County Releases Hospital Score Cards in Trauma Center Battle

Natividad Medical Center, awarded the right to open Monterey County's first trauma center, outscored its competition in a number of key areas that included general surgery and disaster planning and management, according to scorecards released today by the County Counsel's office.

It's the first in-depth look at the secretive process of ranking components of each facility that went into Natividad beating out Salinas Valley Memorial Hospital for the prized trauma-center designation. The evaluations and rankings were done by a still-anonymous independent-review panel contracted by the county's Emergency Services department.

Out of a total possible score of 1,000, Salinas Valley Memorial scored 508.32, while Natividad scored 533.79, according to the documents called "trauma center score sheets." 

The scorecards ranked each facility in 21 separate categories, including organ procurement activities; trauma research and scholarship; organized burn care; rehabilitation; general surgery; emergency medicine; and pediatric trauma care among them. 

In organ procurement activities and burn care, Natividad and Memorial tied with a score of 2.5 and 5.0, respectively. Both scored zeroes in trauma research and scholarship. 

But in high-stakes categories like general surgery, Natividad ranked ahead of Memorial by a score of 60-45, according to the scorecards. Natividad also bested Memorial in performance improvement and patient safety, by a score of 75-72. 

In the neurosurgery category, Memorial came out on top, with a score of 40 to Natividad's 31. In orthopedic surgery, Memorial again bested Natividad, with a score of 40 to Natividad's 36.

The documents were released in response to a Public Records Act request filed by the Monterey County Weekly and at least one other local publication. In a letter emailed with the documents, which were sent to all local media, Deputy County Counsel Susan Blitch writes "an objective, independent review panel was the proper process to avoid any suggestion of impartiality (sic) or bias in the evaluation process."

Memorial spokeswoman Adrienne Laurent said Thursday evening she received the scorecards from the county counsel's office at the same time as the media. 

"We have had no time to really review and take a good, deep look at them, and we may have some comments at that point," Laurent says. "We were surprised by the recommendation and so we do want to be able to review the scorecard. We've asked for additional information that might make a little more sense to us, so that we can study it and really understand it."

The county now has to begin negotiating the parameters of a contract outlining how Natividad will open and operate a trauma center, a process that could take multiple years and untold millions of dollars. As a result, Blitch writes, the county plans to withhold other documents requested by the media. For example, bidder information can be withheld until the final decision to award a contract has been made.

County spokeswoman Maia Carroll says she expects more documents will be released Friday and in the coming days. 

The process of designating a trauma center has been conducted mostly in secret. The county had first solicited hospitals to apply in 2005, but received no response. It wasn't until 2011 that Memorial and Natividad each indicated a desire to become a trauma center, requiring staffing up with costly experts 24/7 to be prepared for the worst, and the unexpected, at all times.