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Seeking Legislative Change for Ohio’s Trauma System

Seeking Legislative Change for Ohio’s Trauma System. Why?. Growing understanding that current system has not resulted in hoped for improvement in outcomes and the widespread belief in the trauma community that we can do better. Why Now?.

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Seeking Legislative Change for Ohio’s Trauma System

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  1. Seeking Legislative Change for Ohio’s Trauma System

  2. Why? • Growing understanding that current system has not resulted in hoped for improvement in outcomes and the widespread belief in the trauma community that we can do better

  3. Why Now? • Interested Party meeting on merging EMS and Medical Transportation Boards • Trauma representatives objected to the proposal because of loss of what was already thought to be inadequate representation on the EMS Board to accomplish necessary changes in trauma system • An “Ah Ha” moment for the legislators and governor’s representative • Trauma had just been “stuck onto” EMS Board by prior legislation • Didn’t really fit EMS Board’s primary mission • Opinion corroborated by many of the other attendees • Hampered the improvement in the trauma system • Senator Widener and Scott Blake requested that Jon Saxe and I bring recommendations for new legislation to them

  4. Process • Meeting Monday, February 18, 2013 in Columbus • Trauma experts from around state – including pediatric, nursing, and EMS representation • Utilized the last several years of work – Trauma Framework, NHTSA report, Erskine’s Strategies and Indicators Document, etc. • Developed some broad ideas that we are now vetting with some of the major stakeholders prior to sharing with the governor’s office and legislators • EMS Board and leadership of ODPS are KEY STAKEHOLDERS!!!!

  5. Legislative RecommendationsStructural • Separate Trauma Committee from EMS Board and create “Trauma Board” as the Lead Trauma Agency • Remain in ODPS • Hire state trauma medical director and state trauma nurse manager • One of major defects in current system is that there is no “effector” arm • These two individuals’ primary job responsibility would be to effect changes

  6. Legislative RecommendationsStructural II • Create a stable, sustainable budget for Trauma

  7. Legislative RecommendationsResponsibilities • Trauma Center Designation (as opposed to just Verification) • Rule making ability for trauma system-related issues (similar to EMS Board’s rule making ability for EMS-related issues) • Develop an inclusive trauma system that recognizes non-trauma centers’ participation and activity • Oversight, development, management of state trauma registry and state trauma rehabilitation registry

  8. Legislative RecommendationsResponsibilities II • Perform periodic trauma system needs assessment AND act on identified deficiencies • Regular reports on the status of the trauma system • Funding for trauma systems research, similar to EMS Board grant system • Develop a panel of trauma surgeon experts who can assist with the development of trauma-related research for EMS

  9. Critical Issues • Maintain close ties to EMS Board • 2 seats on Trauma Board would be set aside for EMS Board members (and vice versa?) • Maintain collaborative relationship with ODH as much of Injury Prevention lies within ODH • Seat on Trauma Board set aside for ODH appointee • Maintain collaborative relationship with OHA • Seat on Trauma Board set aside of OHA appointee

  10. Recommended Trauma Board Composition

  11. Time Critical Diagnosis • Group that met Monday was hesitant to take that on • Little knowledge of stroke and STEMI needs • Changes with Trauma were thought to be big enough to deal with without anything else • HOWEVER, there is a move afoot to bundle trauma, stroke and STEMI together as TCD • Creating a structure would be fairly simple • Trauma Board to become TCD Board • Need to change composition and add stroke and STEMI representatives • Create 3 subcommittees – Trauma, Stroke, STEMI

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