Kansas Trauma System

Advisory Committee on TraumaAdvisory Committee on TraumaRegional Trauma CouncilsRegional Trauma Councils

Trauma in Kansas: Leading cause of death in Kansans under Leading cause of death in Kansans under

age 44age 44 MVC and falls account for over 50% of all MVC and falls account for over 50% of all

injury deathsinjury deaths More MVC occur in urban areas (63%)More MVC occur in urban areas (63%) KDOT KDOT

Most MVC fatalities occur in rural areas Most MVC fatalities occur in rural areas (77%)(77%) KDOT KDOT

Ways to reduce the toll of injury:

Prevention servicesPrevention services Regionalized trauma systemsRegionalized trauma systems

CDC Injury ReportCDC Injury Report

Kansas Trauma System when implemented is expected to: Reduce number of preventable injury deathsReduce number of preventable injury deaths Improve outcomes from traumatic injuryImprove outcomes from traumatic injury Reduce medical costs through appropriate Reduce medical costs through appropriate

use of resourcesuse of resources

- Kansas Trauma - Kansas Trauma Plan 2001Plan 2001

Goals of the Kansas Trauma System: Improve delivery of trauma servicesImprove delivery of trauma services Encourage provider preparation and response Encourage provider preparation and response

to traumato trauma Increase public awareness & preventionIncrease public awareness & prevention Design an inclusive & comprehensive systemDesign an inclusive & comprehensive system Develop trauma education resourcesDevelop trauma education resources

-- Kansas Trauma Plan 2001-- Kansas Trauma Plan 2001

Kansas Trauma Program

Emphasizes local control and decision Emphasizes local control and decision making at the regional levelmaking at the regional level

Coordination of activitiesCoordination of activities Data-driven planning and accountabilityData-driven planning and accountability

What Is A Trauma System? Characteristics

Regionalized Regionalized Efficient use of facilities/resources based on Efficient use of facilities/resources based on

unique requirements of the populationunique requirements of the population Emphasizes prevention as part of Emphasizes prevention as part of

community healthcommunity health Able to expand to meet the medical needs of Able to expand to meet the medical needs of

the community in times of disasterthe community in times of disaster

A Trauma System is

…….an organized, coordinated approach to .an organized, coordinated approach to facilitating & coordinating a multi-facilitating & coordinating a multi-disciplinary system response to injured disciplinary system response to injured patientspatients

Seamless transition between each phase of Seamless transition between each phase of carecare

Involves public & private partnershipsInvolves public & private partnerships

Defined by ACS… A network of definitive care facilities that A network of definitive care facilities that

provides a spectrum of care for injured pts.provides a spectrum of care for injured pts. Includes components identified with optimal Includes components identified with optimal

trauma care:trauma care: PreventionPrevention AccessAccess Acute hospital careAcute hospital care RehabilitationRehabilitation Research activitiesResearch activities

Goal of a trauma system is to…

Match a facility’s resources with a pt’s Match a facility’s resources with a pt’s needs so optimal and cost-effective care is needs so optimal and cost-effective care is achieved.achieved. Integrated with EMSIntegrated with EMS Strives to meet the needs of all injured Strives to meet the needs of all injured

ptspts Recognizes necessity for all hospitalsRecognizes necessity for all hospitals Preplanned response to caring for ptsPreplanned response to caring for pts

Hospitals are classified by levels of service they provide Level I: Provide full range of range of Level I: Provide full range of range of

services and has research responsibilityservices and has research responsibility Level II: Similar level of clinical services Level II: Similar level of clinical services

and community basedand community based Level III, IV: General surgery capability, Level III, IV: General surgery capability,

includes emergency services capabilityincludes emergency services capability

Trauma Centers in the United States – ▲ Level I ■ Level II

Trauma Centers in the United States – All Levels

Kansas Trauma System

Kansas Trauma Plan approved by the Kansas Trauma Plan approved by the legislature in 1999legislature in 1999

KDHE appointed as the lead agencyKDHE appointed as the lead agency Governor's Advisory Committee on Trauma Governor's Advisory Committee on Trauma

provides input provides input Regional Trauma Councils established 2001Regional Trauma Councils established 2001

Role of KDHE: Develop rules and regulations necessary for Develop rules and regulations necessary for

a trauma systema trauma system Develop a statewide trauma system plan Develop a statewide trauma system plan

including regional councilsincluding regional councils Administer a statewide trauma registryAdminister a statewide trauma registry

Current activities of KDHE Administer the Kansas Trauma System PlanAdminister the Kansas Trauma System Plan Support a trauma registry data systemSupport a trauma registry data system Support Regional Trauma CouncilsSupport Regional Trauma Councils Provide rural trauma education through Provide rural trauma education through

contract with KHAcontract with KHA Develop regional trauma plansDevelop regional trauma plans Federal Trauma/EMS grant to support EMD Federal Trauma/EMS grant to support EMD

training & educationtraining & education

Advisory Committee on Trauma

24 member committee representing both 24 member committee representing both urban & rural areasurban & rural areas

Members are appointed by the GovernorMembers are appointed by the Governor Advise KDHE on development & Advise KDHE on development &

implementation of a trauma systemimplementation of a trauma system Meet at least 4 times/ yearMeet at least 4 times/ year

Kansas Trauma Registry

Trauma registry software and support is Trauma registry software and support is provided without charge to hospitalsprovided without charge to hospitals

Trauma data is required by law to be Trauma data is required by law to be reported to state registryreported to state registry

Aggregate data is reported back to regionsAggregate data is reported back to regions

Why have a trauma registry?

