State Trauma Advisory Council Meeting

Transcription

1 State Trauma Advisory Council Meeting Members Present Aaron Burnett, M.D. Ron Furnival, M.D. Craig Henson, M.D. John Hick, M.D. Members Absent Peter Cole, M.D. Dan DeSmet MDH Staff Chris Ballard Cirrie Byrnes December 5, :30-3:30 p.m. Minnesota Department of Health Shoreview Community Center, Shoreview Minutes Carol Immermann, R.N. Alan Johnson, PA-C Col. Matt Langer Steven Lockman, M.D. John Fossum Robert Roach, M.D. Marty Forseth Tim Held Call to Order, Welcome and Introductions Sharon Moran, M.D. Mark Paulson, M.D. Gayle Williams, R.N. Tammy Peterson Mark Schoenbaum Dr. Furnival called the meeting to order at 12:35 p.m. Both State Trauma Advisory Council (STAC) and audience members introduced themselves. Dr. Furnival then called on STAC members to provide an update on anything within their respective discipline that may impact the trauma system today or in the near future. Dr. Furnival: University of Minnesota Masonic Children s Hospital and Children s Minnesota continue to entertain the prospect of shared services or even a merger in the future. Ms. Immermann advocated for the importance of bystanders role in saving lives before first responders arrive, particularly noting the importance of the Stop the Bleed campaign. Dr. Paulson: A shortage of family medicine physicians is resulting in a shortage of emergency department physicians and EMS medical directors in rural areas. Dr. Burnett: In addition to an EMS medical director shortage, fewer young people are choosing a career in EMS, which is resulting in a shortfall of paramedics and EMTs. Ms. Williams noted that many hospitals continue to prepare for mass casualty events resulting in gunshot wounds, which can occur in rural areas just as easily as urban areas. Dr. Henson underscored the importance of the Stop the Bleed campaign, especially in rural areas where response times can be long and resources spaced further apart. Dr. Lockman explained the role of rehabilitation as an important part of trauma care since many trauma patients require treatment for many years, and sometimes indefinitely, after experiencing a major injury. Dr. Moran noted that Essentia Health St. Mary s Medical Center in Duluth is now a rural general surgery residency training site. This is the second year of the program. 1

2 Mr. Johnson underscored his concerns about the continuing and worsening shortage of EMS providers, especially in the rural areas. Dr. Hick characterized the plans being developed in preparation for a mass casualty incident during Super Bowl events, noting the significant cost associated with preparing for such an event. Approve Agenda and September 12, 2017 Minutes Ms. Immermann moved acceptance of both the agenda and the minutes as written. Ms. Williams seconded; the motion passed unanimously. Staff Reports Mr. Held reported that the trauma system has been given additional funds to hire a full time administrative assistant. He shared his gratitude for the dedicated, reliable and competent support provided by Ms. Byrnes, who has been with the trauma system since it began. However, Ms. Byrnes also supports several other programs within the MDH Office of Rural Health and Primary Care, and the trauma system requires a full time dedicated administrative assistant to help manage the demands of a large trauma system. Mr. Schoenbaum announced his retirement effective January 2. He remarked on the successes of the trauma system, noting that the system partners are a great example of how diverse stakeholders can successfully collaborate to improve the lives of the citizens of Minnesota. Mr. Ballard reported: MDH is now receiving EMS data continuously, which will be used to drive performance initiatives in the coming months. Trauma Program 101 was held on September 28 in Bemidji. There were 30 attendees from 24 different hospitals including a few physicians. Another class is being planned for this spring, likely in Mankato. The Level 4 Subcommittee has met twice since September and has arrived at consensus around some of the criteria. They hope to present their recommendations at the March STAC meeting. John Fossum will be retiring from the STAC after today s meeting. Mr. Ballard reviewed some of the important contributions Mr. Fossum made in his vital role as the rural hospital administrator. The commissioner is seeking applications for his successor. EMSRB Update Dr. Burnett reported: The EMSRB is now using the new e-licensing system The Board set a goal (not a mandate) to have all ambulance services report data using a NEMSIS version 3 data set by the end of

