"A total of 14 patients visited by last night, and there was also a helicopter transport from Gwangju. Some patients experienced delays during the transport process, but their lives were not significantly affected. We will review the issues in the transport procedure once again and look for improvements."
On the morning of the 14th of last month, the trauma center at Ajou University Hospital in Suwon was busy. More than 20 medical staff gathered to share the situation that occurred the previous night as they began their day. Director Jeong Kyung-won requested that they closely investigate the reason for the delay in transferring a specific patient while checking the condition of those who had been admitted the day before.
Shouldn't the transport of patients be handled by the 119 emergency responders or the doctor helicopter (medical helicopter) team, allowing physicians to focus on treatment? When Director Jeong Kyung-won asked this, he responded, "The trauma center is not merely a place where patients who arrive are saved through surgery; it is a place that manages everything flawlessly from the accident site to the point of discharge."
The trauma center at Ajou University Hospital is recognized as the best severe trauma center in the country. It also played a significant role in the establishment of trauma centers in South Korea. The establishment of trauma centers gained momentum when Professor Lee Guk-jong, a trauma specialist at Ajou University Hospital, flew to Oman in 2011 and saved Captain Seok Hae-kyun, who had suffered severe injuries. Captain Seok was shot during the 'Aden Dawn' operation by our military to rescue the crew of the Samho Jewelry, who had been kidnapped by Somali pirates. The government began the trauma center project by amending laws prompted by this incident.
Director Jeong succeeded Professor Lee Guk-jong, who moved to serve as the Director of the National Military Medical Center in 2023, in leading the trauma center. After assuming office, he set a goal to reexamine all systems and make it a severe trauma center recognized not only in the country but also worldwide.
In 2000, the American College of Surgeons developed the 'Trauma Quality Improvement Program (TQIP)' to improve the standards of trauma centers. Ajou University Hospital's trauma center is the only one in the country to be a member of TQIP. Director Jeong noted, "Our center's medical quality ranks in the top 1% compared to overseas," adding, "I want to present a successful model for improving the domestic trauma management system."
He identified 'quality management' as the most important factor in the trauma center. Quality management is a medical term that refers to the level of healthcare services and the extent to which they actually improve patients' health. It is a broader concept than simply the cure rate of diseases or the survival rate of patients. It encompasses all procedures of the treatment process, including patient transport, initial treatment, diagnosis, surgery, and postoperative management, as well as management efficiency.
The medical drama 'The Trauma Code: Heroes on Call' primarily depicts scenes of saving patients through surgery, but many more events occur at actual trauma centers, and improvements must be made to fulfill the proper role of a trauma center. Director Jeong stated, "Just as corporations check profitability and business viability through financial audits to ensure healthy management, hospitals must constantly assess and improve their quality management state," adding, "In a trauma center where every second counts, quality management is especially important."
He cited the blood transfusion system at Ajou University Hospital's trauma center as a representative example of improvement. Patients transported to a severe trauma center often require blood transfusions before surgery due to excessive bleeding. Scenes of medical staff checking the blood type of trauma patients during transport can often be seen in medical dramas like 'The Trauma Code: Heroes on Call.' To expedite the transfusion process, Ajou University Hospital's trauma center maintains a constant supply of type O blood. Type O blood can be transfused to any blood type as it lacks A and B antigens.
Director Jeong mentioned, "Previously, it took 10 to 15 minutes to test the patient's blood type and bring compatible blood from the blood bank," adding, "Now, by having type O blood available in the resuscitation room, the survival rate of patients has visibly increased."
In addition, improvements are being made from patient transport to patient management, including the procedures for doctor helicopter dispatch. As a result, the survival rate of patients at Ajou University Hospital's trauma center is at a world-class level. Compared to the United States, which first established a trauma management system, it is not at all lacking; in some indicators, it is even ahead. Director Jeong stated, "Our trauma center has a 1.8 to 2 times higher survival rate even for more critical patients compared to U.S. trauma centers," adding, "We have maintained such indicators for several years since joining the American College of Surgeons' TQIP."
Director Jeong noted that government support, along with the hospital's own investments, has greatly contributed to achieving these results. Ajou University Hospital's trauma center operates 100 beds, the highest among trauma centers in the country. The minimum number of beds required for government-designated trauma centers is 60, including 20 in intensive care and 40 in general wards.
Thanks to this, it was possible to maintain top-level staffing, equipment, and facilities. With a more relaxed staffing situation than other centers, they were able to allocate funds for quality management. This improvement in medical quality has resulted in a virtuous cycle where more patients seek treatment at Ajou University Hospital, enhancing its revenue. They have had to resort to borrowing beds from the main building due to the influx of patients.
Ajou University Hospital's trauma center is attempting to take the next leap forward. Director Jeong stated, "The southern Gyeonggi region served by our trauma center has a population of 10 million, but there is only Ajou University Hospital as a trauma center, leading to a continued shortage of beds," adding, "We are exploring ways to increase bed capacity through the hospital's investment."
A situation where healthcare staff or beds are insufficient to accommodate patients is referred to as 'bypass.' Even Ajou University Hospital's trauma center, which has the most beds, once had a bypass rate exceeding 5% due to an influx of patients. Transfers of patients to Ajou University Hospital from other areas with trauma centers also occurred frequently.
Ajou University Hospital has pursued a plan to increase its trauma center beds by investing its own resources. Although there were plans to expand the trauma center wards and enhance educational facilities in preparation for increasing the medical school, the investment plan itself has now been put on hold. This is due to declining hospital revenues resulting from conflicts with the medical community and uncertainties surrounding the expansion of the medical school.
Despite this, Director Jeong expressed his intention to create a model case suited to the realities of domestic healthcare so that trauma patients in other regions can also benefit. He stated, "The biggest goal of our center is to create a successful case that other trauma centers can refer to," adding, "Ajou University Hospital will proactively invest and provide a standard that other hospitals can reference to improve their systems."