Kansas Advisory Committee on Trauma Meeting Minutes Wednesday, August 20, 2014 Kansas Medical Society, Topeka, KS

Transcription

1 Page 1 of 14 Kansas Advisory Committee on Trauma Meeting Minutes Wednesday, August 20, 2014 Kansas Medical Society, Topeka, KS Members Present: Dr. Paul Harrison, Dr. Dennis Allin, Dr. Craig Concannon, Nancy Zimmerman, Carol Perry, Darlene Whitlock, Cathy Heikes, Dennis Mauk, Kris Hill, Dr. James Longabaugh, Pat Lucke, Dr. Michael Machen, Dr. Jake Breeding, Senator Mary Pilcher-Cook, Senator Laura Kelly, Representative Dave Crum. Members Absent: Dr. Roy Danks, Dr. Bryon McNeil, Debra Pile, John Ralston, James Higgins, John Hultgren, Representative Jim Ward. Guests Present: Carman Allen, Jeanette Shipley, Nancy Akin, Dee Vernberg, Emily Farley, Sara Roberts, Danielle Marten, Joe Moreland, Paul Marx, Jason White, Diana Lippoldt, Lois Towster, Samantha Ramskill, Dan Hudson, Mollie Triplett, Megan Murphy, Kenna Young, Tracy McDonald, Richelle Rumford, Charles Hunt, Dr. William Sachs. Call to Order Dr. Paul Harrison, Chair Dr. Paul Harrison, Chair of the ACT, Called the meeting to order at 10:08 A.M. Approval of Minutes Dr. Paul Harrison, Chair Minutes from the May meeting were distributed and approved as printed. Election of Officers Dr. Harrison: It was time to elect Chair and Vice Chair of the ACT committee. Dr. Harrison excused himself during the nominations and election. Dr. Allin: nominated Dr. Harrison for the Chair position. There were no other nominations. Darlene Whitlock: seconded the chair nominations and all were in favor. Darlene Whitlock: nominated Dr. Allin for the Vice-Chair position. Dennis Mauk: seconded the Vice-Chair nominations and all were in favor. ACS Update Dr. Paul Harrison, Chair Discussion held regarding the convening of an Adhoc committee to address upcoming ACS changes. Dr. Harrison: The Optimal resource guideline book (orange book) itself, cannot be adopted. You have to adopt the words. Do we want to use the college guidelines as we do use the ACS guidelines for verification of Level I, II, and III trauma centers? Dr. Harrison indicated that he has reviewed the orange book multiple times, and does anticipate some modifications will be made over the next several years. An adhoc committee was convened to address the upcoming ACS changes. Those on the committee will be Dr. Harrison, Darlene Whitlock, Tracy Rogers, and Molly Triplett. Expectations of the committee are to adopt ACS changes as the college published. Although for Pediatric Centers and Pediatric Care boarded centers we may need to change requirements. The committee plans to meet in the next couple of weeks. Darlene will organize the first meeting. Joe Moreland: Are deviations from the standards published in the orange book allowed.

