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Jack Champlin

Trauma System Agenda for the Future. The Vision Trauma systems, when fully implemented throughout the United States, will enhance community health through an organized system of injury prevention, acute care and rehabilitation that is fully integrated with the public health system in a community

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Jack Champlin

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    1. Jack Champlin Consultant Prevention Institute Former Deputy Administrator Region 9 National Highway Traffic Safety Administration I’m pleased to have the opportunity to speak to you today, to you the practitioners, coordinators and administrators of trauma and EMS …the often unsung heroes of the medical world and certainly of traffic safety.I’m pleased to have the opportunity to speak to you today, to you the practitioners, coordinators and administrators of trauma and EMS …the often unsung heroes of the medical world and certainly of traffic safety.

    2. Trauma System Agenda for the Future The Vision Trauma systems, when fully implemented throughout the United States, will enhance community health through an organized system of injury prevention, acute care and rehabilitation that is fully integrated with the public health system in a community. 2 I want to begin with a statement from the NHTSA Vision for a Trauma System from the Agency’s “Agenda for the Future”. READI want to begin with a statement from the NHTSA Vision for a Trauma System from the Agency’s “Agenda for the Future”. READ

    3. Trauma System Agenda for the Future The Vision (continued) Trauma systems will have the ability to identify risk factors and related interventions to prevent injuries in a community and to maximize the integrated delivery of resources for patients who ultimately need acute trauma care. 3 You see there’s two references to injury prevention in this vision statement. And because prevention is a focus of my work history, I’ll be making a number of references to prevention initiatives in what I say today. You see there’s two references to injury prevention in this vision statement. And because prevention is a focus of my work history, I’ll be making a number of references to prevention initiatives in what I say today.

    4. The Challenge How to implement a comprehensive trauma care system in California when faced with the current status of a largely decentralized system? 4 Coming out of some discussions with Johnathan, my partner in crime here, we think the biggest challenge for CA’s trauma care system is how to implement a comprehensive system, faced with the current status of a largely decentralized system. We think this issue seems to narrow down to one of improved facilitation of partnering, and moving beyond regionalization when planning and implementing a statewide system envisioned in NHTSA’s Vision statement.Coming out of some discussions with Johnathan, my partner in crime here, we think the biggest challenge for CA’s trauma care system is how to implement a comprehensive system, faced with the current status of a largely decentralized system. We think this issue seems to narrow down to one of improved facilitation of partnering, and moving beyond regionalization when planning and implementing a statewide system envisioned in NHTSA’s Vision statement.

    5. A significant step in the right direction, and a model of partnership is the relatively recent development of the California Strategic Highway Safety Planning process. A significant step in the right direction, and a model of partnership is the relatively recent development of the California Strategic Highway Safety Planning process.

    6. Strategic Highway Safety Plan How it came to be….. SAFETEA-LU, 23 U.S.C. § 148, established the Highway Safety Improvement Program (HSIP) as a core federal highway program. A Strategic Highway Safety Plan (SHSP) is a major component and requirement of the HSIP. SHSP is a statewide-coordinated safety plan that provides a comprehensive framework for reducing highway fatalities and serious injuries on all public roads. 6 Traffic crashes in California in 2007 accounted for 3967 persons killed and more than 266,000 people seriously injured, with some of the greatest impact on the EMS and Trauma resources. Traffic crashes are the big dog of unintentional injury, both nationally and in California. And as you’ll see, a key component of this plan involved EMS statewide challenges. A bit first about how the SHSP came to be for all States including California. (READ this -6- and -7-) ……SAFETEA-LU or the 5 year congressional surface transportation legislation established in 2004 …… Traffic crashes in California in 2007 accounted for 3967 persons killed and more than 266,000 people seriously injured, with some of the greatest impact on the EMS and Trauma resources. Traffic crashes are the big dog of unintentional injury, both nationally and in California. And as you’ll see, a key component of this plan involved EMS statewide challenges. A bit first about how the SHSP came to be for all States including California. (READ this -6- and -7-) ……SAFETEA-LU or the 5 year congressional surface transportation legislation established in 2004 ……

