Denver NICU/ER ?

There are three level one trauma centers in Denver. Saint Anthony's, Denver Health and Swedish. There are also several level two trauma centers that are very similar to level one's. Denver Health is the oldest and is similar to any inner city trauma center (penetrating trauma > MVA). Saint Anthony's and Swedish are both semi suburban trauma centers and see more non-penetrating trauma but are both known for their neurosurgery programs. Both the suburban programs also depend more on their flight programs for patients.

As far as NICUs there are a number of level III's. Off the top of my head, Saint Joseph's, P/SL, and Children's. I think that University, Swedish and Littleton may also be Level III's. If you are talking about true "Level IV's" then its pretty much P/SL and Childrens. Children's is a tertiary referral center affiliated with University of Colorado. Don't bother unless you have your BSN (unless things have changed recently). P/SL is another tertiary center set up by the pediatricians that Children's ****** off (personal bias). They do everything that Children's does with the exception of transplants. P/SL last time I looked had almost 100 NICU beds (II and III). They are also building a new woman and children's hospital. Children's built a new hospital on the University of Colorado Campus in Aurora which is very nice.

If you want to live in the city of Denver (and city of Denver is very different than an east coast city) then P/SL and Denver Health is your best bet. If you both want to work in the same Hospital then Swedish is your only choice (but no ECMO there). Saint Anthony's has good trauma but you'd have to drive a ways to work in a NICU. All in all its pretty easy to commute a fair distance during nursing hours (7-7). Outside of that it gets pretty hard. Some of the Nurses at the NICU at P/SL commuted from Colorado Springs and Wyoming. Just depends on what you want.

David Carpenter, PA-C

As far as I know the only Level III NICUs in the Denver area are at University, Children's ( which gets that cases that are too serious to stay at Universtiy) and Pres/St. Luke's. Most of the surrounding ares send the extreme cases to those hospitals. (Most of the state for that matter as well as WY).

I cannot speak for Level I trauma, I have no experience. I know that University does receive a lot of major trauma.

Good luck in your search.

~H

Swedish is a Level III according to their website. Rose is a level IIIB according to theirs.Actually looking at the designations P/SL and Childrens are level IIIC. Rose, Swedish, Saint Josephs, University, and Littleton are IIIB. Aurora is either IIIB or IIIA same for Denver Health. Outside of that area you have Lutheran and Saint Anthony's which I think are IIIA. On the north side there are a bunch of small hospitals that are again all IIIA I believe. Boulder is probably IIIB.

Outside of the three major trauma centers, University is Level 2 (although now that they are in Aurora there is talk about regaining their level 1). Aurora medical center is level 2 as is Littleton. Again not as familiar with the north side of town. University does get some trauma but in Denver the trauma is controlled by ownership of transport. That means flights go to Swedish and Saint Anthony's for the most part and ground in Denver goes to Denver Health.

From the OPs point of view Littleton presents a nice mix of a IIIB NICU and a somewhat busy Level II trauma center. It also is located in a nice area of town with good schools. Depends on what you are looking for.

David Carpenter, PA-C

I never weigh into these things but had to correct Mr. Carpenter. If you're still interested, Children's Hospital is the only technical "Level IV" hospital in the Denver Metro area because they're the only ones who have the capability to offer ECMO. Diaphragmatic hernia patients and their parents, for one, are grateful for this. P/SL has to refer those kids away or withdraw care. Despite P/SL's advertising, they don't have more NICU beds and can't offer highest acuity care.

If you work at TCH you know that the same cardiac surgeons work at P/SL. You also know that they do ECMO for diaphragmatic hernias and probably have done as many or more than TCH. Granted its been a while since I worked in the PICU, but we were doing around 12 a year when I was there with 5-6 ECMO runs. Not a huge amount but more than sufficient. I have been out of Denver for a year but before I left the only thing that P/SL wasn't doing was pediatric transplant. As for the NICU size, this is from the P/SL website:
Singletons, twins, triplets, quadruplets - even twins born 63 days apart in 2006 - are all specially cared for in our Level III Neonatal intensive Care Unit (NICU), the largest NICU of its kind in the Rocky Mountain Region and is classified as a Level II and Level III care center, the most extensive level of critical care available for newborns.

This is from TCH:
Our program now cares for more than 700 babies each year who are referred from within a 10-state region.

Given how that includes the special care nursery, its pretty obvious that the Neonatal unit at TCH is smaller. Part of that is of course due to the fact that the babies tend to go where the mom's are. Without a high risk OB floor TCH will never have the volume that University has much less what P/SL or Joe's has. If I recall from a few years ago the NICU volume was P/SL > Joe's > University > TCH > DG.

TCH has a lot of things to recommend. The genetics programs are first rate for example. It has the only peds burn center in the state if I recall. However, the attitude and disinformation by people associated with it are the reason that there is such a fracture among pediatricians in Denver (in my opinion). If you look at the history of why P/SL's pediatrics programs exist in the first place you would understand this.

David Carpenter, PA-C

Sounds like maybe you haven't worked in Denver since the new TCH opened. The information on P/SL's website is somewhat misleading, and one shouldn't always trust what one reads on the web. I can't speak to the PICU there but since the initial question addressed NICU acuity, the fact is P/SL hasn't done an ECMO run in 3 years, probably longer. Their ECMO program is no longer active, and in fact babies have been transferred from P/SL to TCH to be placed on ECMO.

P/SL is incapable of performing Norwood procedures for hypoplastic left hearts. They cannot repair complex congenital heart disease. In the last year at TCH babies have been dialyzed for various disorders with good outcomes. Without pediatric nephrology services, this is not possible at P/SL. While the two institutions may share some cardiac surgeons, the scope of procedures performed at the different hospitals is markedly different. The difference in acuity between repairing a hypoplastic left heart or double outlet right ventricle compared to closing an ASD, VSD or coarctation can't be compared.

I wouldn't look to what bifurcated the program many years ago when addressing acuity, dedication to the practice, and quality of care as it stands today. I can tell you people are proud to work at an academic center with a medical staff devoted to the latest technology, procedures and equipment in the region. For anyone interested in practicing in the forefront of medicine, rather than practicing in the 1980's, TCH is the place to go. Where progressive therapies are driven by pharmaceuticals rather than pursuit of science, an institution can't be at the forefront of research and technology outside of an academic center.

While P/SL may be capable of taking care of twins, triplets and quads, TCH has been at the forefront of research for the last 2-3 decades, and has been responsible for therapies that have saved the lives of countless babies. P/SL cannot make the same claim. While they may take care of high acuity babies, they have no choice but to pick up on therapies that started out at academic institutions such as TCH. Where people have the facts, not just what's written on a website, TCH seems to be the obvious choice for patients and health care practitioners.