensive. Or patients wouldn’t able to get past the U.S. Border Patrol Checkpoint (in Falfurrias),” Skubic said. “Now we have the complete puzzle. No trauma patient, no matter any time day or night, should have to be be transferred north any more.”
Anchored in southwest Edinburg on a 130-acre site, with a growing presence in neighboring McAllen, Rio Grande City, Mission, and Brownsville, DHR Health offers some of the most comprehensive medical care on the U.S. southern border, with more than 1,400 nurses and 600+ physicians providing care in 70+ specialties and sub-specialties.
DHR Health is the flagship teaching hospital for the University of Texas Rio Grande Valley School of Medicine and encompasses a general acute hospital with the only dedicated women’s hospital south of San Antonio, a rehabilitation hospital, a behavioral hospital, more than 70 clinics Valley-wide, advanced cancer services, the only transplant program in the Rio Grande Valley – and the only 24/7 Level 1 Trauma Center south of San Antonio.
Doctors Hospital at Renaissance, Ltd (“DHR”) and its general partner, RGV Med, Inc. (“RGV Med”) own and operate a 519 licensed bed general acute care hospital located at 5501 South McColl in Edinburg. The facility is one of the largest physician-owned facilities in the United States that began as an ambulatory surgery center in 1997.
Prior to DHR Health’s designation as a Level One Trauma Center, the Rio Grande Valley was served by three Level II trauma centers – DHR Health in Edinburg, South Texas Health System in McAllen, and Valley Baptist Medical Center in Harlingen.
https://www.dshs.state.tx.us/emstraumasystems/etrahosp.pdf
While Level II Trauma Centers provide adequate care for many traumas, studies have found that patients with certain severe injuries are more likely to survive if they are treated at a Level One.
“When we talk about trauma, we like to talk not only about individual hospitals, but about trauma systems,” Skubic further explained.
A trauma system is an organized, coordinated effort in a defined geographic area that delivers the full range of care to all injured patients and is integrated with the local public health system.
Trauma systems are regionalized, making efficient use of health care resources.
“You may have a smaller facility in the trauma system, but there may be a larger facility in the same system that can take care of that patient with that complex injury or multiple injuries,” he said.
“Previously, all of South Texas never had a complete trauma system. We always lacked the highest level of trauma care. We’ve had Level Two Trauma Centers down here, as well as Level Three and Level Four, which are lower levels. But we’ve never had a complete system. University Health in San Antonio was the Level 1 for all of this region. We know San Antonio is about 250 miles away,” Skubic said. “We were never were able to have a complete system,” he emphasized.
“What this means is for the first time, South Texas has its own trauma system independent of University Health. For the first time, we have our own trauma system, which means every single injury that occurs within this system can be cared for close to home,” he said.
Patients with severe burn injuries still must be transported to San Antonio, which has advanced Level One Trauma Centers for those victims, Skubic added.
In his remarks during his news conference at the Edinburg Conference Center at Renaissance, the Texas governor stressed the significance of DHR Health’s Level One Trauma Center recognition.
“It is a monumental day for this hospital but, equally important, it is a monumental day for the health and safety of everybody in the entire Rio Grande Valley region,” Abbott said at the Wednesday, September 8, 2021 news conference held at the Edinburg Conference Center at Renaissance. “Because of this new Level One Trauma Center designation, lives are going to be saved and better outcomes are going to be achieved because a Level One Trauma Center now exists in the Rio Grande Valley.”
Abbott delivered those and other remarks during his visit to the Edinburg Conference Center at Renaissance, which was attended by leaders, physicians, nurses, emergency medical services personnel, and other medical professionals associated with DHR Health, along with news media from the Rio Grande Valley, northern Mexico, and Texas.
“Today is a day of remarkable achievement for the Rio Grande Valley, for DHR. It is an issue that has been focused on for years now,” the governor noted. “It always so rewarding when you have a goal that you want to achieve, you put the effort into it to achieve that goal and then you ultimately achieve it. And so, as talked earlier today in a meeting before we came in here, this is a substantial milestone for DHR and for the Rio Grande Valley.
“However, it really is not an end unto itself. It really is a stepping stone toward an even broader and better pathway forward,” Abbott predicted.
