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Trauma System Plans for Future Growth

Alameda County, CA

​Alameda County, home to Oakland – its largest and best-known city -- has a population of 1.68 million people, with a mature trauma system formed in 1987. This includes three American College of Surgeons verified trauma centers: an adult Level 1, a pediatric Level 1, and an adult Level 2. As the region continues to see population growth, especially in the southern and eastern parts of the County, it was unclear if the current trauma system could handle additional trauma volumes, especially when looking forward to the next 10-20 years. The Local Emergency Medical Services Agency (LEMSA), the governing body for the trauma system, sought to identify if another trauma center was needed, and if so, where in the County a new trauma center would have the greatest impact.

Collaborative, Data-Driven Approach

The consultants were tasked with three key objectives:

  1. Evaluate the performance of the current trauma system and its three trauma centers

  2. Assess population projections, forecast future trauma system capacity, and determine if new trauma centers were needed

  3. Evaluate prospective trauma centers and recommend the hospital best suited to meet current and future trauma system needs

 

Our approach prioritized three main tasks: ensure all stakeholders had an opportunity participate, conduct a comprehensive and independent assessment, and make data-driven recommendations based on hospital capacities and trauma system needs.

 

To accomplish these goals, the consultants sought input from relevant stakeholders: hospital and trauma program leadership of the three existing and two prospective trauma centers, emergency medical services (EMS) agencies, district and county leadership, and healthcare stakeholders from surrounding counties. The process was heavily driven by data, including trauma registry data, EMS data, hospital inpatient data, and population data from the US Census Bureau and regional economic organizations.

Key Findings

The Trauma System Was Strong

  • Alameda County trauma system began in 1987 and its trauma centers were strong. In 2019 (study year), they treated over 6300 patients and admitted 3800 patients.​

  • 99% of Alameda County residents lived within 30 miles of a trauma center.

Alameda County Population Was Growing

  • Alameda County’s population of 1.68 million people equated to 841,000 population per adult trauma center. The average for major metropolitan areas in California was 760,000 population per adult trauma center.

  • Regions of forecasted population growth were in the densest part of central county (Oakland) and the southern and eastern suburbs.

One New Trauma Center Was Warranted

  • Alameda County’s population of 1.68 million people equated to 841,000 population per adult trauma center. The average for major metropolitan areas in California was 760,000 population per adult trauma center.

  • Regions of forecasted population growth were in the densest part of central county (Oakland) and the southern and eastern suburbs.

Community Impact

Following the consulting engagement, Alameda County LEMSA leadership extended the opportunity to Washington Hospital (Fremont, CA) to become the next trauma center in Alameda County. The hospital spent 2+ years building a brand new trauma program and opened its doors on July 1, 2024. In its first year of operation as a provisional Level II trauma center, the hospital:

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  • Served 2200+ people, with 97% of patients coming from their defined tri-city trauma service area in south County

  • Hosted 85 community events and trained over 2800 people on Stop the Bleed, fall prevention, and choking first aid​

 

The consultants projected that a new trauma center at Washington Hospital would draw volume away from the Level II adult trauma center located 19 miles to the north. However, trauma volume at the nearby trauma center increased by 20% between 2020-2023, an increase that offset the lost trauma volume when the new trauma center opened at Washington Hospital in 2024.

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"The consultants conducted a thorough evaluation of the existing and prospective trauma centers and prospective trauma centers, assessing the system functionality and population projections, while always prioritizing the stability of the system. Their recommendations were comprehensive, data-driven, and well-supported, positioning our community for strong trauma care for the next 10-20 years.”

Lauri McFadden
Former Director, Alameda County EMS

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