2 Page 2 of 14 Dr. Harrison: They are not flexible. The guidelines are on how to run a trauma center not how to take care of a patient. Trauma Program Update Carman Allen, Director Kansas Trauma Program Dr. Harrison introduced the new Kansas Trauma Program Director, Carman Allen. Carman introduced herself and provided a brief overview of her experience. Kansas certified as a Paramedic and EMS Instructor-Coordinator, and a Certified Public Manager Possess Master s degree in Instructional Design and Technology with emphasis in Online Education Hold current provider and/or instructor status as o Paramedic o Emergency Pediatric Care o Brain Trauma Injury o Prehospital Burn Life Support Work Experience o Coordinator, Emergency Medical Services for Children KDHE o Manager, Technician Services Kansas Board of EMS o Director Emergency Medical Services Education & Paramedic Instructor, Flint Hills Technical College o EMS Service Director, Morris County EMS o Paramedic ACT committee members then each introduced themselves. Level IV application Discussion Jeanette indicated a need for discussing Level IV application requirements. There is a need for clarification of the length of time a hospital should be operating as Level IV trauma center and trauma registry compliance requirements. As an example a hospital recently submitting a Level IV application was behind reporting their trauma cases for two quarters. What should be the minimum amount of current reporting time required and should the hospitals be operating as a Level IV center for a minimum amount of time? Darlene and Dr. Longabaugh: Must have 6 months of continuous on time trauma registry data reported. Jeanette: So I want to confirm that submitting hospitals must have 6 months continuous trauma registry data and 6 months of operating as a Level IV trauma center? Darlene and Dr. Harrison: Indicated the urgency of starting site visits soon. Representative Kelly: What does it mean to become a Level IV trauma center? Dr. Harrison: It means they have made a commitment to provide specific treatment to the patent. Level IV does not require a general or trauma surgeon but must be able to stabilize and transport the patient to higher level of care. Representative Kelly: What is in it for the hospital? Dr. Harrison: Better care for the patients and reimbursements for trauma activation. Dr. Machen: Good PR for the hospital. Cathy: Better care for the whole hospital. Dr. Harrison: Initial mission is the right patient to the right place at the right time. Payback to hospital is over time.

3 Page 3 of 14 BIS Assessment Jeanette: The BIS (Benchmark Indicators and Scoring) assessment will take place October 22 nd at the Statewide Executive Committee Meeting. The assessment will be 1 full day, not the typical 1 ½ days as done previously. Due to this change the mediators will be sending out an online survey to all ACT and Regional Trauma Council Executive Committee members to be completed in advance of the October 22 nd meeting. Please complete the online survey in its entirety when you receive it. The last BIS assessment was conducted in The decision to repeat the BIS assessment was due to cost as an ACS State consultation is $65,000. It was determined that since everyone would be together for the statewide meeting it would serve as the best venue. Nels Sandal and Jane Bell will be the mediators for the assessment. Dr. Harrison: The BIS assessment works for Kansas current needs. If we were just starting a consultation may be best. Carman: Update of new Level IV trauma centers attaining designation since March Clara Barton Hospital March 1 Anderson County Hospital April 16 Holton Community Hospital May 13 Pawnee Valley Community Hospital June 11 Community HealthCare System, Onaga July 28 St. Luke Hospital & Living Center, Marion August 11 Susan B Allen Memorial Hospital, El Dorado just received notification they will be designated next week. Carman: Received word that Dr. Roy Danks wishes to resign as KAOM representative to the ACT. He will send notification to KAOM regarding nomination of a new representative. There are several committee members who also have terms expiring in 2015: Dr. Paul Harrison KMS Carol Perry KHA Debra Pile KSNA John Ralston KEMTA Dr. Longabaugh NERTC Dr. Breeding NCRTC Pat Lucke SERTC There have been 22 Level IV onsite reviewer applications received: 6 level I 1 retired Level I 3 Level II 1 retired Level II 4 Level III 4 Level IV 2 with no Trauma Center experience Three webinars have been completed with good feedback. Further information will be provided in the regional trauma council reports.