    7. Strategic Highway Safety Plan How it came to be….. The SHSP is developed by the State DOT in a cooperative process with Local, State, Federal, and private sector safety stakeholders. The SHSP is a data-driven, four to five year comprehensive plan that establishes statewide goals, objectives, and key emphasis areas and integrates the four E's 7

    8. Four E's Engineering Education Enforcement Emergency Medical Services (EMS) 8 Here are the 4 Es of traffic safety just to remind you that EMS plays a key role in stemming traffic safety deaths and reducing the severity of injuries.Here are the 4 Es of traffic safety just to remind you that EMS plays a key role in stemming traffic safety deaths and reducing the severity of injuries.

    9. SHSP Impact on Trauma and EMS Highlights challenges to roadway user safety on California’s streets and highways. Uses data to paint the picture of fatalities experienced on California’s roads. Proposes high level strategies to reduce fatalities for each challenge area. Serves as a guide for the implementation of specific projects and activities through 2010. 9 This is how CA’s SHSP impacts trauma and EMS. It ……. READThis is how CA’s SHSP impacts trauma and EMS. It ……. READ

    10. Impact on Trauma and EMS The California SHSP goal is to achieve less than one roadway fatality per 100 million vehicle miles traveled (VMT). In the year 2010., if current trends in population growth, vehicle use, and travel patterns hold steady, the number of fatalities and injuries will increase. Traffic deaths will grow more than 17 percent to exceed 4,700 per year. Injuries and economic losses will grow at a similar pace. 10 READ First Bullet - I’ve underlined vehicle miles traveled, or VMT, to clarify that this is the current methodology used in traffic safety for setting data measurement goals. Many of you probably know this, but each year the Federal Highway Administration calculates the VMT for the U.S. and the States with a formula based on the number of registered vehicles, the number of total road miles, and the annual fuel consumption. In 2007 in California there were 3967 traffic deaths and the rate for these deaths was 1.18 per 100 million VMT, down from 1.32 per 100 Million VMT in 2005. So although we’re moving in the right direction – achieving a rate of only one death per 100 Million VMT for California by 2010 is still an ambitious goal. READ THE 2nd and the REST So this means increased use of EMS & Trauma resources as well.READ First Bullet - I’ve underlined vehicle miles traveled, or VMT, to clarify that this is the current methodology used in traffic safety for setting data measurement goals. Many of you probably know this, but each year the Federal Highway Administration calculates the VMT for the U.S. and the States with a formula based on the number of registered vehicles, the number of total road miles, and the annual fuel consumption. In 2007 in California there were 3967 traffic deaths and the rate for these deaths was 1.18 per 100 million VMT, down from 1.32 per 100 Million VMT in 2005. So although we’re moving in the right direction – achieving a rate of only one death per 100 Million VMT for California by 2010 is still an ambitious goal. READ THE 2nd and the REST So this means increased use of EMS & Trauma resources as well.

    11. Strategic Highway Safety Plan Current Status of California EMS is Challenge Area 15 and represents improving crash survivability. SHSP Implementation Challenge By 2010, reduce crash-related fatalities in California at least 5 percent from their 2004 level through focused improvements in Emergency Medical Services (EMS) system communications, response, and safety education. 11 READREAD

    12. CA SHSP Challenge Area 15 Strategies: 1. Improve technology for locating crash sites and for improving EMS access routes and response times. 2. Ensure interoperability of communications systems between all responders to crash sites. 3. Improve patient transportation and destination from crash location. 4. Increase availability of appropriate-level trauma centers, with emphasis on rural areas. 12 READREAD

    13. CA SHSP Challenge Area 15 Strategies: 5. Improve access to trauma-related training courses for Emergency Medical Technicians and paramedics. 6. Encourage Emergency Medical Dispatch programs to train dispatchers to assist victims awaiting arrival of EMS. 7. Improve data access to meet the needs of EMS. 8. Increase public access to first aid, cardio pulmonary resuscitation (CPR), and automated external defibrillation training. 13 READREAD

    14. - EMS and Trauma Planning Partners These are the current EMS and Trauma Partner agencies who have representation in the SHSP Challenge Area 15.These are the current EMS and Trauma Partner agencies who have representation in the SHSP Challenge Area 15.

