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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
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
Committee has defined objectives and tasks: 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
Regional Trauma Center Needs Assessment
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
Regional Trauma Center Needs Assessment
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 401-600 severely injured patients = 2 points
Discharges of 601-800 severely injured patients = 3 points
Discharges of greater than 800 severely injured patients = 4 points
TSA = ______ points
Regional Trauma Center Needs Assessment
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
Regional Trauma Center Needs Assessment
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 Trauma Center Needs Assessment
• 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 defined tasks and objectives: Yes No
• 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 defined tasks and objectives: Yes No
• 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 defined tasks and objectives: Yes No
• 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 defined tasks and objectives: Yes No
• 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 defined tasks and objectives: Yes No
• 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?
Committee has defined objectives and tasks: Yes No
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.
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