An inclusive trauma
system - designed to care for all injured patients, and
to provide a continuum of services including prevention,
prehospital care, definitive care and rehabilitation - is
essential.
"..trauma care systems" - the coordinated approach to swift identification of
injury victims and transport to optimal care - are known
to be spectacularly successful in reducing preventable
deaths and associated losses.
Many citizens assume that
if they are severely injured, an ambulance will promptly
arrive and take them to the nearest hospital, which will
be ready and waiting to provide optimal treatment for
their injuries.
However, large geographical
gaps in "systems" care create a situation in
which an injured person's likelihood of survival depends
on where and even what time of the day the person happens
to be injured." (Draft Position Paper, Panel on Trauma
Care Systems, February 14, 1992)
OVERALL TRAUMA SYSTEM OBJECTIVE
The primary objective of an inclusive
trauma care system is to assure rapid discovery of the injured
persons and initial contact with the emergency medical services
system. The injured patient must receive rapid and appropriate
care at the scene from law enforcement and emergency medical
services personnel and receive rapid, definitive, medical/surgical
treatment at an appropriate medical facility.
"All hospitals
involved in treating injured patients, particularly those
in the rural areas, should be in an "inclusive"
system of care facilities. Each facility should provide
that level of specialized care within its capability. Regionalization
of tertiary trauma care should be accomplished by adherence
to trauma care and transfer protocols." (Draft Position
Paper, Panel on Trauma Care Systems, February 14, 1992)
MONTANA TRAUMA CARE SYSTEM - A SUMMARY
Trauma Care Committee
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A broad-based Trauma
Care Committee established by statute
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Adoption and implementation
of a trauma care plan
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Provides advice and
direction to Montana Trauma Care and EMS system
-
Defines an appropriate
role for each hospital
-
Specifies capabilities
and resources of hospitals on a regional level
-
Specifies training
for all pre-hospital and in-hospital personnel
-
Quality assurance/quality
improvement program to assure patients are receiving optimal
treatment based on resources available
-
Ties training to
quality assurance/quality improvement
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Triage protocols
to assure right patient to right facility
-
Training in recognition
and management of trauma patients and assuring their knowledge
of trauma system operation
-
Medical control,
quality assurance, quality improvement
-
Data collection
-
Improved telecommunications
and on-line medical control
-
Establishing a commitment
to improved care of trauma patient in all hospitals
-
Establishing, through
self-assessment and on-site evaluation, the capabilities
of each hospital to manage the various types of trauma
patients
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Regional plans for
trauma patients
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Establishing appropriate
referral mechanisms and procedures for each hospital
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Helping to upgrade
each hospital's capabilities to manage the trauma patient
consistent with the trauma care plan
-
Documenting uncompensated
trauma care
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Training and education
of physicians and nurses
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Provision of technical
assistance to help hospitals improve their trauma care
-
Data collection;
quality assurance/quality improvement; patient outcome
data
-
Involvement in injury
prevention programs
-
Improved telecommunications
and on-line medical control
-
Rehabilitation
Data Collection, Evaluation, Quality
Improvement
-
Development of trauma/EMS
systems standards
-
Data collection
techniques to evaluate system performance both pre-hospital
and in-hospital; compliance with standards and system
-
Coordination of
data from public safety, emergency medical services, medical
facility and medical examiners
-
Determining problems
of care at all levels, and making changes in the system
-
Continuation and
expansion of Montana Trauma Register
Trauma
System Legislation
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Authority to Department
of Public Health and Human Services to plan, develop,
and implement a state-wide trauma system - designated
as the lead agency
-
Allow adoption of
administrative rules regarding trauma center designation
and classification, data collection, triage criteria,
quality assurance/improvement
-
Data confidentiality
and protection from discovery
-
Legal
protection of quality assurance/quality improvement process
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