In an interview conducted on Friday, September 10, 2021 by Marcy Martínez, Director of Public Media Relations & Corporate Communications, DHR Health, Skubic shared other key background about the work behind-the-scenes that led to the Level One Trauma Center designation for DHR Health.
Highlights of that interview follow:
MARCY MARTÍNEZ
We are a designated Level One Trauma Center. When we hear “designated”, what does that mean?
JEFFREY SKUBIC, D.O.
When a hospital wants to be a trauma center, you have to meet all these stringent requirements. You have to have been doing it for the last year before your visit by the American College of Surgeons, the governing body that runs all things surgery-related in this country.
(The American College of Surgeons (ACS) is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice. – https://www.facs.org)
They come and verify you as a trauma center. They take you through a two-day process. Ours was in June (2021). They verify everything you have been doing for the last year. They look at everything from your records to your research publications, they review patient charts, they review your call schedules, they review everything. They tour the hospital, all the facilities, then the American College of Surgeons verifies you at a level of trauma center.
Level One is the highest level possible in this country. It’s something they typically only see at large university hospitals where they have a big academic medical system, which is what we have here.
MARCY MARTÍNEZ
This is really exciting for DHR Health to get to this point, to be the highest level of trauma care. But what is most important to the public? What does it mean for someone to be treated at a Level One Trauma Center?
JEFFREY SKUBIC, D.O.
When we talk about trauma, we like to talk not only about individual hospitals, but about trauma systems.
(A trauma system is an organized, coordinated effort in a defined geographic area that delivers the full range of care to all injured patients and is integrated with the local public health system. … Trauma systems are regionalized, making efficient use of health care resources.)
You may have a smaller facility in the trauma system, but there may be a larger facility in the same system that can take care of that patient with that complex injury or multiple injuries.
Previously, all of South Texas never had a complete trauma system. We always lacked the highest level of trauma care. We’ve had Level Two Trauma Centers down here, as well as Level Three and Level Four, which are lower levels. But we’ve never had a complete system.
University Health in San Antonio was the Level One for all of this region. We know San Antonio is about 250 miles away. We were never were able to have a complete system. What this means is for the first time, South Texas has its own trauma system independent of University Health. For the first time, we have our own trauma system, which means every single injury that occurs within this system can be cared for close to home.
MARCY MARTÍNEZ
This is including Laredo and Corpus Christi as well. We’re talking all the counties south of San Antonio.
Break it down for everyone, when it comes to a tragic accident, stroke, whatever if may be, a lot of times you go to an emergency room, and find they have to be transferred to another hospital, or out of the region.
Now, as a Local 1 Trauma Center, DHR Health has all the people and resources in place to treat everything that is wrong with that person. Would you provide more details?
JEFFREY SKUBIC, D.O.
It’s a huge difference. We have a lot of hospitals here, but the big capstone (most important achievement), the main player for really severe traumas was University Health in San Antonio. We were always dependent on them. No matter what happened when something got really bad, the patients (in Rio Grande Valley hospitals) had to be sent all the way there.
It’s ironic that it would be the worst, sickest patients who were sent there, who maybe could or could not tolerate the journey there. And it was always very expensive. Or patients wouldn’t able to get past the U.S. Border Patrol Checkpoint (in Falfurrias). Now we have the complete puzzle. No trauma patient, no matter any time day or night, should have to be be transferred north any more.
MARCY MARTÍNEZ
What does this means when it comes to who are the players in this? What type of physicians do we have on hand (in the DHR Level One Trauma Center)?
JEFFREY SKUBIC, D.O.
Let’s say you get into a bad car accident, and you have an eye injury that needs immediate evaluation by an ophthalmologist – an eye doctor – and the same time it was such a bad car accident that someone who was in the car with you has a bad open fracture in the hand with tendons exposed and bleeding. Someone else in the car has a bad liver injury, bad facial fractures.
Previously, half of those patients, we would have been able to take care of here in the Valley. But some
of the more complex issues – maybe eye injuries, face injuries – it wasn’t 24/7 coverage. Holidays and weekends it was really difficult, and some of the hospitals had some of those medical specialists
sometimes. But half of the people, maybe, would have to be sent to San Antonio. Now, that no longer has to happen.
