Current Trauma Status Report - Southern Nevada Health District

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Town Hall Meeting Comments Boulder City Town Hall Meeting The following comments, input, questions and answers were provided during the Boulder City Town Hall meeting on trauma in Southern Nevada held on February 12, 2004. People attending the Town Hall included residents of Boulder City plus various stakeholders like Boulder City Fire Department, Clark County Health District, University Medical Center, Sunrise, St. Rose Dominican. Public Education/Involvement: • The public should be involved via injury prevention. • The public needs to understand the difference between trauma centers and emergency departments. • Educating the public as to the different types of trauma centers and systems is important. • UMC does a good job now. They reach out to the public. • Until you need it, you don’t know about it. • The community fabric is fragile and trauma systems are a part of this fabric. The public should expect/demand the care. • We need to educate the public, but injury prevention only works to a certain degree. Trauma Resources/Policy/Configuration: • Boulder City Hospital is supportive of the expansion of EMS and trauma. We need it. • Transportation issues are very important. • We need to consider whether the trauma system is serving our region appropriately Do we have enough resources (EDs, EMS, etc.) Do we need to expand What about in the case of surges • We need help in determining the direction and policies of the trauma system. Once we know that, it will help determine the number of trauma centers. • We are experiencing a unique opportunity right now. • We need another trauma center and we would support any new trauma center. Proximity to Boulder City would be our preference. • EMTALA requires all hospitals to treat all patients who come to them and only two hospitals receive county funds. • St. Rose will carefully consider the study reports. If the study does not call for a level III hospital, they will pull back. • Q. Is Boulder City going to become a trauma center A. Not right now, but maybe in the future. • Q. What is the difference between level I and II A. They provide the same level of care, but a level I also do research and typically teaches. UMC also provides care for burns and replantation. Funding: • We should fund the trauma system with private and public funding. • Trauma centers have the substantial fixed cost of being prepared 24/7. Currently, UMC receives some County funds and reimbursement from insurance companies. • UMC does cost shifting to pay for those patients with no insurance. This means we average our bills. • A level III is less expensive to maintain than a level I or II. • Sunrise’s current trauma center business plan does not rely on any public assistance. Sunrise will also support its sister hospitals as a trauma center. Page 67
• This region would not pass a tax to support the trauma system. • The City of Henderson voted twice against a police/fire initiative. • People aren't aware of what a trauma center can do for you, a tax will never pass. • Q. Can trauma centers be a public or private facility A. Yes. • Q. How are trauma center's normally funded A. Primarily from taxes/fees and insurance reimbursement. • Q. How much is trauma going to cost A. That depends on many factors. Patient Care/Access: • Trauma centers provide a higher level of care to the public. • There needs to be access for everyone in the community. • Patient care is also a key component, not just how long it takes us to unload a patient. Data Analysis: • We need to anal yze the data to determine where we need a trauma center(s). • When UMC closed, it showed us that we need more trauma centers. There should be 2.2 trauma centers per 1,000, 000 people. • Need to look at capacity and volume criteria in determining the number of trauma centers. • We need to review data. The argument for more trauma centers is like building fire stations. One on every corner is good, but is it feasible • UMC does an excellent job. We need to expand our infrastructure. UMC and Sunrise are the only 2 hospitals who could be a level I and II. • In order to determine where the trauma centers will go, it must be data driven. • We also need to consider traffic patterns. • We need to consider the huge number of visitors to Las Vegas each year. Other models won't work here because of that. • We need to determine where trauma patients coming from. • Hospitals in the region have continued to expand and grow. We need to look at the data, especially by geography. Clinical Staffing: • Physician call specialists are an issue. • One issue is physician specialist coverage and finding the staff to work at a trauma center. Governance: • I think the Clark County Health District should govern the trauma system. The State is up north and is not responsive to our needs. • Q. Does the federal government provide any oversight for a trauma system A. No. Other: • Q. When will this study be finished A. A draft report will be available in April 2004 with final recommendations to the State in June. Page 68
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SOUTHERN NEVADA CURRENT TRAUMA STAT
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Table of Contents Executive Summary
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Chronology of Trauma Care in Southe
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Exhibit 33 - Map Displaying Trauma
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• From January through April 2004
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Clearly trauma center staffing and
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A series of focus groups was also c
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• 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 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: ED Diversion Hours by Hospital ED D
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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