4 Page 4 of 14 Kansas Trauma Annual Report has been updated. Minor changes were made that include updating the cover date due to the need for updates more frequently than once a year; on page four, the current Kansas map indicating location of trauma centers; and the back page updating Regional Trauma Council members. Level IV online resources. Trauma Program staff will be working through 2015 to develop online resources to assist Level IVs with FAQs. EMS for children program. Working to develop a Pediatric Trauma Recognition Program for hospitals that do not have the resources to attain ACS verification. The goal of this program is to recognize continuous improvement in pediatric trauma capabilities. Dr. Dimitrios Stephanopoulos will be invited to present at the November ACT meeting. Board of EMS. Working with the Board of EMS to develop a Trauma Recognition Program for EMS services. This program will recognize ambulance services for continuous improvement in trauma capabilities. Areas of review may include trauma protocols, field triage guidelines, appropriate equipment, etc. KBEMS and EMSC. Working to develop a pediatric Trauma recognition program for EMS services. EMResources it to go live September 2, 2014 at 0700hrs. Refer to picture of SE site in packet. Click here for copy of SE Site. Education Offerings. Dr. David D. Miller, M.D. Memorial Trauma Symposium, September 25&26, Springfield MO 7 hours of credit each day, 2 of which is pediatrics each day for more information Upcoming meetings and events. Level IV Training Workshop, August 29, Rolling Hills Zoo, Salina. Currently 50 registered. BIS assessment, October 22, Wesley Medical Center, Wichita. Trauma Managers Meeting, October 30, Rolling Hills Zoo, Salina. Trauma Manager-Coordinator Workshop. Trauma Managers Workshop will be held October 30, Rolling Hills Zoo, Saline. Tracy and Kris have modeled the meeting. Data Submission Regional Reports Results are in your packet. Click here for copy. At this point discussion regarding Level IV application submissions was readdressed. Darlene: Back to approval of Level IV applications, should the trauma registry be current for 6 months or should it be longer? Dr. Harrison: ACS requires one and half years of data and operating as a trauma center. Dr. Harrison and Darlene: Both are concerned that there are no activations being reported on Level IV submissions. If there are no activations they are not a trauma center. Darlene: Hospitals that have been designated without reported trauma activations should receive a site visit first. Dr. Harrison: We have some hospitals close to 3 years now and have to do them first.

5 Page 5 of 14 Molly Triplett: What is meant by current, 80% of cases are submitted or 100% are submitted? Dee: Should have closer to 100% of cases reported. We do review for cases that have been transferred but not captured by the hospital. Smaller number is reported by Level IV hospitals. Dennis: Do you have a probationary review? Dr. Harrison: Hospital Designation is based on Level IV submission. Hospitals are notified a site survey will be done within their 3 year designation. We have not spelled out what happens if they fail the site review and not re-verified. Secretary Moser actually designates the hospital as a Level IV trauma center. The college (ACS) process is after site review 6 weeks later they will receive their verification and then reviewed at the end of the verification which is 3 years. Upcoming meetings and events. Level IV Training Workshop, August 29, Rolling Hills Zoo, Salina. Currently 50 registered. BIS assessment, October 22, Wesley Medical Center, Wichita. Trauma Manager-Coordinator Workshop, October 30, Rolling Hills Zoo, Salina. BCBS Level IV Reimbursement Carman Allen, Director Some hospitals have received level IV activation reimbursements from Blue Cross Blue Shield. Recently providers have received notification from BCBS indicating they are implementing new policies. With these changes BCBS will request Level IV hospitals repay any monies paid for trauma team activations for 2014 and will pay $1.00 for level IV activations in Click here for copy of BCBS letter. Blue Cross Blue Shield was invited to the ACT meeting to discuss Level IV activation reimbursements but did not feel they needed to attend the ACT meeting. Blue Cross s policy is to discuss issues with their providers only. During the SE RTC meeting last week, this was a big concern. There is a need for discussion on how to proceed and inform BCBS of our concerns. Pat: At the SE RTC meeting it was discussed that ACT and RTC councils should send letter. We were informed that letters from the ACT and RTC were not possible. Can send letter as an individual but cannot reference as an ACT or RTC member, due to the purpose of these entities is to advise the Secretary. Dr. Harrison: This is possibly discriminatory and possibly not legal. Jeanette: For background information: Was discussing with Mitchell County and Seneca their experiences in collecting level IV activation reimbursements from BCBS. Since Seneca was not having as much luck as Mitchell County they contacted BCBS. BCBS then determined they should not be reimbursing for level IV activations. Follow up with hospitals indicates there were no problems with other carriers. Kris: There are issues with American Family for reimbursement to level IV s. Carman: We have checked with other states trauma programs and they have not experienced any problems. Darlene: In Michigan BCBS is a leader in trauma. They have determined the trauma system saves them money in the long run. BCBSKS needs education. Carman: BCBS will only have contact with their providers. Dr. Harrison: BCBS needs to hear from KHA etc. Nancy Zimmerman: I am the KHA representative. I can take information back to KHA. May need education BCBS, can work with KHA. Darlene: ACT would like to contact BCBS. Paul: ACT cannot communicate directly with BCBS. Will need to bring to Dr. Moser s attention and let him know so appropriate action can be taken. Dennis: We need to provide information.

