Jack ChamplinConsultant

Prevention Institute

Former Deputy AdministratorRegion 9

National Highway Traffic Safety Administration

California Trauma System SummitSeptember 21, 2009

Trauma System Trauma System Agenda for the FutureAgenda for the Future

The Vision The Vision

Trauma systems, when fully implemented Trauma systems, when fully implemented throughout the United States, will enhance throughout the United States, will enhance community health through an organized community health through an organized system of injury prevention, acute care system of injury prevention, acute care and rehabilitation that is fully integrated and rehabilitation that is fully integrated with the public health system in a with the public health system in a community.community.

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Trauma System Trauma System Agenda for the FutureAgenda for the FutureThe Vision (continued)The Vision (continued)

Trauma systems will have the ability to Trauma systems will have the ability to identify risk factors and related identify risk factors and related interventions to prevent injuries in a interventions to prevent injuries in a community and to maximize the community and to maximize the integrated delivery of resources for integrated delivery of resources for patients who ultimately need acute trauma patients who ultimately need acute trauma care.care.

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The ChallengeThe Challenge

How to implement a comprehensive How to implement a comprehensive trauma care system in California trauma care system in California when faced with the current status of when faced with the current status of a largely decentralized system?a largely decentralized system?

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Strategic Highway Safety Strategic Highway Safety PlanPlan

How it came to be…..How it came to be…..► SAFETEA-LU, 23 U.S.C. § 148, established SAFETEA-LU, 23 U.S.C. § 148, established

the Highway Safety Improvement Program the Highway Safety Improvement Program (HSIP) as a core federal highway program. (HSIP) as a core federal highway program.

► A Strategic Highway Safety Plan (SHSP) is a A Strategic Highway Safety Plan (SHSP) is a major component and requirement of the major component and requirement of the HSIP. HSIP.

► SHSP is a statewide-coordinated safety plan SHSP is a statewide-coordinated safety plan that provides a comprehensive framework that provides a comprehensive framework for reducing highway fatalities and serious for reducing highway fatalities and serious injuries on all public roads. injuries on all public roads.

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Strategic Highway Safety Strategic Highway Safety PlanPlan

How it came to be…..How it came to be….. ►The SHSP is developed by the State The SHSP is developed by the State

DOT in a cooperative process with DOT in a cooperative process with Local, State, Federal, and private sector Local, State, Federal, and private sector safety stakeholders.safety stakeholders.

► The SHSP is a data-driven, four to five The SHSP is a data-driven, four to five year comprehensive plan that year comprehensive plan that establishes statewide goals, objectives, establishes statewide goals, objectives, and key emphasis areas and integrates and key emphasis areas and integrates the four E'sthe four E's

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Four E'sFour E's

►Engineering►Education►Enforcement►Emergency Medical Services

(EMS)

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SHSP Impact on Trauma and SHSP Impact on Trauma and EMSEMS

►Highlights challenges to roadway user Highlights challenges to roadway user safety on California’s streets and highways.safety on California’s streets and highways.

►Uses data to paint the picture of fatalities Uses data to paint the picture of fatalities experienced on California’s roads.experienced on California’s roads.

►Proposes high level strategies to reduce Proposes high level strategies to reduce fatalities for each challenge area.fatalities for each challenge area.

►Serves as a guide for the implementation of Serves as a guide for the implementation of specific projects and activities through specific projects and activities through 2010.2010.

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Impact on Trauma and Impact on Trauma and EMSEMS

► The California SHSP goal is to achieve less The California SHSP goal is to achieve less than one roadway fatality per 100 million than one roadway fatality per 100 million vehicle miles traveled (VMT).vehicle miles traveled (VMT).

► In the year 2010., if current trends in In the year 2010., if current trends in population growth, vehicle use, and travel population growth, vehicle use, and travel patterns hold steady, the number of patterns hold steady, the number of fatalities and injuries will increase.fatalities and injuries will increase.

► Traffic deaths will grow more than 17 Traffic deaths will grow more than 17 percent to exceed 4,700 per year. percent to exceed 4,700 per year.

► Injuries and economic losses will grow at a Injuries and economic losses will grow at a similar pace.similar pace.

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Strategic Highway Safety Strategic Highway Safety PlanPlan

Current Status of CaliforniaCurrent Status of California► EMS is Challenge Area 15 and represents EMS is Challenge Area 15 and represents

improving crash survivability. improving crash survivability.

SHSP Implementation ChallengeSHSP Implementation Challenge► By 2010, reduce crash-related fatalities in By 2010, reduce crash-related fatalities in

California at least 5 percent from their 2004 California at least 5 percent from their 2004 level through focused improvements in level through focused improvements in Emergency Medical Services (EMS) system Emergency Medical Services (EMS) system communications, response, and safety communications, response, and safety education.education.

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CA SHSP Challenge Area CA SHSP Challenge Area 1515

Strategies:Strategies:1. Improve technology for locating crash sites 1. Improve technology for locating crash sites

and for improving EMS access routes and and for improving EMS access routes and response times.response times.

2. Ensure interoperability of communications 2. Ensure interoperability of communications systems between all responders to crash systems between all responders to crash sites.sites.

3. Improve patient transportation and 3. Improve patient transportation and destination from crash location.destination from crash location.

4. Increase availability of appropriate-level 4. Increase availability of appropriate-level trauma centers, with emphasis on rural areas.trauma centers, with emphasis on rural areas.

