GETAC Trauma System Committee...

GETAC Trauma

System

Committee

Meeting Jorie Klein, BSN

Dan Dao, MPH

Jane Guerrero, BSN

Robert Greenberg, MD

Trauma Service Area 2016 Survey

GETAC

Trauma System Committee

Trauma Service Area 2016 Survey

RAC Executive Director: (DSHS can provide) *

Contact Information (DSHS)

RAC Chair: (DSHS)

Contact Information (DSHS)

Number of counties in the region: (DSHS)

Population of the region: (DSHS)

Geographic size in square miles of RAC: (DSHS)

* Data will be provided by DSHS

RAC

• Current RAC bylaws address organizational structure, membership and committees Yes No

• Current RAC bylaws are reviewed annually and revisions are approved by the membership: Yes No

• Current RAC bylaws align with the GETAC Emergency Health Care System Strategic Plan: Yes No

• RAC Strategic Initiatives align with the GETAC Emergency Health Care System Strategic Plan: Yes No

TSA 2016

Number of FTEs :

FTEs have defined job descriptions: Yes No

Each employee receives an annual performance

evaluation: Yes No

There is a process for the annual performance

review of the Executive Director: Yes No

If no, define process for performance

evaluation:

TSA 2016 Survey

Does your RAC receive funding from any of the following sources?:

– Tobacco Account (DSHS can provide)

– EMS / RAC (DSHS)

– EMS County Assistance (DSHS)

– HPP (DSHS via HPP)

– Ebola

– CVD

– Membership dues

TSA 2016 Survey

Does your RAC receive funding from any of the

following sources?

– Grants

– Contracts for service

– Donations

– Educational Endeavors

– Annual Conference

– Please list the entrepreneurial activities of RAC

TSA 2016 Survey

• Each county has 911 service: Yes No (DSHS)

• Each county has advanced 911 Services: Yes

No (DSHS)

• Name counties that do not have 911 services: (DSHS)

TSA 2016 Survey

• Total number of EMS agencies (DSHS can provide)

– Urban Fire Based (DSHS)

– Urban Non-Fire Bases (DSHS)

– Rural (DSHS)

– Volunteer (DSHS)

– Air Medical Services (DSHS)

– Non 911 responder services in region

• Total number of BLS ambulances (DSHS)

• Total number of ALS ambulances (DSHS)

• Total number of air medical helicopters routinely in region

• Total number of fixed wing aircraft routinely in region

TSA 2016 Services

• Total number of hospitals: (DSHS can provide all except pediatric and verified burn centers info. But, verified burn center info can be found at http://www.ameriburn.org/verification_verifiedcenters.php )

– Trauma Centers • Level I

• Level II

• Level III

• Level IV

• Pediatric

• Verified Burn Center

• IAP Hospitals

• Military Trauma Centers

• Military non-Trauma Centers

http://www.ameriburn.org/verification_verifiedcenters.php

TSA 2016 Survey

• Number of Free Standing Hospital Associated ERs:

• Number of Non-Hospital Free Standing ERs: (DSHS)

• Number of Micro-Hospitals (Need to define)

• Number of Specialty Hospitals (Need to define)

• FSERs are integrated into the RAC capabilities planning? Yes No

• FSERs are categorized or typed for clarity of capabilities and resources? Yes No

TSA 2016 Survey

• Stroke Centers (Joint Commission) (DSHS can provide)

– Acute (DSHS)

– Primary (DSHS)

– Comprehensive (DSHS)

• AHA Cardiac Centers

• Long-term Care Facilities (DADS can provide)

• Skilled Facilities (DADS)

• Nursing Homes (DADS)

• Rehabilitation Facilities (DSHS/DADS can possibly provide?)

TSA 2016 Survey

• Maternal / Neonatal Resources

• Established RAC Committee: Yes No

• Included in RAC Bylaws: Yes No

• Included in Executive Committee activities:

Yes No

TSA 2016 Survey• Non-Hospital, Non-EMS organizations participating as a

general member– Public Health

– Council of Government

– City Emergency Management

– County Emergency Management

– Red Cross

– DARS

– Transportation Industry

– Academic Systems

– Law Enforcement Agencies

– Entertainment Industry

– Business Leaders

– Other Community Members

TSA 2016 Survey

There is an established EMS Oversight Committee: Yes No

Committee has identified members: Yes No

Committee has defined tasks: Yes No

Committee addresses

Regional EMS medical control

Regional field destination criteria

Regional EMS protocols

Regional EMS communication systems

Regional EMS documentation standards

Regional EMS data integration that meets NIEMSIS standards

Regional EMS plan is documented and integrated into the regional system plan: Yes No