Resource utilizationResource utilization Performance improvementPerformance improvement Injury control & epidemiologyInjury control & epidemiology Research and educationResearch and education Most importantly hospitals may utilize data Most importantly hospitals may utilize data

for QI/QAfor QI/QA

Participation of hospitals in national data bank

American College of Surgeons .National Trauma Data BankTM 2003

GSW/Firearms

PedestrianBurns

MVC

MCC

Falls

Pedal CycleStab

Assault/FightMachinery

Deaths by Mechanism of Injury

Figure 9A

Proportional distribution of deaths,grouped by mechanism of injurydefined in Appendix B . Total N =23,730.

MVC

Falls

GSW/Firearms

PedestrianMCC

Assault/FightStab

Pedal CycleMachinery

BurnsPatients by Mechanism of Injury

Proportional distribution of patients,grouped by mechanism of injurydefined in Appendix B. Total N =453,806.

Figure 8A

American College of Surgeons .National Trauma Data BankTM 2003

Map of Regional Trauma Councils

Prepared 6/28/01 SAM

CHEYENNE RAWLINS DECATUR NORTON

SHERMAN THOMAS SHERIDAN GRAHAMROOKS

WALLACE

GREELEY

HAMIILTON KEARNEY FINNEY

PHILLIPS

LOGAN GOVE TREGO ELLIS

RUSHNESSLANESCOTTWICHITA

HODGEMAN

PAWNEE

STANTON GRANT HASKELL

STEVENS SEWARD

MEADE CLARK

GRAY

FORD

KIOWA

COMANCHE

BARBERHARPER

KINGMANPRATT

MORTON

RENO

EDWARDS

STAF-FORD

RICE

ELLSWORTH

LINCOLN

MCPHERSON

HARVEY

SEDGWICK

SUMNER

MARION

DICKINSON

CLAY

WASHINGTONREPUBLICJEWELL

MITCHELL

CLOUD

OSBORNE

RUSSELL

BARTON

OTTAWA

SALINE

SMITH MARSHALL NEMAHA BROWN

RILEY

MORRIS

CHASE

BUTLER GREENWOOD

LYON

OSAGE

WABAUNSEE

DOUGLAS

SHAWNEE

POTTAWA-TOMIE

JACKSON ATCHISON

JEFF-ERSON

JOHNSON

MIAMIFRANKLIN

LEAVEN-WORTH

WYAN-DOTTE

COFFEYANDERSON LINN

WOODSONALLEN BOURBON

COWLEYELK

CHAUTAUQUA

WILSON NEOSHO

CRAWFORD

LABETTECHEROKEE

MONT-GOMERY

DONIPHAN

NW NC

SW SCSE

GEARY NE

Regional Trauma Councils

Cornerstone of the state systemCornerstone of the state system Provide input into the state systemProvide input into the state system Provide leadership at the regional levelProvide leadership at the regional level EMS, Health Department, Hospitals are EMS, Health Department, Hospitals are

representedrepresented

Regional Trauma Councils: Mission

Develop regional plansDevelop regional plans Promote cooperation & support among Promote cooperation & support among

membersmembers Promote education, public awarenessPromote education, public awareness Identify trends & pt. outcomes based on Identify trends & pt. outcomes based on

datadata Assure PI to achieve highest level of careAssure PI to achieve highest level of care Advise the ACT on issues related to regionAdvise the ACT on issues related to region

Regional Trauma Plans

Designed to facilitate development, Designed to facilitate development, implementation and operation of a regional implementation and operation of a regional trauma systemtrauma system

Template and survey have been provided to Template and survey have been provided to regionsregions

Staff and limited funding has been provided Staff and limited funding has been provided to region for development of planto region for development of plan

Trauma Program Funding

Trauma Fund: line item in state budgetTrauma Fund: line item in state budget Revenue: docket fees on moving violationsRevenue: docket fees on moving violations

District courtDistrict court Municipal courtMunicipal court

Kansas Trauma Summary

Kansas Trauma Plan approvedKansas Trauma Plan approved KDHE is the lead agencyKDHE is the lead agency Advisory Committee on Trauma provides Advisory Committee on Trauma provides

input input Regional Trauma Councils are keyRegional Trauma Councils are key

The Kansas Trauma System needs your involvement!!

Kansas Trauma Program

Sign up for the trauma program notices Sign up for the trauma program notices specific to your region atspecific to your region at

http://krhis.kdhe.state.ks.us/http://krhis.kdhe.state.ks.us/

Kansas Trauma Program

WEB SITE:WEB SITE:

http://www.kdhe.state.ks.us/olrhhttp://www.kdhe.state.ks.us/olrh

Includes up to date information on RTC & ACT activities including minutes etc.

Questions???

Injury Case Criteria for the State Registry: All injury related deathsAll injury related deaths ICD-9 diagnoses code 800.0-959.9ICD-9 diagnoses code 800.0-959.9 ANDAND admitted to hospital for 48 hours or admitted to hospital for 48 hours or

moremore OROR transferred into or out of hospital transferred into or out of hospital OROR died during treatment in ED died during treatment in ED Exclusions: contusions, abrasions, blisters, Exclusions: contusions, abrasions, blisters,

isolated hip fractures, etc.isolated hip fractures, etc.