SPEARFISH | Spearfish Regional Hospital has a new banner as a Level III trauma center.
The American College of Surgeons recognizes it is one of South Dakota's top five hospitals for treatment of violent injury victims.
Thursday's announcement of the verification of the hospital's capability was not about new equipment or specialists.
It's national recognition that the hospital has far above average fast, high quality treatment for trauma victims.
Spearfish Regional serves a four-state area of the Northern Hills, Northwest South Dakota, Northeast Wyoming, Southeast Montana and southwest North Dakota.
Rapid City Regional is one of three South Dakota Level II hospitals, the highest in the state. Spearfish is the second statewide to have its designation lifted into Level III, putting it into the top five.
The designation recognizes 24-7 emergency care equipment and a trained trauma team available at Spearfish Regional.
The team includes a trauma surgeon and an emergency department. The trauma response includes physicians, respiratory therapy, radiology, CT scanning, operating room staff, lab and blood bank services, and an orthopedic surgeon as needed.
Regional Health's chief officer Tim Sughrue said Thursday, "It's really a remarkable achievement."
He said it's also an achievement the hospital staff wanted.
Spearfish CEO Larry Veitz also thanked the hospital's Spearfish and Belle Fourche advisory council, Spearfish and Belle Fourche ambulance services for their part in the upgrade.
Veitz credited trauma medical director Dr. Terry Altstiel and emergency trauma coordinator Lacey Joens for exceeding the Level III ACS standards.
Altstiel said the designation credits more than the hospital itself.
"This is a Northern Hills trauma system," he said.
A Butte County ambulance responding to a traffic accident north of Belle Fourche can call in a "trauma alert."
That alerts the emergency room for full-scale operation in less than half an hour.
"A lot of this we were doing already," Altstiel said.
The difference, he said, is in the details.
"The care has improved monumentally," he said. "The response to the injured patient will be faster, higher quality and greater survivability."
Altstiel added, "Part of the process is knowing your limitations."
Spearfish may stabilize an accident victim while awaiting a helicopter to Rapid City Regional.
He said Spearfish had the resources for a higher level of care.
"I think all people have a gravitational pull to mediocrity," he said. "This was an opportunity to raise the bar."
Joens added that a team effort pushed for the recognition that Spearfish offered a location to better serve a huge area from North Dakota, eastern Montana and Wyoming and northwest South Dakota.
She is from Sundance and is very aware of the region served by the hospital.
One point, she said, is that ambulance crews have a larger role in caring for a trauma victim at the hospital level as well as with their first response.
"They're involved in paperwork to see what could be done better," she said.
She includes the Belle Fourche ambulance service as being part of the team - as well as Rapid City Regional.
For example, Joens said, a patient brought to Spearfish with a serious head injury may be stabilized and receive additional treatment, but a head injury will be forwarded as quickly as possible to Rapid City Regional. Most other injuries are more likely to be treated in Spearfish.
The ambulance service calls the hospital as soon as they can to allow the hospital trauma staff advanced information on the type and seriousness of an injury so the staff is prepared for a specific case.
Altstiel said that for the patient, when they are hurt, "Your world suddenly stops."
That's when his world begins, he said.
In the emergency room, he said, "You would probably say it's chaotic."
Instead, he said, it's a ballet of care with each person on the staff taking up their own special role in concert with the others.
The study committee that visited the hospital to verify the staff's declaration they are Level III had an extensive study.
"They go through your stuff like you can't believe," he said. "We did marvelous."
But, he said, "You've got to work to remain there."
Another survey is scheduled in three years. "Every single trauma is evaluated."