6 Page 6 of 14 Darlene: Level IV hospitals help decrease mortality etc. Dr. Machen: We found if testing is done by an out of state company, BCBS will not reimburse the due to not being located in Kansas. BCBS will get out of anything they can. It is a slap in the face if only going to pay $1.00. Senator Pilcher-Cook: Show that level IV centers are not on probation and in good standing. Dr. Harrison: More important we can say they are operating as a level IV. Darlene: Level IV can stabilize a severely injured patient for immediate transfer. Dr. Harrison: We will be sure Dr. Moser is aware of the issue. Peer Review Paul Marx, Associate Chief Counsel, KDHE Paul Marx: There are 2 statutes that pertain to peer review activities. General peer review statute which provides broad peer review of healthcare providers, what circumstances peer review takes place and what are the results of peer review discussions. Trauma Program peer review statute dealing with ACT and RTC when either group meets it can act as a peer review body and be protected under peer review statutes. To protect themselves, RTCs must: conduct PI in closed session and ensure the process results in education, not punitive action. Issue then becomes who could be invited to closed session. Discussion handled no differently; meet with agency/facility representatives and medical providers in closed session. Dr. Allin: This has been dealt with at Johnson County EMS because of the number of hospitals and agencies. An opinion came out that you should have an official designated coalition. Do our regions constitute coalitions or does there have to be another layer of protection? Paul Marx: No other layer required for RTC. Statute says any meeting of RTC or part of meeting can be a peer review meeting and is provided protection. Dr. Harrison: RTC announces going into peer review session and some attendees may be asked to leave or some may be called in if needed for discussion. Paul: Yes, this would happen in hospital setting. Dr. Allin: Committee is not an adhoc. Does committee in region have to be named with the RTC. Paul: Statute does not discuss sub-committee, may not preclude. The concept was that RTC would be doing this type of work, not a separate body or committee. Peer review statues are very broad on who constitutes a committee. Don t see anything that would preclude whom, who, or what constitutes health care providers and what they can do. Dr. Harrison: Do we need to change statutes to include EMS as health care providers? Paul: They are, EMS are health care providers. Darlene: What about Sunset? Paul: Trauma sunsets We have this session and next session to address. There is no indication any animosity will come from the agency. Dr. Harrison: Will have to be extended. Paul: Will need to remove or extend Sunset clause. Carman: Asked Paul, Should this be done this year? Paul: Does not need to be done this year. Does not believe it will be part of legislative agenda for the upcoming session. Representative Crum: Legislation should be prepared and filed fall Paul: Preparing already for upcoming legislative session in January. Carol: What is sunset? Paul: Sunset expires 7/1/2015. Provisions give peer review protection to ACT, RTC. If it expires peer review would no longer exist. Carol: Do we need to have a committee: Dr. Harrison: Language in statute assures ACT, RTC covered.

