Current Trauma Status Report - Southern Nevada Health District

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Trauma Care in Southern Nevada Overview Currently there is one trauma center in Southern Nevada, the University Medical Center (UMC), which is a State designated and American College of Surgeons (ACS) verified Level I trauma center. In the fall of 2003, two hospitals in Southern Nevada notified the Nevada State Health Division that they would like consideration for designation (Sunrise Hospital and Medical Center is seeking a Level II designation and St. Rose Dominican-Siena is seeking a Level III designation). If these two hospitals are to be approved as a trauma center, they must first obtain verification by ACS and then be designated by the Nevada State Health Division Administrator, the state agency that has the responsibility for designation of trauma centers. Under Nevada Revised Statutes (NRS 450B, et seq), the responsibility for establishing the trauma program for the treatment of trauma and for designation rests with the Nevada Board of Health. The oversight of this process for the trauma center application, designation and monitoring process is performed by the Nevada State Health Division through its EMS Section. The Nevada State Health Division’s role is set by statute to include developing and monitoring the: • Trauma center application process • Trauma verification and designation meeting ACS standards • Trauma center monitoring • Trauma patient destination policies • Statewide Trauma Registry Under state statute (NRS 450B.077), the EMS personnel and clinical supervision of the prehospital system for Clark County has been delegated to the Clark County Health District. The District is governed by a 13-member policy making board composed of representatives from each of the region’s six governmental entities, as well as a physician member at-large. As such, it represents a unique consolidation of the public health needs of Boulder City, Las Vegas, North Las Vegas, Mesquite, Henderson, and Clark County into one regulating body. The Clark County Health District Board of Health, through policy development and direction to staff, identifies public health needs and, as mandated by County Ordinance 163, establishes priorities on behalf of local taxpayers, residents, tourists/visitors, and the commercial service industry, "to establish and conduct a comprehensive program of health to prolong life and promote the well-being of the people of Clark County" (subsection b of Section 6). The District has no official role with trauma except as it interfaces with its authority on prehospital care policy. However, the Nevada State Health Division asked the Clark County Health District to conduct an assessment of the trauma system in the Las Vegas region. This assessment is being conducted partially by a system consultation visit by the ACS and through a needs assessment being conducted by The Abaris Group, a consulting firm that specializes in assessing trauma systems. In order to assure an objective and unbiased approach to the study, the Clark County Health District Board of Health created an 11-member Citizens Trauma Task Force. The task force is comprised of business and community leaders in the Las Vegas area. Once the ACS and The Abaris Group’s assessment have been completed, the Task Force will make recommendations to the Clark County Health District Board of Health regarding the future trauma system and its configuration. The Clark Page 17
County Health District Board of Health will present its findings and recommendations to the Nevada State Health Division Administrator for the ultimate decision. Statewide Trauma Efforts An EMS-Trauma Stakeholders Group was established in 2000 in response to the federal funding from the Health Resources and Services Administration (HRSA) for their Trauma-EMS Systems Program. This is a 14-member group assembled to provide advice on the key goals of the HRSA grant project. The EMS-Trauma Stakeholder’s Group reports to the Trauma Institute, which is a freestanding nonprofit organization based in Las Vegas with a primary focus on injury research. While trauma system planning is an area of interest for this committee and for the State, there are significant resource limitations that have hindered the progress of this group towards developing momentum on statewide planning and monitoring of a trauma system. This Southern Nevada trauma assessment will culminate in a series of recommendations regarding trauma in the region. At this time, Southern Nevada does not have a formal trauma system or plan. However, it is anticipated that a recommendation will be made to establish a formal trauma plan and system. Nevada Trauma Centers In addition to UMC, the other trauma center in Nevada is Washoe Medical Center in Reno, a Statedesignated and ACS-verified Level II trauma center. The following comparative data is from the most current Nevada Trauma Registry report published in November 2003. Exhibit 3 – Nevada Trauma Registry Patients Nevada Trauma Registry Patients, 2000-2002 Percent Change 2000-01 Percent Change 2001-02 Trauma Center 2000 2001 2002 University Medical Center 3,117 3,570 3,714 14.5% 4.0% Washoe Medical Center 2,123 2,120 2,520 -0.1% 18.9% Other 1 329 654 672 98.8% 2.8% Total Trauma Cases 5,569 6,344 6,906 13.9% 8.9% 1 Other: All other Nevada counties, unknown in Nevada, out of state, and unknown. Source: Center for Health Data & Research, Bureau of Health Planning & Statistics, NV State Health Div., 5/04 Page 18
Page 1 and 2: SOUTHERN NEVADA CURRENT TRAUMA STAT
Page 3 and 4: Table of Contents Executive Summary
Page 5 and 6: Chronology of Trauma Care in Southe
Page 7 and 8: Exhibit 33 - Map Displaying Trauma
Page 9 and 10: • From January through April 2004
Page 11 and 12: Clearly trauma center staffing and
Page 13 and 14: A series of focus groups was also c
Page 15 and 16: • Information Management • Fina
Page 17: (This study did not attempt to meas
Page 21 and 22: on an average length of stay of 3.4
Page 23 and 24: Exhibit 8 - Projected Population Ch
Page 25 and 26: Trauma Stakeholder Interview Result
Page 27 and 28: three years, and felt that a Level
Page 29 and 30: EMS providers ranked Acute Care Fac
Page 31 and 32: Town Hall Meeting Comments A series
Page 33 and 34: (CAAS) and the air ambulance provid
Page 35 and 36: Triage Criteria The determination o
Page 37 and 38: With the exception of the year 2000
Page 39 and 40: Exhibit 20 - Trauma Patients by Age
Page 41 and 42: The following chart shows that abou
Page 43 and 44: Exhibit 27 - Trauma Ground Transpor
Page 45 and 46: E codes enable the classification o
Page 47 and 48: The day of the week with the greate
Page 49 and 50: A different view of the 2002 trauma
Page 51 and 52: As part of The Abaris Group’s tra
Page 53 and 54: The table below summarizes the key
Page 55 and 56: All EMS and ED stakeholders appear
Page 57 and 58: Exhibit 43 - Specialty Physician Co
Page 59 and 60: Clark County Health District has id
Page 61 and 62: Trauma Center Standards by Level Th
Page 63 and 64: Nevada Trauma Registry Submission R
Page 65 and 66: Trauma Center Capacity Benchmark Da
Page 67 and 68: ED Diversion Hours by Hospital ED D
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• This region would not pass a ta
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• Instead of calling it a tax, we
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Mesquite Town Hall Meeting The foll
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North Las Vegas Town Hall Meeting T
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Las Vegas Town Hall Meeting The fol
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Trauma Center Funding Comparison St
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Los Angeles County, CA Los Angeles
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Chronology of Trauma Care in Southe
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January 22, 1999 December 10, 2001
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List of Trauma System Assessment St
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Southern Nevada Trauma System Asses
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to hospitals that accept Medicare r
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ehabilitation - services that seek
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Current Trauma Status Report - Southern Nevada Health District

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