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HRSA Model Trauma Systems Planning & Evaluation

HRSA Model Trauma Systems Planning & Evaluation. July 24, 2008 Gail Cooper. Common Names. HRSA Model Trauma Systems Planning & Evaluation (MTSPE) Model Trauma Plan “National Trauma Plan”. HRSA Model Trauma Plan. Do you fit?

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HRSA Model Trauma Systems Planning & Evaluation

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  1. HRSA Model Trauma Systems Planning & Evaluation July 24, 2008 Gail Cooper

  2. Common Names • HRSA Model Trauma Systems Planning & Evaluation (MTSPE) • Model Trauma Plan • “National Trauma Plan”

  3. HRSA Model Trauma Plan • Do you fit? • Sure, with a little tweaking here & there all States fit one way or another • It’s not a prescriptive document, it is a guide!

  4. HRSA Model Trauma Plan • How does California fit? • By identifying resources already at work in California to reduce trauma death & disability (Assessment) • Working to close the gaps in service delivery (Policy Development) • Measuring results, morbidity & mortality (Assurance)

  5. HRSA Model Trauma Plan What does it mean? Change; Toward more universal statewide coverage

  6. Looking Back: The Need for Change • New Plan/New Model • Move away from components • Toward inclusive, integrated, & evidence based • Develop Trauma System Planning and Evaluation: A Public Health Approach • Planning Guide • Integrates essential elements of the model trauma system plan using a public health approach • Incorporates new information on Systems Development • Self-evaluation document • BIS (Benchmarks, Indicators, & Scoring)

  7. Process for Future TraumaSystem Development • Funded by HRSA • Use the village approach • Solicit comments frequently • Incorporate ideas from key trauma leaders • Build consensus among stakeholders • Repeatedly educate stakeholders about the public health approach to trauma care

  8. Why Public Health • Gives credibility to trauma as a public health problem • Reasonable, methodical approach recommended by the IOM • Grounds trauma in a theoretical base • Incorporates trauma & injury within the framework of public health • Allows trauma to be more competitive for funding

  9. The Process • Review: • 1992 Draft Model Trauma Care System Plan • Trauma System Agenda for the Future • HRSA Evaluation instrument • ACS/COT Trauma system consultation manual • Literature review: • Skamania conference • Literature since Skamania conference

  10. The Village people: ACEP STN NASEMSP NASEMSO Leaders & Task Groups • Key Framers of New Document • Use ACS/COT as entity to produce new document • HRSA • ACS/COT • CDC • NHTSA

  11. Trauma System Planning & Evaluation: A Public Health Approach … the public health approach is simply a proven, systematic method of problem identification & problem solving; it provides a conceptual framework for trauma system development, management & ongoing performance improvement Draft, DHHS/HRSA, Feb 2003, p. 5

  12. Trauma System Planning & Evaluation Guide • Fresh approach to trauma system planning • Focus around 3 Core Functions of Public Health (A, PD, A) • Use Trauma Agenda for the Future components (NHTSA) • Provide practical information • Include updated version of HRSA Trauma System evaluation tool (BIS self evaluation) • Incorporate NACCHO Standards for Public Health Offices where applicable

  13. Public Health Goals • Prevent epidemics & spread of disease • Protect against environmental hazards • Prevent Injuries • Promote and encourage healthy behaviors • Respond to disasters & assist communities in recovery • Assure the quality & accessibility of Health Services

  14. Mission of Public Health Assuring conditions in which people can be healthy Substance of Public Health; Organized community efforts aimed at the prevention of disease & the promotion of health IOM, 1988

  15. Trauma System Goals • Decrease the incidence and severity of trauma • Ensure optimal, equitable & accessible care for all persons sustaining trauma • Prevent unnecessary deaths & disabilities from trauma • Contain costs while enhancing efficiency • Implement quality & performance improvement of trauma care through out the system • Ensure certain designated facilities have appropriate resources to meet the needs of the injured

  16. Mission of the Trauma System Prevent injuries while ensuring that the right patient gets to the right hospital in the right amount of time