3 The Department of Human Services has approved a measure to make supplemental Medicaid payments to public ambulance services. The board is undertaking a project to identify and categorize all ambulance services, as either public or private. Congress recently passed the Protecting Patient Access to Emergency Medications Act of It enables EMS personnel to administer controlled substances on standing order and the ambulance service to hold one DEA license collectively rather than requiring each base to hold a separate license. The board is pursuing a change in its rules that will allow EMTs to administer D10W to treat hypoglycemia. This has positive implications for rural EMS providers. Applicant Review Committee Report (ARC) Ms. Peterson reported on behalf of the Committee. There were no Level 3 applications this quarter. The Committee recommended the following hospitals for designation as Level 4 trauma hospitals: CentraCare Health System-Paynesville; CentraCare Health System-Sauk Centre; Fairview Lakes Medical Center, Wyoming; LifeCare Medical Center, Roseau; Mayo Clinic Health System-Springfield; Mille Lacs Health System, Onamia; Sanford Jackson Medical Center; Sleepy Eye Medical Center. Dr. Paulson recused himself from voting on Sanford Jackson Medical Center, and Ms. Immermann from Mayo Clinic Health System-Springfield. Dr. Hick moved acceptance. Dr. Paulson seconded; the motion carried. Ms. Peterson then reviewed the hospitals recommended for extension of their current designation due to deficiencies: Essentia Health Ada; Olmsted Medical Center, Rochester; Pipestone Medical Center; Sanford Bagley Medical Center; Sanford Westbrook Medical Center. An administrative extension is recommended for Ridgeview Emergency Department at Two Twelve Medical Center, Chaska. Ms. Williams recused herself from voting on Ridgeview Emergency Department at Two Twelve Medical Center and Dr. Paulson recused himself from Sanford Bagley Medical Center and Sanford Westbrook Medical Center. Dr. Paulson moved extensions for all of the above. Dr. Henson seconded; the motion carried. Ms. Peterson reviewed a letter received from Avera Tyler Medical Center reporting that one of their providers had previously been out of compliance with the education requirements of the trauma system. The issues has since been remedied. Ms. Peterson reported that Appleton Area Health Services withdrew its application following their site visit. They have indicated their intent to regroup and rejoin the system in the future. PI Work Group Report Mr. Ballard reported that the PI Work Group met on November 1 but was only able to address about half of their agenda items. The work group reviewed the methodology used to link trauma registry records together with other trauma and EMS registry records of the same incident. This makes it possible to count 3

4 incidents vs. records and to analyze and entire incident vs. an individual record. There were 27,000 records reported in 2014 and approximately 24,000 incidents. He noted that about 4,000 records appear to be missing, probably from out of state hospitals. The work group is asking all hospitals to complete a transport delay survey to measure the degree to which trauma patients transfer is delayed due to difficulty in obtaining acceptance from the receiving hospital. The next meeting of the work group is January 29 when the group will consider the regional EMS transport report, the annual legislative report and the creation of a system dashboard containing benchmark reports. --Break 10 minutes CALS Benchmark Lab Changes Mr. Ballard reviewed a request of the STAC from the Comprehensive Advanced Life Support (CALS) program to recognize the new CALS Benchmark Lab model as an acceptable pathway to satisfying the education requirements of the system. The Benchmark Lab model is changing from live tissue to a cadaver-mannequin model. After some discussion, Dr. Hick moved to continue to recognize the CALS Provider Course plus Benchmark Lap as an acceptable option to satisfy the educational requirements of the system. Dr. Burnett seconded; the motion carried. RTAC Leadership Report The RTAC Leadership Forum scheduled for this morning was cancelled. Ms. Bong reported that the Central Minnesota Regional Trauma Advisory Committee is scheduled to teach Bleeding Control to a community group. ACS COT Update No report from the American College of Surgeons (ACS) Committee on Trauma (COT) was available. Mr. Held mentioned the trauma system has requested updates from the ACS COT on the initiative to establish a National Trauma System, noting that, in its current form, it would fundamentally change the way state trauma systems function. Dr. Hick and Ms. Immermann offered their perspectives on the proposal. He also mentioned that the ACS is considering doing a rural needs assessment to gather information about trauma care in rural settings by surveying every rural hospital. He encouraged everyone to watch for and participate in the survey. Open Floor Dr. Hick recognized Brenda Anderson, RN, who has been the trauma program manager at Hennepin County Medical Center for 30 years. She is retiring at the end of this year. 4

5 Adjourn/Next Meeting The next STAC meeting is March 13, 2018, from 12:30-3:30 p.m., at the Shoreview Community Center, 4580 Victoria Street North, Shoreview. With no further business, Dr. Furnival adjourned the meeting at 2:35 p.m. 5