    15. Click It Or Ticket National Law Enforcement Campaign The goal is to get more drivers and passengers to always buckle up every trip, every time. Seat belts save lives: They are the best defense against injuries and fatalities. In 2007 alone, seat belts saved an estimated 15,147 lives. An additional 5,024 lives could have been saved if seat belts were worn at the time of the crashes. One in five Americans still fail to buckle up regularly. Because I’ve been employed by NHTSA up until last month, I wanted to let you know about the agency’s prevention efforts where the DOT thinks it has the best chance of effective short term prevention to save lives and reduce injuries. And it’s through two very visible national campaigns, that you’re no doubt aware of. The first is: READ The… What we’ve learned over the years is that the most likely way to modify driver behavior is to do high visibility advertising about impending law enforcement on an issue, and then follow through on that enforcement for a sustained period. NHTSA spent $8 million this year on national media ads targeting high risk populations on radio and Television – typically for programs you here are less likely to be watching or listening too. (Read some of the target groups if time). And then there’s significant funding by each state’s highway safety office to help pay for law enforcement to conduct overtime for a 2 or 3 week period.Because I’ve been employed by NHTSA up until last month, I wanted to let you know about the agency’s prevention efforts where the DOT thinks it has the best chance of effective short term prevention to save lives and reduce injuries. And it’s through two very visible national campaigns, that you’re no doubt aware of. The first is: READ The… What we’ve learned over the years is that the most likely way to modify driver behavior is to do high visibility advertising about impending law enforcement on an issue, and then follow through on that enforcement for a sustained period. NHTSA spent $8 million this year on national media ads targeting high risk populations on radio and Television – typically for programs you here are less likely to be watching or listening too. (Read some of the target groups if time). And then there’s significant funding by each state’s highway safety office to help pay for law enforcement to conduct overtime for a 2 or 3 week period.

    16. Drunk Driving Over the Limit, Under Arrest National Law Enforcement Campaign Designed to crack down on alcohol impaired drivers August 21 through Labor Day, 2009. Main Points: Impaired Driving Is a Crime and Will Not Be Tolerated. Impaired driving is one of America’s most-often-committed and deadliest crimes. Overall in 2007, nearly 13,000 people were killed in highway crashes involving a driver or motorcycle operator with an illegal blood alcohol concentration (BAC) of 0.08 (80) or higher. The same techniques are applied to the DUI. Over the Limit. Under Arrest. Crackdown campaign. $11 million was spent nationally this year on the media ads for high visibility, and then the state funding went for overtime law enforcement to do what they say they’re going to do in the ads.The same techniques are applied to the DUI. Over the Limit. Under Arrest. Crackdown campaign. $11 million was spent nationally this year on the media ads for high visibility, and then the state funding went for overtime law enforcement to do what they say they’re going to do in the ads.

    17. Alcohol Impaired Motorcycle Riders Alcohol Impaired Motorcycle Riders are a focus of the “DUI. Over the Limit. Under Arrest” Crackdown Nationally, deaths are down, but in the nation and in California, the number of motorcycle fatalities has risen every year for the past 10 years. In California in 2008, 560 motorcyclists died, where there were 489 deaths in 2005 …as a comparison.Nationally, deaths are down, but in the nation and in California, the number of motorcycle fatalities has risen every year for the past 10 years. In California in 2008, 560 motorcyclists died, where there were 489 deaths in 2005 …as a comparison.