Plan includes regional performance improvement plan: Yes No

Define percent of EMS medical director that attend 50% or more of the meetings:

Committee defines education and resource needs identified by the EMS medical directors: Yes No

List educational programs and resources provided over the past three years:

TSA 2016 Survey

There is an established EMS providers committee: Yes No

Committee membership is defined and includes EMS providers, educators, communication specialist, dispatch, program directors, other EMS staff: Yes No

Committee has defined objectives and tasks: Yes No

Communication between EMS providers and hospitals is integrated with a back up plan: Yes No

There is a documented EMS system plan that is reviewed and revised a minimum of every 24 months and integrated into the regional system plan

The EMS system plan has defined regional performance improvement process: Yes No

What percent of the EMS providers attend the committee at least 50% of the time:

There is opportunity for the EMS Medical Directors and Medical Directors for Trauma, Stroke, Cardiac and Maternal/Neonatal facilities to participate in decision making and discussion: Yes No

Committee provides EMS program development assistance: Yes No

Committee identifies education and resources needed to advance the EMS system:

List educational programs and resources provided in last three years:

TSA 2016 Survey

• There are adequate educational programs for

paramedics and EMT in the region?

• The region is underserved by pre-hospital

providers? Yes No

• If yes , please define.

TSA 2016 Survey

• RAC has assessed the prehospital provider

training program volume to define needs and

capabilities: Yes No

• Have there been EMS or Air medical Services

that closed within the RAC in the past three

years?

• If yes, describe the impact.

TSA 2016 Survey There is an established trauma committee: Yes No

Committee membership is defined and includes trauma medical directors, program managers/directors, registrars and other trauma staff: Yes No


The trauma system plan is reviewed and revised a minimum of every twelve months and integrated into the regional system plan: Yes No

The trauma system plan has a defined regional performance improvement process: Yes No

How many trauma patients from the region are submitted to the state trauma registry:

What percent of this population are from out of RAC:

What percent of this population is from out of State:

What percent of the time did the trauma medical directors attend the trauma committee in the past twelve month:

There is opportunity for the surgical specialist for trauma to participate in decision making and discussion: Yes No

Committee provides trauma center designation assistance: Yes No

Trauma Committee reviews aggregate data from the regional or state registry to define opportunities: Yes No

Have trauma centers dropped out of participation in the past three years?

If yes, define impact to the region.

Have trauma centers upgraded or down graded in the region in the past three years?

If yes, please define.

Committee identifies education and resources needed to advance the trauma system:

List educational programs and resources provided in last three years:

TSA 2016 Survey

• Regional trauma center needs assessment is

completed annually Yes No Population

Total TSA population of less than 600,000 = 2 points

Total TSA population of 600,000 to 1,200,000 = 4 points

Total TSA population of 1,200,000 to 1,800,000 = 6 points

Total TSA population of 1,800,000 to 2,400,000 = 8 points

Total TSA population of greater than 2,400,000 = 10 points

TSA = ____ points

Regional Trauma Center Needs Assessment

Median Transport Times (combined air + ground - scene only)Median transport time of less than 10 minutes = 0 points

Median transport time of 10 -20 minutes = 1 point

Median transport time of 21 – 30 minutes = 2 points

Median transport time of 31 to 40 minutes = 3 points

Median transport time of greater than 41 minutes = 4 points

TSA = ___________ points


Lead agency support for a trauma or an additional trauma = 5 points

center in the TSA

Lead agency position that no additional trauma centers are = - 5 points

needed

Trauma System Advisory Committee statement of support = 5 points

for a trauma center or an additional trauma center in TSA

Community support demonstrated by letters of support from = 1 point

25-50% of city and county governing body within the TSA

Community support demonstrated by letters of support from = 2 points

over 50% of city and county governing body within TSA

TSA = _______ points


Severely injured patients (ISS>15) discharged from acute facilities not

designated as Level I, II or III trauma centers:

Discharges of 0-200 severely injured patients = 0 points

Discharges of 201-400 severely injured patients = 1 point



Discharges of greater than 800 severely injured patients = 4 points

TSA = ______ points


Level I trauma centers

For the existence of each verified Level I trauma center already in the TSA = ____ points

assign a -1 point (negative 1 point)

For the existence of each verified Level II trauma center already in the TSA = ____ points

Assign a -1 point (negative 1 point)

For the existence of each verified /designated Level III trauma center already = ____ points

in the TSA assign a - 0.5 point (negative 0.5 point)

