Current Trauma Status Report - Southern Nevada Health District

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The following table presents the trauma patients reported by Clark County hospitals for 2000 through 2002. Exhibit 42 – Nevada Trauma Registry Patients Nevada Trauma Registry Patients Reported by Hospital in Clark County, 2000 - 2002 Hospital 2000 2001 2002 Boulder City Hospital - - - Desert Springs Hospital 8 1 18 Lake Mead Hospital 20 53 97 Mountain View Hospital - - 10 St. Rose Dominican Hospital - de Lima 13 26 - St. Rose Dominican Hospital - Siena 7 4 9 Spring Valley Hospital - - - Summerlin Hospital - - - Sunrise Hospital 38 26 9 UMC 3,117 3,570 3,714 Valley Medical Center 38 57 96 Total 3,241 3,737 3,953 Note: Dashes indicate the value was zero or not reported. Source: Center for Health Data & Research, Bureau of Health Planning & Statistics, NV State Health Div., 5/04 While the intent of the Nevada Trauma Registry is to capture all data on patients who meet the State’s trauma criteria, the reality is that several hospitals have difficulty meeting this requirement. These difficulties primarily include not having the staff to collect and submit the data and an understanding about what qualifies as a trauma patient for the registry. A summary of the statutorily required data set can be found in the Appendix. Specialty Physician Coverage On-call coverage to the EDs by physician specialists was identified as a major concern by the hospitals. This can impact the trauma center as there is a community expectation that the trauma center act as the “safety net” for those injury cases that may not meet trauma center criteria but need specialist care. ED managers at each of the Las Vegas region hospitals (adult and pediatric) and the trauma center were surveyed about whether they have had problems maintaining specialty physician coverage for their facility, and if so which types of coverage present problems. Eleven responses were received. As indicated in the table below, four respondents said they have no problems with on call specialists at all, three respondents reported occasional problems and four reported frequent problems. The greatest number of problems were with hand and plastics (reported by four respondents), followed by neurology, orthopedics and pediatrics coverage (each indicated by three respondents). Page 55
Exhibit 43 – Specialty Physician Coverage Southern Nevada Specialty Physician Coverage Survey Frequency of Problems No Problems Occasional Problems Frequent Problems Total Responses Total Reporting Problems Overall 4 3 4 11 7 Hand 4 0 4 8 4 Plastics 4 1 3 8 4 Neurology 5 0 3 8 3 Orthopedics 5 1 2 8 3 Pediatrics 5 1 2 8 3 ENT 6 0 2 8 2 Neurosurgery 6 0 2 8 2 Cardiology 7 1 0 8 1 General Surgery 8 0 0 8 0 Internal Medicine 8 0 0 8 0 Primary Care 8 0 0 8 0 Source: Survey of Las Vegas region ED managers by The Abaris Group The following additional comments were made by individual hospitals: • More and more physicians want to be paid for on call coverage and it's very expensive. • As a result of the change in the EMTALA rule, physicians can take call at more than one hospital, which has increased physician specialty coverage challenges. • On the whole at this time things are good. However, orthopedics can be a challenge. • As of this date there are no problems, but that could change. • There are rare problems with orthopedics only. • Overall we have pretty good on call specialty coverage. • If we had coverag e, we wouldn't have to transfer. • Not having neurosurgery, neurologists and gastroenterologists is a big problem. Rehabilitation There are four rehabilitation hospitals in Southern Nevada: • Healthsouth Rehabilitation Hospital, Las Vegas • Healthsouth Rehabilitation Hospital, Henderson • Sunrise Hospital & Medical Center Rehabilitation Unit • UMC Rancho Rehabilitation Center While there is no coordinated regional rehabilitation mechanism in place, the directors of the different rehabilitation hospitals work together informally. In addition, the UMC Trauma Center interacts closely with the UMC Rancho Rehabilitation Center. For example, representatives from trauma and rehabilitation meet monthly. In addition, the Director of Physical Medicine and Rehabilitation organizes a rotation of community physiatrists through the trauma center. Physiatrists also conduct rounds in the trauma ICU. Typically a physiatrist will work with a patient in the trauma center and then continue that care with the patient in the Rancho Rehabilitation Center. Page 56
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 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: All EMS and ED stakeholders appear
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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