    18. Federal Trauma and EMS Funding CDC Federal Block Grant fully funds the CA EMS Authority System Division In 2009, NHTSA provided grant funds for E-911 program under the Ensuring Needed Help Arrives Near Callers Employing 911 (Enhance 911) Act $43.5 Million to states 18 I want to say a little about the federal funding for Trauma and EMS programs. READI want to say a little about the federal funding for Trauma and EMS programs. READ

    19. CA Office of Traffic Safety (OTS) Grants - from NHTSA federal funding - Imperial County Public Health Department’s Local Emergency Medical Services Communications System Plan Grant Period 2003 – 2012 Emergency Medical Services Authority’s Traffic Records improvement, the California EMS Information System (CEMSIS) Update Grant - Period 2007 – 2011 Fresno County Fire Protection District Regional Vehicle Extrication Equipment Request Grant Period 2008 -2009 WWW.OTS.CA.GOV 19 Here in California, the California Office of Traffic Safety provides federally funded grants to a number of EMS agencies each year. READ Bullets Only OTS solicits grant proposals each year, with the applications due in to the OTS by the end of January. If you’d like to learn more about how to apply you can go to their website at www.ots.ca.govHere in California, the California Office of Traffic Safety provides federally funded grants to a number of EMS agencies each year. READ Bullets Only OTS solicits grant proposals each year, with the applications due in to the OTS by the end of January. If you’d like to learn more about how to apply you can go to their website at www.ots.ca.gov

    20. Motor Vehicle Trauma The Prevention Challenge “A historic commitment to wellness initiatives will keep millions of Americans from setting foot in the doctor's office in the first place -- because these are preventable diseases and we're going to invest in prevention.” President Obama (February 2009) 20 Finally…more about prevention: This administration knows that injury is part of the disease model…. and current efforts to forge a health reform package include the proposals for strong prevention initiatives. A number of advocates are working hard to bring this about, including the Prevention Institute where I currently consult.Finally…more about prevention: This administration knows that injury is part of the disease model…. and current efforts to forge a health reform package include the proposals for strong prevention initiatives. A number of advocates are working hard to bring this about, including the Prevention Institute where I currently consult.

    21. The Future “One of my goals as Chairman of the Committee on Transportation and Infrastructure is to create a new model for surface transportation, one that invests in alternative modes and promotes active, healthy lifestyles.” James Oberstar, Chairman, Transportation and Infrastructure Committee, United States House of Representatives 21 The newest thinking about this correlates injury prevention and good urban planning that promotes healthy lifestyles as a part of the effort to address childhood and adult obesity and the related health problems. It is thinking more holistically about how we approach health care. Congressman Oberstar, Chair of the House Transportation Committee has been a leader in this thinking.The newest thinking about this correlates injury prevention and good urban planning that promotes healthy lifestyles as a part of the effort to address childhood and adult obesity and the related health problems. It is thinking more holistically about how we approach health care. Congressman Oberstar, Chair of the House Transportation Committee has been a leader in this thinking.

    22. Transportation Prescription Bold new ideas for healthy, equitable transportation reform in America …….. A report commissioned and funded by the Convergence Partnership including: The California Endowment Kaiser Permanente Health System The Kresge Foundation The Nemours Health System The Robert Wood Johnson Foundation W. K. Kellogg Foundation - Technical advisor: The Centers for Disease Control and Prevention 22 To give you an idea about what kind of thinking is going into the next reauthorization of the transportation act, part of this effort is the development of an important report – the Transportation Prescription. This is a report of new ideas for healthy, equitable transportation reform in America. It’s a report commissioned… READTo give you an idea about what kind of thinking is going into the next reauthorization of the transportation act, part of this effort is the development of an important report – the Transportation Prescription. This is a report of new ideas for healthy, equitable transportation reform in America. It’s a report commissioned… READ

    23. Transportation Prescription Developed By The Prevention Institute Putting prevention and equitable health outcomes at the center of community well- being. The Policy Link A national research and action institute advancing social and economic equity. 23 READREAD

    24. The Challenge Implementing a comprehensive trauma care system in California – the focus: Trauma Registry Interoperability of the system Federal, state, public, and private partnership - Regionalized approach to care Thinking and acting towards prevention So let me end with your Challenge to develop a comprehensive trauma care system in California. And what I believe the focus should be includes…. READ bullets. Thank you.So let me end with your Challenge to develop a comprehensive trauma care system in California. And what I believe the focus should be includes…. READ bullets. Thank you.

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