Omaha Trauma System
Omaha is unique for its size in that it is home to two excellent medical schools (University of Nebraska Medical Center (UNMC) and Creighton University Medical Center (CUMC)). It is likewise serviced by two major hospital systems associated with each medical school. In our early years, trauma services offered to the people of Omaha were provided by a joint Level One trauma center operated by UNMC and CUMC.
History (adapted from An Excerpt from Omaha trauma news, Volume 1, edition 1, winter 1999)
On Dec. 1 1993, Saint Joseph Hospital and Nebraska Health System University Hospital agreed to participate in a joint effort to develop a system to provide the highest level of trauma care to its patients. The objective of the Omaha Trauma System was to provide the community with a comprehensive trauma system linking pre-hospital, hospital, rehabilitation, and injury prevention. In a city the size of Omaha, with two university-based medical centers, the number of severely injured patients did not justify the competition between hospitals. Cooperation eliminates the costly duplication of resources that are required to maintain a trauma center.
Joseph Stothert, MD, professor of surgery at UNMC, designed this trauma system in operation for Omaha. “The trauma system was implemented in 1993 to always have a facility available in Omaha that can care for badly injured patients without delay,” said Dr. Stothert. Dr. Stothert also said that his most exciting experience while working at UNMC was watching and participating in the development of this higher level of trauma care for NHS University Hospital, the community and the state of Nebraska.
For 20+ years, each trauma center had protocols for patient management, trauma registry, quality improvement and educational programs for trauma management and injury prevention. The trauma center of the day must have 24-hour availability of a surgeon and trauma team, operating room personnel in-hospital and a CT scan technician in-hospital. Paramedics in the Omaha-metro area utilized criteria to determine if the patient is a trauma-center candidate. If the patient is considered a trauma-center candidate, the paramedic would take the patient directly to the trauma center of the day. For trauma referrals from outside of the metro area, the same trauma system was used for acutely injured and multiple injured patients. During the tenure of the joint trauma system, many activities were conducted together such as outreach and EMS education, trauma grand rounds, and trauma prevention and intervention activities.
At the time the Omaha Trauma System began, Saint Joseph Hospital was caring for 60 percent of the severely injured patients and NHS University Hospital was caring for 40 percent. It was decided that Saint Joseph Hospital would be the trauma center of the day for four days each week (Monday, Wednesday, Thursday, and Saturday) NHS University Hospital would be the trauma center of the day three days each week (Tuesday, Friday, and Sunday). Trauma center coverage began at 7 a.m. If either trauma center was unable to provide these services, the other trauma center would provide these services. This was coordinated through the Omaha Communication Center to direct paramedics to the operational trauma center.
Nebraska Medicine was first formed by the 1996/1997 merger of Clarkson and University hospitals, which created the Nebraska Health System (NHS). Before the merger, Clarkson Hospital, founded in 1869, and University Hospital, founded in 1917, had each established themselves as leaders in health care. Because Clarkson Hospital was founded in 1869, Nebraska Medicine is the oldest medical center in the state. In 2003, the NHS changed its name to The Nebraska Medical Center – which is the state’s largest and highest-rated hospital. Saint Joseph Hospital later became CHI Health Creighton University Medical Center – Bergan Mercy in 2017.
Dr. Stothert served as trauma medical director at both Saint Joseph Hospital and Nebraska Health System University Hospital starting in 1997, and remained as trauma medical director at UNMC from the program’s inception until 2012. He also served as medical director of Omaha Fire Department, which is the leading pre-hospital agency for trauma care in the state. In addition, he served as the State Trauma Medical Director, where he frequently traveled to hospitals throughout the state of Nebraska to provide education and coordinate quality care for trauma patients. In 2008, the joint trauma program in Omaha received Level One designation from the State of Nebraska- the highest level of designation given by the state.
Dr. PJ Schenarts was recruited to UNMC in 2012 as Chief of the Section of Acute Care Surgery and Vice Chair of Academic Affairs in the Department of Surgery at UNMC to build upon the solid foundation created by Dr. Stothert. During his tenure as trauma medical director, Dr. Schenarts grew the section of Acute Care Surgery to include a full time faculty and a robust medical education program for residents, medical students and other learners.
In March 2014, this 20+ year joint trauma agreement changed as both healthcare systems- Nebraska Medicine and CUMC announced that they would operate independently as two separate 24/7 Level One trauma centers. In September 2017, Nebraska Medicine became the first hospital in the state of Nebraska to earn the nation’s highest certification for trauma care as a Level One center as verified by the American College of Surgeons.
In 2019, Dr. Brett Waibel was named as interim chief of the section of Acute Care Surgery.
In April 2020, Dr. Charity Evans was named the first chief of the new UNMC Division of Acute Care Surgery. Under her leadership, the Division of Acute Care Surgery has grown to include 15 dually board certified Acute Care Surgeons and 17 advanced practice providers.