Current Trauma Status Report - Southern Nevada Health District

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Executive Summary Overview A trauma system is a critical component of a community’s health care system. By providing a resource continuum dedicated to the prevention, treatment, and study of trauma, the system plays a major role in preventing needless death and disability. Recognizing this significance, the Clark County Health District, at the request of the Nevada State Health Division, has undertaken an assessment of the Southern Nevada trauma system. This trauma system assessment consists of both a consultative visit by the American College of Surgeons (ACS) and a needs assessment by The Abaris Group. There is currently one designated trauma center in Southern Nevada, University Medical Center (UMC). Two other hospitals, Sunrise Hospital and Medical Center and St. Rose Dominican-Siena, have indicated an interest in becoming a designated trauma center for Southern Nevada. The Current Trauma Status Report is The Abaris Group’s assessment of the trauma system as it exists today. A second report by The Abaris Group will provide more refined input on this assessment and make recommendations on the future needs of the Southern Nevada trauma system. The second report will also analyze the new trauma center interests and the impact of their potential addition on the current trauma center and future trauma system. Trauma Chronology The following is an abbreviated summary of the trauma chronology in Southern Nevada. A more detailed chronology can be found in the appendix. • UMC underwent its first ACS consultation review for a Level II designation in January 1988 • Sunrise Hospital received Level III designation in October 1989 • UMC was verified in December 1989 • UMC did not receive full ACS verification for Level II during their site visit in December 1992 • UMC appeals ACS survey in January 1993 and the appeal is granted, extending their verification as a Level II trauma center • Nevada Board of Health provided a “provisional trauma designation” to UMC in January 1993 to permit UMC to continue to serve the community as a trauma center • UMC was re-verified as a Level II trauma center in May 1993 • Sunrise Hospital’s health facility certificate was issued without notation of a Level III trauma center in January 1995 • UMC trauma center closed for a 10-day period in July 2002 due to issues with medical staff malpractice concerns • In October 2003, Sunrise Hospital and St. Rose Dominican Hospital notified the Nevada State Health Division of their interest in becoming trauma centers (Level II and Level III, respectively) • The Nevada State Health Division asked the Clark County Health District in November 2003 to facilitate a trauma system needs assessment, leading to the engagement of The Abaris Group to assist with the study and ACS to conduct a trauma system consultation visit • The Clark County Health District Board of Health created a Citizen’s Trauma Task Force in January 2003 to make recommendations regarding trauma in Southern Nevada Page 7
• From January through April 2004, four Citizens Trauma Task Force meetings were held and six Town Hall meetings were also held • In March 2004, Sunrise Hospital had a consultation by ACS for Level II trauma center designation, which led Sunrise to request a “provisional” trauma center designation from the Nevada State Health Division because ACS informed them that they needed to observe and review actual trauma cases at Sunrise Current Status Southern Nevada (or Clark County) is an area with a growing population and 41.4 million visitors a year (includes Las Vegas, Mesquite and Laughlin). The region is served by the UMC trauma center, a freestanding Level I trauma center that is one of two trauma centers in the state. Injured patients are transported to UMC from more than a dozen public and private EMS providers by ground and air ambulance. Twelve area emergency departments (ED) are also available to treat less severe injuries. There are four rehabilitation hospitals in Southern Nevada as well. The Nevada State Health Division is designated by state statute as having primary authority over emergency medical services (EMS) for the entire state, except in Clark County, and for trauma throughout the state. This authority includes trauma center designation, which is based on ACS verification. The Clark County Health District is designated by state statute to oversee the EMS system in Clark County. This role includes the prehospital component of trauma in Southern Nevada. However, it is important to note that neither the State of Nevada nor Clark County have a formal trauma system or trauma plan. It is the intent of this study to recommend the elements of a trauma system be created for Southern Nevada and the state as a whole. Trauma Care Components The National Highway Traffic Safety Administration (NHTSA) has identified the components of a trauma system in their publication Trauma System Agenda for the Future 1 . These are: • Injury Prevention • Prehospital Care • Acute Care Facilities • Rehabilitation • Leadership • Professional Resources • Education and Advocacy • Information Management • Finances • Research • Technology • Disaster Preparedness and Response The American College of Surgeons Consultation for Trauma Systems 2 document, in general, mirrors the NHTSA model trauma system components but specifies important details on such topics as system development and legislation. This document additionally outlines credentialing steps needed to identify progress and the status of each of the key trauma system components. 1 Trauma System Agenda for the Future, National Highway Traffic Safety Association, Washington DC, 2002 2 Consultation for Trauma Systems , American College of Surgeons , Chicago, IL, 1996 Page 8
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: Exhibit 33 - Map Displaying Trauma
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 and 56: All EMS and ED stakeholders appear
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Clark County Health District has id
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Trauma Center Standards by Level Th
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Nevada Trauma Registry Submission R
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Trauma Center Capacity Benchmark Da
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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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