Area residents now have a Level 1 Trauma Center less than two hours away.

Recently, Billings Clinic announced it had been verified as a top tier trauma hospital by the American College of Surgeons. That makes it the only one in a 550-mile radius that includes all of Montana and Wyoming.

“Billings Clinic’s core mission is to provide the highest quality, complex care close to home for the entire region, and becoming the region’s first Level I Trauma Center is a reflection of both that commitment and the compassionate dedication of so many people across every facet of our organization,” said new Billings Clinic CEO Clint Seger, MD, in a news release. “Being a Level I Trauma means we provide the highest level of trauma care available while elevating lifesaving care, creating better patient outcomes and advancing trauma care throughout the communities we serve.”

Powell Valley Healthcare is affiliated with the Montana hospital. Billings Clinic representative Tracey Walker, director of regional operations at Billings Clinic, said it was a big honor in May when the hospital was recommended for approval.

“It’s really exciting for our trauma team at Billings Clinic,” she said.

According to the American Trauma Society, a Level I Trauma Center is a comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level I Trauma Center is capable of providing total care for every aspect of injury — from prevention through rehabilitation.

Trauma injuries are the leading cause of death for Americans up to the age of 44, and the fourth leading cause overall for all ages. With a highly rural population sometimes living hundreds of miles from the nearest trauma center, trauma survival rates in Montana are lower than much of the rest of the country. This adds up to make the availability of high-level trauma services throughout the region are both critical and urgent.

Seriously injured patients have a 25% greater survival rate if treated at a Level I Trauma Center. At the same time, Billings Clinic sees a 10% annual increase in trauma patients each year, and with this verification Billings Clinic continues to lead the way for local, independent trauma services of the highest level for anyone who needs them in Montana and Wyoming.

“We work tirelessly day in and out to improve care in Montana and Wyoming, and being a Level I Trauma Center is another major step to support everyone in the region who is a victim of trauma. This is the top level of trauma center verification any hospital can receive,” said Michael Englehart, MD, FACS, general and trauma surgeon and Billings Clinic trauma medical director. “We already offer the most comprehensive trauma services in the region and have the busiest emergency and trauma center in Montana. We also know that people do better when they get their care close to home, and that’s why we’ve passionately pursued this — to give everyone the same level of lifesaving care when they need it, no matter where they live.”

The verification comes after an expert ACS review team rigorously reviewed every aspect of Billings Clinic’s trauma program in May of 2023. This decision from the ACS recognizes that, as a Level I Trauma Center, Billings Clinic provides system leadership and comprehensive trauma care for all injuries and that it has the right people and resources to do so effectively and consistently.

In addition to providing acute trauma care, being a Level I Trauma Center means Billings Clinic plays an important role in local trauma system development, regional disaster planning, increasing capacity, and advancing trauma care through research.

Level I Trauma verification is given to comprehensive care facilities with a large patient capacity and the ability to treat trauma patients with greater degrees of injury severity, while providing the highest level of trauma care to critically ill or injured patients. There currently are no other ACS verified Level I Trauma Centers in Montana, Wyoming, Idaho or South Dakota. The next closest Level I centers to Billings are in Salt Lake City, Utah (548 miles); Denver (555 miles); and Seattle (819 miles).

“The Level I verification is a huge win for the city of Billings and the entire region,” said Gordon Riha, MD, FACS, trauma surgeon and Billings Clinic assistant trauma medical director and surgery residency director. “No longer will families have to travel hundreds of miles out of state for complex care. Patients can expect top notch injury management right here at home.”

Because trauma can happen anywhere, having the best care available no matter where you are is critical. In Montana, Wyoming and the western Dakotas, the miles between people and the right resources can stretch into the hundreds, and Billings Clinic is focused on creating a regional trauma network that connects facilities throughout Montana and Wyoming.

This coordinated regional network shares resources and expertise so that much of that lifesaving care can be administered before a patient is taken to Billings, and every step of a patient’s trauma journey is connected. This includes providing specialized trauma training to staff at rural facilities, streamlining communication, enhanced telehealth to connect trauma specialists remotely, having surgical residents on rotation at rural facilities and the upcoming construction of a new state-of-the-art transfer center at Billings Clinic to more smoothly coordinate transfers, reduce transport delays and get patients where they need to go more quickly.

“You don’t get to choose when a serious accident happens,” Englehart said. “But that doesn’t mean you shouldn’t have access to lifesaving care anywhere you are. That’s why partnering with hospitals and communities across Montana and Wyoming to develop additional trauma services and education is so important to us.” Billings Clinic has taken the lead on treating trauma patients across a multi-state region, experiencing a 55% increase since 2010.

Billings Clinic has been continually verified as Montana’s first Level II Trauma Center since 1992 and already had many of the required pieces in place to become a Level I center. This includes dedicated trauma services, emergency services, 24/7 multispecialty care services, immediately available operating rooms, facial trauma and plastics, cardiothoracic surgery, urology, OBGYN, fellowship-trained orthopedic trauma surgeons, other 24/7 surgical services, emergency heart surgery and cardiopulmonary bypass, neurosurgery for traumatic brain and spine injuries, state-of-the-art 24/7 interventional radiology for adjunct hemorrhage control in trauma, a broad affiliate network throughout a multistate region, and strong relationships with rural hospitals.

As part of its journey to becoming a Level I Trauma Center, Billings Clinic is hosting surgical residents and in 2022 announced Montana’s first rural surgical residency track in collaboration with the University of Arizona. There are currently two surgical residents practicing at Billings Clinic on one-year rotations. Trauma research is also an essential component of a Level I Trauma Center, and internal research scientists continue to work with the Billings Clinic trauma team to complete and publish trauma research.

As a Level I Trauma Center, Billings Clinic provides the care and resources to treat every type of injury, no matter how serious, at any time. It means a community-focused, integrated system of care will be available to all in need. Additional benefits of Level I include:

Provides leadership in prevention, training and public education to surrounding communities.

Provides continuing education for the trauma team members and others throughout the organization.

Regional care coordination

Incorporates a comprehensive quality assessment program.

Operates an organized teaching and research effort to help direct new innovations in trauma care.

In support of achieving this monumental investment in trauma care for the region, Billings Clinic Foundation launched a $30 million capital campaign, the largest in Billings Clinic’s history. The Foundation is more than halfway to this goal, including a gift of $7 million from the Philip N. Fortin Foundation, a $1 million gift from Tim and Carmen Sheehy, an anonymous $5 million gift and funds raised from the 2022 Billings Clinic Classic.

In order to meet the needs of residents and visitors to the region, Billings Clinic Foundation’s capital campaign will provide funding to expand operating rooms, build a new state-of-the-art transfer center to reduce transport delays, build Montana’s first dedicated Surgical Intensive Care Unit (expected to open in 2024) and expand the Emergency Department. Billings Clinic also recently opened two new operating rooms and, in 2022, opened a new 28-bed step-down unit called the Intermediate Care Unit.

To learn more or to support Billings Clinic’s commitment to providing the highest level of trauma care, visit billingsclinic.com/trauma. To support Billings Clinic’s Emergency, Trauma and Complex Care campaign, visit billingsclinicfoundation.com.

— Reporting by Zac Taylor