Current Trauma Status Report - Southern Nevada Health District

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According to the National Center for Health Statistics, in 2001 unintentional injury was the leading cause of death for persons aged 1 – 34 and was the second leading cause of death for those aged 35 – 44 in the United States. While the age cohorts for persons aged 50 and older are expected to have the largest growth rate from 2005 to 2010 in Clark County, the growth of those aged 0 – 49 accounts for almost 60 percent of the total growth in absolute change. Exhibit 9 – Clark County Population Projections by Age Clark County Population Projections by Age Cohort Age Cohort 2005 2010 Absolute Change Percent Change 0 - 9 255,986 289,832 33,846 13.2% 10 - 19 242,792 266,833 24,042 9.9% 20 - 29 261,375 278,723 17,347 6.6% 30 - 39 267,292 289,402 22,110 8.3% 40 - 49 256,465 280,606 24,141 9.4% 50 - 59 205,307 238,217 32,910 16.0% 60 - 69 143,715 174,577 30,862 21.5% 70 - 79 88,506 101,468 12,962 14.6% 80 Plus 40,175 49,690 9,515 23.7% Total 1,761,614 1,969,348 207,734 11.8% Source: Nevada State Demographer's Office. Clark County Population Projections Absolute Change from 2005 to 2010 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 - 0 - 9 10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 Plus Page 23
Trauma Stakeholder Interview Results The Abaris Group conducted greater than 100 interviews with trauma stakeholders in Southern Nevada. This included one-on-one interviews and a series of focus groups. The following are brief synopses of each type. Interview Synopses All synopses are presented in the stakeholder aggregate (all EMS providers were aggregated, all hospitals with EDs, etc.) except for UMC Trauma Center. Hospitals with EDs The most commonly reported strength of the trauma system among ED respondents was the quality of care at the UMC trauma center, which was described with words such as excellent, well-located, well known, respected, and possessing committed resources and efficient and high quality care. Respondents also cited as strengths UMC’s location and the fact there is no confusion in the community about where to take trauma patients. The triage criteria were also cited as strengths by some respondents (see triage criteria effectiveness survey results). The most commonly reported weakness of the trauma system was acceptance of transfers at UMC - mostly those patients that did not meet defined trauma triage criteria but that UMC was perceived to have the resources to treat. Other weaknesses reported during some interviews were the community’s sole reliance on UMC and a lack of competition, collaboration, or back up system due to UMC being the only trauma center. There was also concern that growth had overwhelmed the system and that UMC was an overly political or politically-connected institution. Over-triage was a reported concern as well. There are at least two hospitals willing to be added as trauma centers in the community. There is the possibility of others in the future as the new hospitals mature and their product line needs become identified. Of the original two new hospitals, their perspective is that their individual locations provide the ideal site for a new trauma center. All hospitals are impacted by capacity problems and subsequent ambulance diversions. There was a level of frustration from the EDs and in some cases a belief that the EDs had done all they could to improve flow and capacity but that not all had been done throughout the hospital to solve the problems. Four hospitals admitted during the inventory process that they did not have a written diversion policy. Several hospitals, though, were implementing an “adopt a boarder” program to assist with ED flow which is considered to be a best-practice inpatient flow strategy. Hospital CEOs expressed concerns about the on-call specialist challenge in the community with the number of subspecialty issues varying from hospital to hospital. At the time of the interview one hospital had no on call orthopedic coverage, one did not have general surgical coverage and many had issues with neurosurgeons, ENTs, plastic and hand surgery coverage. The CEOs in general expressed an interest in further studying this issue and coming up with common solution strategies. Responses varied as to the need and preferred location of additional trauma centers. Sunrise Hospital and Medical Center and St. Rose Dominican-Siena were the hospitals suggested most often, although there was concern about the location of Sunrise from a traffic standpoint and whether St. Rose Page 24
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 and 18: (This study did not attempt to meas
Page 19 and 20: County Health District Board of Hea
Page 21 and 22: on an average length of stay of 3.4
Page 23: Exhibit 8 - Projected Population Ch
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
Page 69 and 70: • This region would not pass a ta
Page 71 and 72: • Instead of calling it a tax, we
Page 73 and 74: Mesquite Town Hall Meeting The foll
Page 75 and 76:
North Las Vegas Town Hall Meeting T
Page 77 and 78:
Las Vegas Town Hall Meeting The fol
Page 79 and 80:
Trauma Center Funding Comparison St
Page 81 and 82:
Los Angeles County, CA Los Angeles
Page 83 and 84:
Chronology of Trauma Care in Southe
Page 85 and 86:
January 22, 1999 December 10, 2001
Page 87 and 88:
List of Trauma System Assessment St
Page 89 and 90:
Southern Nevada Trauma System Asses
Page 91 and 92:
to hospitals that accept Medicare r
Page 93 and 94:
ehabilitation - services that seek
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Current Trauma Status Report - Southern Nevada Health District

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