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ADMINISTRATIVE REPORT
January 2014
Annual Strategic Planning Workshop
23 January 2014 Meeting Agenda Page: 2
December 2013 HB 160 Revenues Report Page: 4 Proposed CY 2014 Commission meeting schedule Page: 5 Commission Subcommittee list (Dr. Ashley appointed) Page: 6 FY 2014 Mid-year Expenditure Report Page: 7
FY 2015 Governor’s Budget Report (excerpts) Page: 9 Trauma Medical Director’s Subcommittee Transfer Poster recommendations Page: 10
Trauma System Evaluation Committee handouts Page: 11 eBroselow Quarterly Report on Artemis
(January 2014) Page: 15
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Thursday, 23 January 2014 Midtown Medical Center Conference Room
710 Center Street Columbus, Georgia 31902
CLOSED SESSION: 8:30 am to 9:30 am (60 minutes) Executive Director performance review Commission members and
Executive Director OPEN SESSION: 9:30 am to 9:35 am (5 minutes) Welcome! Ryan Chandler, CEO Midtown Medical Center Sam Cunningham EMS Region 7 Program Director Dr. Beverley Townsend District Health Director West Central Health District 7 9:35 am to 9:45 am (10 minutes) Chairman’s Report Dr. Dennis Ashley
9:45 am to 10:00 am (15 minutes) Admin Report and Agenda Review Commission Staff 21 November 2013 minutes approval* CY 2014 Meeting Schedule* FY 2014 Expenditure Review 10:00 am to 10:45 am (45 minutes) Reports: EMS Subcommittee Courtney Terwilliger GCTE Elaine Frantz
Trauma Medical Directors Dr. Dennis Ashley Resource Availability Display Elaine Frantz
System Development John Cannady Georgia Trauma Foundation Report Lori Mabry
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10:45 am to 12:00 noon (75 minutes) “Analysis of the Georgia Trauma System” Etienne E. Pracht, Ph.D. Associate Professor Department of Health Policy & Management University of South Florida 12:00 noon to 12:30 pm (30 minutes) Lunch Everyone invited 12:30 pm to 12:45 pm (15 minutes) Trauma System Evaluation Committee Alice Zimmerman Strategic Planning Coordinator Governor’s Office of Planning and Budget 12:45 pm to 2:45 pm (120 minutes)
DPH OEMST Report and Dr. Pat O’Neal State Trauma Plan Presentation and Discussion
2:45 pm to 3:15 pm (30 minutes) eBroselow Update Peter Lazar, CEO eBroselow, LLC 3:15 pm to 4:00 pm (45 minutes) Old Business/ New Business/ Adjourn Dr. Dennis Ashley
* Commission action anticipated
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Department of Driver Services
HB 160 Notice and Revenue Tracking
HB 160
Super Speeder Reinstatement
Total
Month and Year
($200 Fine) Fees
Collected
FY 2010 Total 705,070 1,331,835 2,036,905
FY 2011 Total 9,549,235 4,618,264 14,167,499
FY 2012 Total 11,927,783 6,462,610 18,390,393
FY 2013
July 2012
1,071,250 409,550
1,480,800
August 2012
1,010,430 518,870
1,529,300
September 2012
902,910 445,875
1,348,785
October 2012
989,260 442,885
1,432,145
November 2012
993,910 535,365
1,529,275
December 2012
1,008,000 423,870
1,431,870
January 2013
1,052,900 456,207
1,509,107
February 2013
1,059,920 716,320
1,776,240
March 2013
1,040,650 983,591
2,024,241
April 2013
982,300 631,650
1,613,950
May 2013
1,054,232 659,110
1,713,342
June 2013
741,950 462,035
1,203,985
FY 2013 Total 11,907,712 6,685,328 18,593,040
FY 2014
July 2013
1,090,950 462,710
1,553,660
August 2013
917,650 457,825
1,375,475
September 2013
1,017,360 445,610
1,462,970
October 2013
1,119,480 608,960
1,728,440
November 2013
479,135 435,805
914,940
December 2013
1,676,656 627,210 2,303,866
January 2014
0 0
0
February 2014
0 0
0
March 2014
0 0
0
April 2014
0 0
0
May 2014
0 0
0
June 2014
0 0
0
FY 2014 Total 6,301,231 3,038,120 9,339,351
OVERALL TOTALS 40,391,031 22,136,157 62,527,188
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Georgia Trauma Commission
2014/2015 Meeting Schedule
23 January 2014 Columbus, Georgia
Strategic Planning Workshop 20 March 2014 (Thursday) Macon, Georgia
Legislature in Session 15 May 2014 (Thursday) Atlanta, Georgia
Approve AFY 2014 and FY 2015 Budgets
21 August 2014 (Thursday) Macon, Georgia
Address FY 2014 Amended Budget 20 November 2014 (Thursday) Atlanta, Georgia
Annual Meeting 22 January 2015 (Thursday) Macon, Georgia
Strategic Planning Workshop