7 Page 7 of 14 Darlene: Can we combine both? Dr. Harrison: Suggest not to. Dennis Mauk: Would statute protect Johnson Co? Dr. Allin: Not constituted as a single coalition, i.e.: hospital, EMS, firefighters. Are unofficial coalitions. Paul: Should discuss with Johnson County council. Mechanism through RTC or providers in area. Jeanette: Should we clarify PI approved by groups to align with orange book language. Then proceed with PI? Dr. Harrison: Regulations to perform PI do not have to have anything to do with orange book. Orange book directs how to proceed with PI. Orange book items are how to conduct PI review. Jeanette: PI is ready to do in three regions. Dr. Allin: Is there anything now in case law that informs regions how to document, store, and disseminate information in hospitals? How to best carry on Peer Review? Paul: Could be a problem if additional documents are other than those presented to peer review committee. Original records are not protected and findings would be discoverable. What is protected is opinion from professional body on delivery of care. Dr. Allin: So keep separate. Dr. Harrison: Hospitals may want to keep in trauma registry. Paul: During record review for drug copies. Prelitigation review for drug companies is attorney/client privilege and is not protected. Darlene: So need to be particularly careful about what is documented. Dr. Harrison: You don t want to come out of meeting and place blame on a specific person. Representative Crum. It is important this is agenda item when legislation is prepared. Dr. Harrison: Everything needs to be done by fall. Paul: Spring meetings are used to prepare legislation for upcoming legislative year. Senator Pilcher-Cook: Strategy to legislature should include what progress we have made. Dr. Allin: Need to develop track record starting spring. Level IV Review Tool Update Carman Allen, Director Survey Worksheets were sent with request for response. No comments were received. Carman did identify minor issues and made changes to formatting to ensure consistency throughout document; added mid-level providers under Education, as document did not included mid-level providers; changed terminology as necessary to ensure consistency throughout the document. Jeanette: Recommendation from last level IV committee meeting was to put together review tool and provide webinar, so everyone is completing site reviews the same. Will start with reviewer teams from level I and II and will then invite others as needed. Dr. Harrison: The reasons to start with level I and II reviewers are that they have been through reviews before. Other levels have not. Darlene: Will offer a trial run for reviews later. Dr. Harrison: What is next step with webinar? Jeanette: Set up an education webinar. Dr. Harrison: Is there a motion to adopt Level IV review tool. Dr. Machen: Moved, and seconded by someone, None opposed. Level IV review tool approved. Dr. Harrison: Need to start on webinar next. Darlene: Is there an appeal process? Carman: Have not started webinar. Needed a place to start development. Dr. Harrison: Now have worksheet so need to provide training and start surveys. We have discussed parts of onsite survey agenda today. Need to look at this to develop thoughts and processes. Currently

8 Page 8 of 14 do not have a process for revocation of level IV. Do have an idea what to do regarding deficiencies. We need to think about this and will discuss when we come back to it. Carol: Why do you need to revoke if you have a re-designation? Dr. Harrison: What is criteria to revocation? Do not want it to be arbitrary. Are hospitals doing what they say they are doing? Review teams will review and verify. Committee will make decision after site review. Secretary will designate based on review teams report. Jeanette: Do we want to give opportunity to correct if there are problems? Dr. Harrison: Need to determine what does meet a problem. Site reviews are peer reviews and are not intended to be punitive. Jeanette: Regarding onsite survey agenda, should we put team together to work out issues first? Dr. Harrison: Need small committee for small issues but come back to ACT with recommendations. Jeanette: Dr. Fishman and Darlene are on committee now we need two additional members? Dr. Harrison: Need to add a couple more on committee. Adding Lois Towster and Tracy Rogers. Certificate of Appreciation Presentation Dr. Paul Harrison, Chair Rosanne Rutkowski was honored with a certificate of appreciation from the state of Kansas. Dr. Harrison: Kansas has a trauma program due in large part to Rosanne and she will be missed. Trauma Registry Update Dee Vernberg, Epidemiologist, Kansas Trauma Program Dee presented findings from the trauma registry, hospital discharge data, ED discharge data and death certificates. In all of the data sources, falls and motor vehicle crashes were predominant external causes of unintentional injuries. Falls affect all ages but the highest risk groups are in pediatrics and the elderly. The highest risk group for falls is the over 75 years of age group. Motor vehicle trauma and deaths increases dramatically in the year old group. The risk for MVC mortality also increases in the older age groups. These data support the focus that the trauma program has on fall and motor vehicle crash prevention. With regard to the Kansas Trauma System, data from 2013 show that about half of trauma patients arriving from the scene of injury are treated in Level I, II and III trauma centers and about half are first treated in Level IV trauma centers or non-trauma centers. About 45% of patients seen at Level IV trauma centers and non-trauma centers are transported by private vehicles from the scene, compared to 26% of patients arriving by private vehicles at Level I, II, and III trauma centers. About 58% of trauma patients are transferred to Level I, II, and III trauma centers from Level IV and non-trauma centers. When Level IV trauma centers are examined separately, 83% of patients are transferred to higher level of care with approximately 63% being transferred to KS Level I, II, and III trauma centers. Approximately 21% of trauma patients from Level IV trauma centers are transferred to non-trauma centers or to other Level IV trauma centers. These patients tend to have injuries such as non-complicated fractures. Most Level IV centers are located in frontier, rural or densely settled rural areas of the state with the number of trauma patients treated each year being in a range from 3 to 73. The external cause of injury for patients treated in Level IV trauma centers is very similar to other hospitals treating trauma in the state.