  17. Benefits to the Trauma System: • Access to a well-established & accepted conceptual model for health care system assessment, planning, intervention, & evaluation. • Potential communications infrastructure (notification systems) • Access to all-hazards information • Population-based data • Resources for disaster preparedness • Opportunity to integrate the trauma system into other community health efforts to promote overall health • A more precise identification of populations at risk & a targeting of specific issues based on these data • Framework for injury prevention strategies

  18. Benefits to the Public Health System: • Access to all-hazards information • Access to a well-established health system infrastructure • Health system response that differentiates facilities by level of resource availability • Existing protocols and guidelines for the care process • Access to patient outcome data • Existing performance improvement process • Additional resources for injury prevention efforts • Resources to provide all-hazards care • Recognition that injury continues to be a public health problem despite significant efforts at trauma system development

  19. Why a public health approach? • Assure consistency with the Trauma System Agenda for the Future • Begin looking at outcomes rather than just the structure & process • Give credibility to trauma as a public health problem • Improve dialogue between trauma/EMS professionals, public health professionals & policy-makers

  20. Why a public health approach ? • Reasonable, methodical approach recommended by the Institute of Medicine • Enhance integration of trauma systems into public health disaster planning & bioterrorism response planning • Allow trauma & EMS to be more competitive for funding • Grounds trauma system in theoretical base • Incorporates both EMS & trauma within a public health system

  21. Supporting the Model • Recent IOM report on the Future of Emergency Medical Services • ACS/COT Systems Consultation Guide • Regional Trauma Systems: Optimal Elements, Integration, & Assessment • Key Trauma System Leadership, National, State & Local

  22. Vision for the Future of Emergency Care • Emergency Care System • Coordinated, • Regionalized, • Accountable IOM, 2005

  23. Key Problems • Fragmentation: • Lack of coordination between local service providers; between EMS and public safety; & between EMS & air medical services • Uncertain Quality: • Little or no performance data; lack of national standards for training & credentialing. • Disaster Preparedness: • Inadequate training, equipment, funding. • Evidence Base: • limited understanding of effectiveness

  24. Key Recommendations • Communications • Improve data & communications systems interoperability between EMS agencies, hospitals, & public health departments. • State regulation of air medical providers with respect to communications, dispatch, & transport protocols.

  25. Workforce Standards • Improve the quality & consistency of EMS by encouraging states to: • Require national accreditation of paramedic education programs. • Accept national certification as a prerequisite for state licensure. • Establish a common scope of practice for EMS personnel across states, with state licensing reciprocity.

  26. Research • Study to examine the gaps in emergency and trauma care research. • Development of a research strategy. • Increased funding for prehospital EMS research, emphasizing systems & outcomes research.

  27. Disaster Preparedness • Elevation of emergency care to a position of parity with other public safety entities in disaster planning & operations. • Increase in funding for EMS-related disaster preparedness through dedicated funding streams. • Incorporate disaster preparedness training into EMS professional training & continuing education.

  28. CA & Model Trauma System • The HRSA Model Trauma System Planning and Evaluation (MTSPE) document provides a guide for states in enhancing trauma care. • The guide provides a structure for further developing the statewide system • MTSPE guide is one tool for states to use in developing an inclusive trauma system • ACS/COT Systems Consultation guide • Public Health and Trauma System both focus on risk reduction • Trauma continues to be a leading cause of death in California

  29. Conclusion: California’s Direction • Use the MTSPE guide to evolve a statewide system • Continue developing the regional approach to trauma care within California using the BIS as a guide to improvement • Rely on data to assist in setting standards, guidelines and benchmarks that may be unique to California • Incorporate the COT Systems Consultation Guide (Regional Trauma Systems: Optimal Elements, Integration, and Assessment)

  30. Conclusion: California’s Direction • Leadership in Trauma Systems • State, Regional, Local, • Many Benchmarks & Indicators already achieved • Statutes, Regulations, Funding available • It will never be enough! • The timing is right to move California to the next level of trauma system development

  31. JUST DO IT Build on the synergy & cooperative spirit of this summit

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