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CA SHSP Challenge Area CA SHSP Challenge Area 1515

Strategies:Strategies:5. Improve access to trauma-related training 5. Improve access to trauma-related training

courses for Emergency Medical Technicians courses for Emergency Medical Technicians and paramedics.and paramedics.

6. Encourage Emergency Medical Dispatch 6. Encourage Emergency Medical Dispatch programs to train dispatchers to assist programs to train dispatchers to assist victims awaiting arrival of EMS.victims awaiting arrival of EMS.

7. Improve data access to meet the needs of 7. Improve data access to meet the needs of EMS.EMS.

8. Increase public access to first aid, cardio 8. Increase public access to first aid, cardio pulmonary resuscitation (CPR), and pulmonary resuscitation (CPR), and automated external defibrillation training.automated external defibrillation training.

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- EMS and Trauma Planning Partners

Click It Or Ticket National Law Enforcement Campaign►The goal is to get more drivers and

passengers to always buckle up every trip, every time.

►Seat belts save lives: They are the best defense against injuries

and fatalities. In 2007 alone, seat belts saved an

estimated 15,147 lives. An additional 5,024 lives could have been

saved if seat belts were worn at the time of the crashes.

One in five Americans still fail to buckle up regularly.

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Drunk DrivingOver the Limit, Under Arrest►National Law Enforcement Campaign ►Designed to crack down on alcohol impaired

drivers August 21 through Labor Day, 2009.

►Main Points: Impaired Driving Is a Crime and Will Not Be

Tolerated. Impaired driving is one of America’s most-often-

committed and deadliest crimes. Overall in 2007, nearly 13,000 people were killed in

highway crashes involving a driver or motorcycle operator with an illegal blood alcohol concentration (BAC) of 0.08 (80) or higher. 16

Alcohol Impaired Motorcycle Riders

Alcohol Impaired Motorcycle Riders are a focus of the

“DUI. Over the Limit. Under Arrest”Crackdown

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Federal Federal Trauma and EMS FundingTrauma and EMS Funding

►CDC Federal Block Grant fully funds CDC Federal Block Grant fully funds the CA EMS Authority System Division the CA EMS Authority System Division

► In 2009, NHTSA provided grant funds In 2009, NHTSA provided grant funds for E-911 program under the Ensuring for E-911 program under the Ensuring Needed Help Arrives Near Callers Needed Help Arrives Near Callers Employing 911 (Enhance 911) ActEmploying 911 (Enhance 911) Act $43.5 Million to states$43.5 Million to states

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CA Office of Traffic Safety (OTS) CA Office of Traffic Safety (OTS) Grants Grants

- from NHTSA federal funding -- from NHTSA federal funding - ► Imperial County Public Health Department’s Imperial County Public Health Department’s

Local Emergency Medical Services Local Emergency Medical Services Communications System PlanCommunications System Plan Grant Period 2003 – 2012Grant Period 2003 – 2012

► Emergency Medical Services Authority’s Emergency Medical Services Authority’s Traffic Records improvement, the California Traffic Records improvement, the California EMS Information System (CEMSIS) EMS Information System (CEMSIS) Update Grant - Period 2007 – 2011Update Grant - Period 2007 – 2011

► Fresno County Fire Protection District Fresno County Fire Protection District Regional Vehicle Extrication Equipment Regional Vehicle Extrication Equipment Request Request Grant Period 2008 -2009Grant Period 2008 -2009

WWW.OTS.CA.GOVWWW.OTS.CA.GOV19

Motor Vehicle TraumaThe Prevention Challenge

“A historic commitment to wellness initiatives will keep millions of Americans from setting foot in the doctor's office in the first place -- because these are preventable diseases and we're going to invest in prevention.” President Obama (February 2009)

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The FutureThe Future

“One of my goals as Chairman of the Committee on Transportation and Infrastructure is to create a new model for surface transportation, one that invests in alternative modes and promotes active, healthy lifestyles.”

James Oberstar, Chairman, Transportation and Infrastructure Committee,United States House of Representatives

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Transportation Transportation PrescriptionPrescriptionBold new ideas for healthy, equitable Bold new ideas for healthy, equitable

transportation reform in America ……..transportation reform in America ……..►A report commissioned and funded by the A report commissioned and funded by the Convergence Convergence PartnershipPartnership including: including:

The California EndowmentThe California Endowment Kaiser Permanente Health SystemKaiser Permanente Health System The Kresge FoundationThe Kresge Foundation The Nemours Health SystemThe Nemours Health System The Robert Wood Johnson Foundation The Robert Wood Johnson Foundation W. K. Kellogg Foundation W. K. Kellogg Foundation - Technical advisor: The Centers for Disease - Technical advisor: The Centers for Disease

Control and PreventionControl and Prevention22

Transportation PrescriptionDeveloped By

►The Prevention Institute Putting prevention and equitable

health outcomes at the center of community well- being.

►The Policy Link A national research and action

institute advancing social and economic equity.

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The ChallengeThe ChallengeImplementing a comprehensive Implementing a comprehensive trauma care system in California – trauma care system in California – the focus:the focus:

►Trauma RegistryTrauma Registry►Interoperability of the systemInteroperability of the system►Federal, state, public, and private Federal, state, public, and private partnershippartnership- Regionalized approach to care- Regionalized approach to care►Thinking and acting towards Thinking and acting towards preventionprevention

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