9 Page 9 of 14 With regard to outliers found on the data report, most Level IV trauma centers are transferring their patients quickly. Temperature is the most frequently missing vital sign that is missing in the registry. The Policy Group has recommended that two comprehensive variables be retired: Policy Report Number and On Lap. The Policy Group also recommended to edit Unassisted Respiratory Rate to read Respiratory Rate and to add a new field Respiratory Assistance with options: yes, no. In an effort to align the Kansas dataset with the National Trauma Data Standard, The Policy Group has recommended to rename the Comorbidity Page to read Non-trauma diagnoses and to add an optional Comorbidity Page that Level I, II, and III trauma centers can use to record their NTDB comorbidities. This would allow these trauma centers to run reports on these comorbidities and will help the data entry to be more visible for this important covariate for risk adjusted analyses. The ACT agreed with all of these recommendations. Dee presented a report with mock data that she has been developing for Level III centers that allows them to compare themselves with other like trauma centers on variables such as type of injury, age, transfers, comorbidities, injury severity, injury mechanism, length of stay, death rates, and complications. She also mentioned that she is working on linking the trauma registry with itself and with crash data. Discussion: Darlene: This information would be good for Level IV workshops. Dee: Thought so also and will work on it. Darlene: Would any of this be good for meeting with BCBS. Dee: Continuity of care and will take a look but cannot look at now. Darlene: Is there anything helpful? Dee: Length of time to transfer, triple jumps but may not have enough data. Activation was only added last year. Lois: You can compare before Level IV and after Level IV. Have LOS decreased or is care provided quicker. Dee: We could do that. Darlene: Definitive care does decrease complications. Kris: Do we have a handle on whether level IV s transfers to outside the state? Do we have any info from those hospitals? Dee: No only inside state transfers. Preparedness Regional Health Care Coalitions Presentation Emily Farley, Communication & Collaboration Mgr, KDHE Emily provided an overview of what is a Health Care Coalition (HCC), what a HCC does and who are members of the HCC. Click here for copy of presentation. Board of EMS Report Joe Moreland KBEMS has a new executive director: Joe House