TSA = ______ points


Number of severely injured patients (ISS>15) seen in trauma centers (Level I

and II) already in the TSA

Calculation: 500 x (# of Level I and Level II centers in TSA) = _______

If the TSA has more than 500 severely injured patients above the expected = 2 points

number

If the TSA has 0-500 severely injured patients above the expected number = 1 point

If the TSA has 0-500 fewer severely injured patients than expected number = -1 point

If the TSA has more than 500 fewer severely injured patients than expected = -2 points

TSA = ________ points assigned

Regional Trauma Center Needs Assessment1. Population = ____ points

2. Transport times = ____ points

3. Lead Agency / Support = ____ points

4. Severely injured discharged = ____ points

from non-trauma center

5. Level I trauma centers = ____ points

6. Severely injured evaluated in = ____ points

level I or II trauma center

TSA Total Points _____

TSA with score of 5 points or less – shall be allocated 1 trauma center

TSA with scores of 6-10 points – shall be allocated 2 trauma centers

TSA with scores of 11-15 points – shall be allocated 3 trauma centers

TSA with scores of 16-20 points shall be allocated 4 trauma centers


• Regional system utilizes a completed trauma

system needs assessment to develop regional

plan to assist trauma centers Yes No

• If process is not used – how does the system

support trauma center growth and

development?

TSA 2016 Survey• TSA has a defined Stroke Committee: Yes No

• Stroke Committee has defined membership: Yes No

• Stroke Medical Directors, program coordinators are targeted members.

• The committee has defined tasks and objectives: Yes No

• The committee has a written Stroke Plan that is approved by the RAC and is disseminated to the community: Yes No

• The plan defines the regional performance improvement process for stroke events: Yes No

• Define percentage of time a stroke medical director attends a regional stroke committee:

• The committee defines the educational and resources needed to improve stroke care in the region: Yes No

• List the educational programs and resources provided by the RAC to improve Stroke Care for the last three years:

TSA 2016 Survey

• TSA has a defined Cardiac Committee: Yes No

• Cardiac Committee has defined membership: Yes No

• Cardiac Medical Directors, program coordinators are targeted members.


• The committee has a written Cardiac Plan that is approved by the RAC and is disseminated to the community: Yes No

• The plan defines the regional performance improvement process for cardiac events: Yes No

• Define percentage of time that a cardiac medical directors attended the Cardiac Committee meetings:

• The committee defines the educational and resources needed to improve cardiac care in the region: Yes No

• List the educational programs and resources provided by the RAC to improve Cardiac Care for the last three years:

TSA 2016 Survey

• TSA has a defined Pediatric Committee : Yes No

• Pediatric Committee has defined membership: Yes No

• Pediatric physicians, nurses and staff are targeted members.


• The committee has a written pediatric plan that is approved by the RAC and is disseminated to the community: Yes No

• The plan defines the regional performance improvement process for pediatric events: Yes No

• The committee defines the educational and resources needed to improve pediatric care in the region: Yes No

• List the educational programs and resources provided by the RAC to improve pediatric for the last three years:

TSA 2016 Survey

• TSA has a defined Prevention Committee: Yes No

• Prevention Committee has defined membership: Yes No

• Physicians, nurses and staff are targeted members.


• The committee has a written prevention plan that is approved by the RAC and is disseminated to the community: Yes No

• The plan defines the regional performance measures for prevention activities: Yes No

• The committee defines the prevention priorities to prevent death or disability in the region: Yes No

• List the educational and resources provided by the RAC related to prevention activities for last three years:

• List the community coalitions for prevention supported by the region:

TSA 2016 Survey

• TSA has a defined Professional Education Committee: Yes No

• If no, define how this need is addressed:

• Education Committee has defined membership: Yes No

• Physicians, nurses, EMS providers and staff are targeted members.


• The committee has a written educational plan that is approved by the RAC and is disseminated to the members: Yes No

• The plan defines the regional performance measures for educational activities: Yes No

• List the educational programs and resources provided by the RAC not already covered for last three years:

• List the community partners engaged to supported educational activities in the region:

TSA 2016 Survey

• TSA has a defined System Performance Improvement Committee (SPIC): Yes No

• If no, define how system performance measures are addressed.

• The System Performance Improvement Committee is supported by the regional data base that integrates the hospital data, EMS data and performance improvement measures to define opportunities

• SPIC Committee has a defined membership: Yes No

• Physicians, nurses and EMS individuals are targeted members.