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Georgia Trauma Commission Active Subcommittees and Supported Committees and Foundation
December 2013
Trauma Commission Committee of Officers: Commission chair: Dr. Dennis Ashley Vice Chair: Linda Cole Secretary/Treasurer: Elaine Frantz Trauma Medical Directors Subcommittee: Dr. Dennis Ashley, chair Dr. Fred Mullins Dr. Jeffery Nicholas Trauma Centers and Physician Funding Subcommittee: Linda Cole, chair
Dr. Dennis Ashley Dr. Fred Mullins Mark Baker
Budget Subcommittee: Elaine Frantz, chair Dr. Dennis Ashley Linda Cole
Data Subcommittee: Dr. Dennis Ashley, chair Elaine Frantz Mark Baker Dr. Jeffrey Nicholas
EMS Subcommittee on Trauma:
Courtney Terwilliger, chair Dr. Jeffrey Nicholas (Governor’s EMS representative appointee)
Georgia Committee for Trauma Excellence (GCTE): Elaine Frantz, chair Trauma System Evaluation Committee (Commission supported): Dr. Dennis Ashley Courtney Terwilliger
Dr. Fred Mullins Georgia Trauma Foundation, Inc. Dr. Fred Mullins, president Dr. Bob Cowles, vice president Elaine Frantz, secretary/treasurer
6Appointed by Commission Chair on 05 December 2013
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The Governor’s Budget Report Fiscal Year 2015
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Indications for Trauma Patients Requiring Rapid Transfer to a Major Trauma Center
The objective is to identify and then transport Trauma System patients to an appropriate hospital for definitive care within an optimal time. These patients should
preferentially be transported to the appropriate level of trauma center within the trauma system.
“WHEN IN DOUBT...TRANSFER OUT!”
TRAUMA TRIAGE CRITERIA (ADULT AND PEDIATRICS)
Neurologic
● GCS < 14 or lateralizing neurological signs ● Penetrating injury to head/neck or open skull fracture ● Spinal fracture or spinal neurological deficit ● Paralysis
Hemodynamic
● Hemodynamic instability ● SBP <90mm/Hg or age appropriate hypotension ● RR <10 or >29 (Adults) ● RR <20 (Infants <1 y.o.)
Cardio-vascular/Thoracic
● Injury to carotid, vertebral artery, aorta or great vessels. ● Cardiac rupture ● Pulmonary contusion with P/F <200 ● Flail Chest ● Penetrating injuries to torso associated with energy transfer
Abdominal/Pelvic
● Penetrating injuries to abdomen or groin associated with an energy transfer ● Pelvic fractures, as evidenced by positive “pelvic movement” exam
Extremities
● Fracture or dislocation with loss of distal pulses ● Two or more obvious proximal long-bone fractures ● Crushed, de-gloved, or mangled extremity ● Amputation proximal to wrist and ankle
**Criteria above based on CDC Field Triage Criteria and ACS Resource for Optimal Care of the Injured Patient (2006)
If your trauma patient meets any of the above criteria OR care for that injury exceeds local capabilities, transfer to a trauma center utilizing existing
relationships or established transfer agreements or
For assistance with the transfer of trauma patients call the Georgia Trauma Communications Center (TCC) at:
Statewide Toll Free: 866-556-3314
The TCC has up-to-the-minute information on Trauma Center resource availability and will connect you to an accepting Trauma Center. 10
Handout: GTCNC Workshop January 23, 2014
Georgia Trauma System Evaluation Committee Members Dr. Dennis Ashley/Commission Chair, Committee Chair
Dr. Pat O'Neal/Committee Co-‐Chair, Director of Health Protection, Department of Public Health (DPH)
Ms. Elizabeth Atkins, Trauma Program Manager, Grady Hospital
Ms. Rana Bayakly, Chief Epidemiologist, DPH
Greg Bishop, Bishop & Associates Mr. John Cannady, Manager Trauma Communications Center, Georgia Trauma Commission (GTC)
Elaine Frantz, Director of Trauma, Memorial Hospital Mr. David Foster, EMS Region 1 coordinator
Ms. Debra Kitchens, Trauma Program Manager. MCCG
Dr. Danlin Luo, Epidemiologist, DPH
Ms. Michelle Martin, Operations Specialist, TCC
Mr. Russ McGee, EMS Region 5 coordinator
Dr. Regina Medeiros, Director of Trauma, Georgia Regents Hospital Ms. Renee Morgan, Trauma Systems Manager, DPH OEMST
Dr. Fred Mullins, Medical Director, JMS Burn Center, Commission member
Ms. Ashley Pandit, Special Projects Analyst, Governor’s Office of Planning and Budget (OPB)
Mr. Jim Pettyjohn, Executive Director GTC
Ms. Carol Pierce, Public Health Consultants