10 Page 10 of 14 Joe has been the deputy director for the past three years. He has 15 years of EMS experience with both McPherson and Pottawatomie County. If you have any EMS questions please contact Joe at or through the website. Currently regulations are in the public comment stage for ambulance equipment. Process just started last week and runs for 609 days. Refer to: KAR : Standards for type I, type II, type IIA, and type V ground ambulances and equipment KBEMS is moving to NEMSIS V3 on April 1, This NEMSIS V3 move has been delayed from this Discussion: Dr. Allin asked how many agents were using KEMSIS. Joe indicated 72 out of 170 which covers 65% of the population. Dr. Allin indicated he had played with ImageTrend and was concerned it was easy to use but hard to obtain information. Joe indicated neither he nor Joe House have found that to be a problem. Dr. Allin also was concerned on whether the Trauma Registry would be able to access by linking information they currently receive now. Joe indicated trauma vendor Digital Innovations and ImageTrend will be working together. Dee indicated we will need to start planning now. Joe also indicated that training has been provided to over ½ of hospitals staff to access KEMSIS. Trauma Education and EMS Service Directors Survey Sara Roberts, Director, Primary Care & Rural Health, KDHE Sara Roberts wanted to request feedback for the draft of the Emergency Medical Service Director Survey, Findings Brief, July Click here for draft copy of brief. Looking for information on how you would like it in final form. Wants to build a sustainable healthcare delivery system by collecting health related information and linking providers and communities to programs. The survey was funded by grant from Medicare Rural Hospital Flexibility (FLEX) Grant Program. FLEX program is a federal initiative created by the balanced budget act of Flex funds uses for are for performance improvement activities, training programs, needs assessments and network building. Partners are encouraged to grow collaborative local and or regional rural delivery systems across the continuum of care of EMS and Trauma. OLRH partners with EMS and Trauma through: Level IV trauma designation educations for rural hospitals, trauma outcome performance improvement workshops, promotes for the development of EMS model protocols for time critical diagnosis, trauma training funding to regional trauma councils, ATLS training stipends, trauma education. Key findings from survey are included in the draft brief. Sara indicated a 50% response rate was obtained from the survey but response for the 2009 report was higher. Discussion: Jeanette: The brief looks good and has initiated conversations between Carman and me for training. Currently in the NW region physicians have to go outside the state for ATLS training, as they are unable to find classes in Kansas. Out west they have problems getting classes set up for training for RTDD. Hoping in the future Salina will be able to help. For TNCC west of Salina there are no instructors or very limited. I want to thank all for help trying to figure out how to build resources. Sarah: Need to look at it by region for lack of teachers.

11 Page 11 of 14 Richelle Rumford: It is the cost of the courses incurred, to follow the standard of ACS. Molly Triplett: We have attendees wait until a month out then the classes are full. Richelle Rumford: Midlevel s must be trained now so classes can fill up with the hospitals own staff. It is going to be difficult going forward to add additional classes. Darlene: RTC does help with costs. Sarah: We will continue what we are doing, but what can they do to help increase availability of classes. Dr. Breeding: ATLS cost is prohibitive so a subsidy to hospital would help. Kris: Appreciate any help as resources are limited. Sarah: There are 44 other FLEX states. Will bring up to regions how we can help increase access to rural hospital communities by possibly adding additional stipend, continue to support or pay for the cost, how to have more training Wichita. Tracy: Is it possible ACS would allow ATLS on line. Dr. Harrison: Possibly down the line though. Tracy: Training center at KU now, hopefully that will help. Dr. Harrison: If an exception is needed for the course you need to ask when you apply to offer the case. You cannot easily change after the fact. Sarah: We provided $20,000 towards stipends, but requests received were double. Jeanette: Ended up with $40,000 for ATLS classes. Money was from trauma program, RTC and OLRH. Amounts reimbursed were dependent on class and size. Dr. Machen: Unused Money from RTC s could be used for classes. Sarah: What are needs in EMS? Dr. Allin: Would like to have QI tools to use Dennis: Used to be easy to measure response time. Sarah: Finalized brief will be placed on their website and will send copy to Carman to pass along. Regional Safety Coalitions Presentation Danielle Marten, Traffic Safety Consultant, KDOT Danielle reviewed traffic safety and how it relates to healthcare, state vs regional approach on safety efforts, and coalitions structure. Click here for copy of presentation Safety coalitions are organized to represent the state s regions. The regional coalitions will analyze data to identify regional goals and emphasis areas, facilitate communication between local law enforcement officials and public works personnel, recommend safety-related projects and programs to KDOT and others, administer a state-funded Traffic Safety Fund used to support the goals of local traffic safety plans, promote access by local decision makers to KDOT crash data to help in the identification of roads with high crash rates for possible safety improvements, recommend systemic safety improvements that are eligible for High Risk Rural Roads Program funding or moneys from other sources and promote timely and relevant safety training for personnel at the local level. Regional Trauma Council Reports NE RTC Dr. James Longabaugh The NERTC hosted: o Webinar: Trauma Centers: Differences Between Level I, II, III, and IV Centers o August 12, 12:00pm o Darlene Whitlock presented o 57 sites connected