Anybody gets hurt anywhere here in the Valley, and the nearest hospital (other than DHR Health) that receives those trauma patients, if they can’t deal with some of the more complex injuries, they no longer have to send them to San Antonio. Instead, they are diverted here to DHR Health. We become the backstop for the whole region in preventing anyone from having to leave the trauma system (in deep South Texas).
MARCY MARTÍNEZ
Being designated as a Level One Trauma Center helps the other Valley hospitals?
JEFFREY SKUBIC, D.O.
I regularly talk with the other trauma surgeons at the other hospitals in the region, and we all agree it is best to keep the patients here and give them the care they need. A patient hurt 50 miles from here, there is another trauma center near them of a lower (trauma care) level, and if those patients wants to go there, they should go there and be evaluated there. But those hospitals that may get that bad, complex patient, they would send them to Edinburg. At least we are way closer than San Antonio.
MARCY MARTÍNEZ
We talk about the trauma team, but everyone at DHR Health has put something into getting us to where we are.
JEFFREY SKUBIC, D.O.
It truly is a team effort, from the RAC, from all the EMS providers Valleywide who work with us.
(A RAC stands for Regional Advisory Councils. RACs are the administrative bodies responsible for trauma system oversight within the bounds of a given Trauma Service Area in Texas. Each of the 22 RACs is tasked with developing, implementing, and monitoring a regional emergency medical service trauma system plan. Generally, RAC stakeholders are comprised of healthcare entities and other concerned citizens with an interest in improving and organizing trauma care. As such, not every Regional Advisory Council is structured the same. However, each RAC has the same objectives – to reduce the incidence of trauma through education, data collection, data analysis and performance improvement. Typically, this is accomplished via the provision of educational programs and performance improvement efforts designed to offer every provider guidance and motive to reduce the incidence of trauma, as well as improve outcomes of trauma patients. https://www.dshs.texas.gov/emstraumasystems/etrarac.shtm)
The nurses are so important, the doctors, our resident team.
(Residents are doctors in training. They have graduated from medical school, been awarded an M.D. degree, and now are training to be a particular type of doctor — such as a pediatrician or pediatric specialist, or a type of surgeon. All residents are supervised by a legally responsible senior physician.)
…We have three residents who are in the hospital every night with us, the trauma surgeon, in-house. They have a staff of three of them have to sleep in the hospital along with us every night. That’s a lot of manpower, and a lot of effort by a lot of people.
https://www.health.harvard.edu/healthcare/should-i-see-a-resident-doctor )
Without getting all your specialists on board to make call schedules for 24/7, 365 days a year, including holidays, that could be really challenging. If your hospital has only one ophthalmologist. It’s going to be really difficult to get them to cover every holiday of the year. So, you have to put together a big team of every possible type of specialist, and get all of them to agree to take calls for the entire year so that there is never a day that goes without coverage where a patient can be cared for.
BIOGRAPHY
JEFFREY SKUBIC
DO SURGICAL CRITICAL CARE
Dr. Jeffrey Skubic is board certified by the American Board of Surgery in both Surgical Critical Care and General Surgery, and is the only surgeon in the Rio Grande Valley to have completed an Acute Care Surgery fellowship.
Skubic specializes in trauma surgery, emergency general surgery and surgical critical care.
As part of the Rio Grande Valley’s largest and most comprehensive surgical team, Skubic offers patients the latest in trauma surgical treatment and technology. He provides a wide range of surgical care, with minimally invasive options for conditions such as tracheostomy, feeding tube insertion, hernia repair, gallbladder removal, video assisted thoracic surgery (VATS) and thoracic reconstruction for rib fractures and sternal fractures.
Skubic earned his Doctor of Osteopathic Medicine and Master of Science in Musculoskeletal Medicine at New York College of Osteopathic Medicine of New York Institute of Technology, located in Old Westbury, New York.
His general surgery residency was completed at the University of Arizona College of Medicine in Phoenix, Arizona. That is where he found a passion in trauma surgery and decided to attend Harvard University (The Brigham and Women’s Hospital) to pursue a fellowship in acute care surgery/critical care.
In addition to his education, Skubic has been a recipient of many awards including 2019 Surgery Faculty of the Year and Surgery Intern of the Year. He is also a member of several professional societies (EAST, AAST and Pan-American Trauma) and is widely published in peer-reviewed medical journals.
Skubic is bilingual and speaks English and Spanish.
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