Ms Marie Probst, State Trauma Registrar DPH
Ms. Angie Rios. GEMSIS Coordinator, DPH OEMST
Ms. Erin Ruoff, Budget Analyst, OPB
Ms. Kristal Smith, RTAC 6 coordinator
Mr. Courtney Terwilliger, EMS Director, Emanuel County, GTC member
Mr. Keith Wages, EMS Director, State of Georgia
Ms. Alice Zimmerman, Strategic Planning and Performance Management Coordinator, OPB
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Inputs
Super speeder funds Other fund sources (future) GTC staff Commission member (unpaid) :me Communica-‐:on system Equipment
Outputs -‐ Ac,vi,es
Network Development, Marke:ng and Technical Assistance
Outputs – Customers
• Physicians, providers
• Trauma centers
• Teaching hospitals
• Hospitals seeking trauma designa:on
• EMS providers and regions
• Trauma pa:ents (indirect)
• Legislature (funding decisions and repor:ng)
Outcomes – Short Term
Outcomes -‐ Mid Term
Outcomes -‐ Long Term
Report to General Assembly
Iden:fy, collect and analyze data
Answer calls and staff communica:on system
Training trauma care stakeholders (providers, EMS, Hospitals)
Improved hospital staff readiness, par:cipa:on, knowledge/skills (ex. Rural ER physicians)
Increased awareness, public support, and quality rela:onships
Streamlined communica:on Manage trauma
system funds
Increased region/ EMS individual agency par:cipa:on
Regions with limited access iden:fied
Data driven / targeted injury preven:on programs
Increased trauma center availability – access, quan:ty
Improved quality of care delivery
Decreased :me to defini:ve care
Data driven policy changes recommended
Data analyzed to iden:fy high-‐risk groups & causes of injury
Changes in ac+on -‐ behavior, decision making, policies
Lives saved (reduced mortality/ morbidity rates)
Improved cost efficiency
Reduced trauma injuries
Influence policy changes
Changes in condi+on -‐ environmental, health, social, financial
Increased diagnos:c capabili:es & triage accuracy
Changes in learning – awareness, knowledge, skills
Georgia Trauma Care Network Commission Developed by the Georgia Trauma System Evalua:on CommiYee, June 2013
Handout: GTCNC Workshop, January 23, 2014 12
Logic Model Assump:ons • Network will result in net gain/efficiency • Everyone understands the meaning of the network • We have all the resources for success • Increasing access will increase u:liza:on • Metrics exist that demonstrate improvement (and can capture these metrics/data) • All stakeholders will par:cipate • Public is aware that Trauma System is needed • Specialized care results in beYer outcomes • Con:nua:on of funding (legislature) • Triage decisions impact outcomes (golden hour) • Trauma system pa:ent is a pa:ent as defined by CDC • Barriers to access to care • Data is accurate, available for care • Popula:on density, aging and other factors will impact long term outcomes
Handout: GTCNC Workshop, January 23, 2014 13
Handout: GTCNC Workshop, January 23, 2014
Georgia Trauma System Evaluation Committee: Metric Evaluation
Proposed Metrics FY 2013 Actuals
Number of individuals trained through commission funding 272
Percentage of approved readiness costs funded by the Commission
7.35%
Percentage of severely injured patients treated at designated trauma centers
84.3%1
Number of regions with Commission-approved regional plans2
4
Average response time from dispatch to destination for trauma patients3
43.1 minutes4
Average time from ER to arrival at trauma center5 N/A
Average time from dispatch to trauma center Sum of above two measures
1 As reported in Dr. Etienne Pracht’s January 2014 report “An Analysis of The Georgia Trauma System,” data represent severely injured patients treated at designated trauma centers in CY 2012.
2 OEMS/T is developing a state trauma plan to use as a template for the regions that have not already developed a Commission-approved Regional Trauma Advisory Council.
3 Trauma patients were determined using provider impression of traumatic injury and include 911 emergency treated and transported calls. Destination is defined as all hospitals including the designated trauma centers.
4 Data are preliminary CY 2013 and based on 42,710 incidents occurring through November 2013. Due to current data limitations, “trauma patients” here include more than just “severely injured” patients.