12 Page 12 of 14 o Evaluations were good Last executive committee meeting o Extensive discussion regarding regional PI. The NERTC is ready to move forward with regional PI. Regional Trauma Plan o Will begin work on updating the regional trauma plan. Next executive committee meeting: o October 13 at 1:00pm by conference call NC RTC Dr. Jake Breeding General Membership meeting held on May 21 st at Salina Regional 35 members in attendance Great evaluations All presenters did a fantastic job including guest speakers Dr. Ryan Jacobsen & Representative Susan Concannon New members: o Don Bates, CEO, Cloud County Health Center o Wendy Gronau, EMS Director, Lincoln County EMS o Rachelle Giroux, Trauma Program Manager, Salina Regional Health Center o Dr. Jake Breeding, Salina Regional Health Center o Dana Rickley, Administrator, Clay County Health Department Regional Trauma Plan: Will begin work on regional trauma plan soon Next executive committee meeting: August 27 th at Mitchell County Hospital NW RTC Regional Trauma Plan: We will begin work on the regional trauma plan soon Next executive committee meeting: September 10 th by conference call Dr. Michael Machen SC RTC Kris Hill Education: The Executive Committee hosted a webinar on Current Strategies in Management of Traumatic Hemorrhage on July 15 th. Dr. Haan was the presenter. 36 sites connected Regional Trauma Plan: We will begin work on the regional trauma plans soon Next executive committee meeting:

13 Page 13 of 14 October 8 th at Wesley Medical Center SE RTC Pat Lucke Education: The SERTC in collaboration with Region VI EMS Council hosted a webinar on Mounting Evidence against the Long Spine Board in EMS. Dr. Ryan Jacobsen presented. o 86 sites connected General Membership Meeting: New member o Carolyn Muller, Montgomery County Health Department, Coffeyville o Tom Schorr, Labette Health Last executive committee meeting: Extensive conversation regarding the regional PI. The SERTC is ready to start regional PI. Regional Trauma Plan: Will begin work to update SERTC plan Injury Prevention: Justin Noel-Cherokee County Sheriff Office/USD 493 SRO Justin Noll presented on the Cherokee County Sheriff Office s Safer Education about Traveling (SEAT) program. The SEAT program was designed to educate students about seatbelts and was constructed to be moved easily throughout the schools and classrooms. The program has grown from the initial SEAT construction. SEAT is also providing child safety restraint education among other safe traveling education. The program has grown and the Sheriff s Office needed a way to transport and maintain all of the SEAT materials. The Sheriff s Office approached USD 493, Columbus about acquiring a mini bus and the Columbus school district donated a mini school bus to the SEAT program. The Sheriff s Office wants to construct a texting and driving simulator in the bus to educate teen drivers about distractive driving. Justin submitted a request to the SERTC to assist with the construction of the simulator in the amount of $ injury prevention calendar o Excellent comments about 2014 calendar o Collaborating with Region VI Ems o Will be distributing 6000 calendars Funded the SAFE program for the school year Notes: Mercy Joplin has submitted for state designated level II trauma center. Next executive committee meeting: October 16 th at Allen County Hospital (?) SW RTC Cathy Heikes General Members meeting scheduled for May 14 th was cancelled. Working on rescheduling business meeting to elect officers. Regional Trauma Plan: Will begin work on the regional trauma plan soon.

14 Page 14 of 14 Next executive committee meeting: October 15 th by conference call. Final Business Darlene Whitlock reported KNEA has subsidized $1000 to each region for ATLS education. Meeting Adjourned at 3:18 P.M.