• The committee has a written SPIC plan that is approved by the RAC, is disseminated to the stakeholders, and integrated into the system plan: Yes No

• The plan defines the regional performance measures for the region: Yes No

• Data in dashboard formats is used to define the status, improvements and needs of the RAC: Yes No

• The committee defines the data priorities to monitor for trends and outcomes in the region: Yes No

• Region is engaged in research activity to improve care: Yes No

• List the routine data reports and resources provided by the RAC specific to SPIC activities for last three years:

TSA 2016 Survey

• TSA has a defined Closed System Performance Improvement

Committee (SPIC): Yes No

• If no, define how the sensitive performance improvement issues

are managed in the region:

• SPIC Closed Committee has defined membership: Yes No

• Physicians, nurses and EMS are targeted members.

• The closed committee has defined tasks and objectives: Yes No

• The SPIC closed committee functions as a regional peer review

committee for referral case reviews. Yes No

• The process to submit a case for review is provided on the website

and is available to all members. Yes No

• This committee is led by a trauma surgeon. Yes No

TSA 2016 SurveyThere is an established Disaster or Emergency Management / Response committee: Yes No

Committee membership is defined and includes EMS providers, hospital representatives, Infectious disease specialist, communication specialist, dispatch, emergency managers (city, county, district), Department of Public Health, Red Cross, volunteer agencies : Yes No

Regional disaster planning includes trauma medical directors and trauma staff: Yes No

If no, how is mass casualty planning addressed?


There is a documented regional disaster response plan that is reviewed and revised a minimum of every 24 months

The region has established criteria for activation of a regional medical operations center: Yes No

If no, what process is used?

The disaster response plan has a defined regional performance improvement process: Yes No

What percent of the members attend at least 50% of the meetings:

There is opportunity for the EMS Medical Directors and Medical Directors for Trauma, Stroke, Cardiac and Maternal/Neonatal facilities to participate in decision making and discussion in regional disaster response activities: Yes No

Committee provides disaster program development assistance: Yes No

Committee identifies education and resources needed to advance the disaster response system in the region:

List programs and resources provided in last three years:

TSA 2016 Survey• Region completes and annual HVA: Yes No

• Region has developed standardized activation systems utilizing standard language across the RAC: Yes No

• Region has a standardized communication system for emergency response that has a redundant back up process plan? Yes No

• If no, please define this process:

• Regional response plans address all ages and populations to include behavioral health and all special needs patients ? Yes No

• If no, define how is this being addressed:

• Region has adopted a standardized field and hospital triage system for mass casualty events: Yes No

• If no, how is the process being addressed:

• Region has implemented a resources sharing and tracking system for utilization in disaster response: Yes No

• Region has an ID badge system for credentialing to facilitate personal resource utilization? Yes No

• Region has a current listing of all capabilities and resources within the region: Yes No

• Region has engaged in EMTF program: Yes No

• Region has identified Strike Teams: Yes No

• Region has provided Strike Team Leader training: Yes No

• Region has an ambus for response? Yes No

• If o, defi e our RAC’s pro ess for i tegratio i to the a us shari g pla for Te as:• Region has an all hazard approach to regional planning?

• If no, define how specific issues are addressed.

• Region has engaged community partners in the planning process: Yes No

• Region provides assistance with preparing for Highly Infectious Fatal Diseases or diseases that produce long term impact: Yes No

• Region proves assistance with preparing for Active Shooter response: Yes No

TSA 2016 Survey

• List the actual events the RAC has responded

to over the past three years:

• Define the cost of this response

TSA 2016 Survey

• Regio has e gaged i the Stop the Bleed Program: Yes No

• Region has identified BCon instructors: Yes No

• If so, how many trainers are in the region?

• Region has engaged community stakeholders to parti ipate i the Stop the Bleed program: Yes No

• If so, how many total people in the region have received training?

TSA 2016 Survey

• RAC Executive Committee integrates the

GETAC Emergency Health Care System into its

strategic plan: Yes No

• Executive Committee has a dashboard report

for monthly review of progress: Yes No

• Executive Committee has measures to foster

accountability and developments to move the

system forward: Yes No

TSA 2016 Survey

• Total population in region (DSHS)

• Total funding received:

• Funding / individual in RAC = $__________

• Total annual RAC operating budget:

$______

• Total funding needed to sustain operations

and develop the regional system:

• $ _________

TSA 2016 Survey

Identify the three top priorities for 2016-2017

1.

2.

3.

TSA 2016 Survey

• List the Top Three Patient Care System Issues

That Are Continuing Problems:

– 1.

– 2.

– 3.

Thank You

• Thank you for your time and commitment to

the patients we serve and your contributions

to improve the Texas trauma and emergency

health care system.

GETAC Trauma System Committee...

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