5 Emergency rooms (ERs) include community hospitals and the lower level designated trauma centers.
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eBroselow Report to Georgia Trauma Care Network Commission January 13, 2014 1
eBroselow’s Quarterly Report on Artemi s Geor gia Fiscal Y ear 2014 Contract # 41900-032-10100282
January 13, 2014 Report
TO: Jim Pettyjohn Executive Director Georgia Trauma Care Network Commission gtcbusiness [email protected]
Fro m: Bozorg Zonneveld MD Director of Strategic Development eBroselow, LLC [email protected]
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eBroselow Report to Georgia Trauma Care Network Commission January 13, 2014 2
Quarterly pr ogress report to the Georg ia Tr aum a Comm ission:
i. Summar y
Artemis is a drug dosing and tracking system for EMS and hospitals. Getting the correct dose in mL to a patient can be critically time sensitive. Recording and communicating what happened can be complex. Acute medication administration in hospitals, especially in the ER and ICU, is complex and error prone. Many of these errors are not at all obvious. Frequently they are not recorded. Artemis helps solve this problem. Originally based on the idea of the Broselow tape, Artemis now is a clinical support system for children and adults. More details can be seen on www.ebroselow.com, including introductory videos under the “News” category on the left. As we see in the details below, since the last report on November 11, 2013, we still have most hospitals actually using the system and we have a few not generating usage where we have to clarify if all are using the correct link or are accidently generating usage on a wrong link. It is interesting to note that the hospitals that generate the most usage are the regional hospitals that received a lot of training. A good example is Meadows Regional Medical Center that had requested us to train the whole ER nursing staff in several training sessions a whole afternoon and has the highest usage in Georgia, with an average of 226 usages per month, representing an average of 7.5 times a day. But also smaller community hospitals that received good training show high usages for a small hospital. Examples are Clinch Memorial, Burke Medical, Emanuel and Jefferson. Our goals for the next 3 months:
- Have all 49 hospitals using the system, working with webinars and phone calls to help the 8 hospitals that did not generate usage in the last 2 months.
- Help hospitals with low usage to recognize the real potential of Artemis, including some handy and easy to learn new features, putting special emphasis on the very basic drug dosing functions, the ability to create a report and our infusion preparing and administration tool. Learning from Hospitals like Meadows Regional, we are looking for efficient ways to train staff more broadly and continuously, including holding webinars and adding interactive online training on the different parts of the system.
- Discuss with the GTC if we can include another hospital to complete the 50 hospitals again, considering that Charlton Memorial Hospital closed its services. Also, in theory there were more than 50 hospitals in our list but we actually had some of them double and that explains our present 49 hospitals.
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eBroselow Report to Georgia Trauma Care Network Commission January 13, 2014 3
ii. Participation Report - Usage statistics for each h ospital.
49 hospi tals are pre sently in the list: 17 in region 9 7 in region 6 14 in region 5 11 other participating hospitals
From this total, since th e last re port: 41 generated u sage statistics, 8 did not generate usage statistics. Region 9: Since the last report, from a total of 17 hospitals: 12 generated usage statistics. 5 did not generate usage statistics (Effingham Hospital, Liberty Regional Medical Center, Optim Medical Center – Tattnall, Wayne Memorial Hospital, Winn Army Community Hospital). Effingham : did not receive a visit or webinar since July. Liberty : did not receive a visit or webinar since July. Optim medical center : they did receive a visit in July and had usage at first, presumably training-related, but then there wasn’t follow through and usage stopped. We already contacted them and are planning a follow – up webinar. Wayne Mem orial Hospital : we tried a personal visit and webinar but could not schedule them up to now. We will follow-up with this again. Winn Army C ommunit y Hospital : after a successful visit and generating usage after it, we were informed by Maj. Patricia Davis from the hospital that “ We were later informed that our hospit al was actually not in the list to receive this covered funded service. A couple of staff accessed from personal devices but usability was limited due to the limitations for access and decision to not pursue purchasing the software at this time” . As the hospital is included in the list we have with GTC, we still have to clarify where this confusion comes from.
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eBroselow Report to Georgia Trauma Care Network Commission January 13, 2014 4
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eBroselow Report to Georgia Trauma Care Network Commission January 13, 2014 5
Region 6 Since the last report, from a total of 7 hospitals: 6 generated usage statistics. 1 did not generate usage statistics (Georgia Health Sciences University) Regarding Georgia Health Sciences University we contacted them several times offering a personal visit in July and afterwards webinars but with no result up to now. We will insist again in this period.
Region 5 From a total of 14 hospitals: Since the last report, from a total of 14 hospitals: 12 generated usage statistics. 2 did not generate usage statistics (Peach Regional Medical Center, Putnam General) Peach Regional: did not receive a visit or webinar since July. Putnam General: did not receive a visit or webinar since July.
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eBroselow Report to Georgia Trauma Care Network Commission January 13, 2014 6
Other Hospitals Since the last report, from a total of 11 hospitals: 11 generated usage statistics. 0 did not generate usage statistics
iii. Survey results
See November 11 report.
Respectfully,
Bozorg Zonneveld MD Director of Strategic Development eBroselow, LLC
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