Regional Trauma Plan

OVERVIEW OF WISCONSIN TRAUMA SYSTEM

Wisconsin's Trauma Care System is located in the Bureau of Communicable Disease and Emergency Response (BCDER) in the Division of Public Health, Department of Health Services. Chapter 118 (PDF, 65 KB) provides the authority for the Department of Health Services to develop and implement a statewide trauma care system. The departmental lead for the program is the State Trauma Coordinator.

In July of 2009, the Department of Health Services (DHS) restructured several program areas in an effort to improve the coordination and communication across program areas with common interests or populations. Placement of these program areas within the same bureau facilitates integrated grant funding and planning. It is designed to promote synergy with program integration and collaboration related to the daily management of injured patients, disaster, mass casualty, and surge capacity planning.

As a result of the reorganization, the Trauma Care System, Emergency Medical Services (EMS), Emergency Medical Services for Children (EMSC) and Public and Hospital Preparedness programs were strategically located within the Department of Health Services (DHS), Division of Public Health (DPH), in the Bureau of Communicable Disease and Emergency Response (BCDER).

A Regional Trauma Advisory Council is an organized group of healthcare entities and other concerned individuals who have an interest in organizing and improving trauma care within a specified region. It serves as the unifying foundation to bring together all local, county, regional, state, federal and other agencies, for the planning, education, training and prevention efforts needed to assure the exemplary care needed pre, acute and post injury. The primary purpose of an RTAC is to design, implement and evaluate a trauma system within a region that is data-based, confidential and sensitive to the needs and limitations of each regional area.

The purpose of a Regional Trauma Advisory Council is to develop, implement, monitor and improve the regional trauma system. The functions and responsibility of the RTAC are delineated in DHS 118.06. RTAC programming efforts are funded through state tax dollars (GPR) by the State Trauma Program through Appropriation 101. This document also serves as Exhibit I to the 2016-2017 RTAC Contract.

NEWRTAC MISSION STATEMENT
The North East Wisconsin RTAC is dedicated to designing, implementing, and evaluating a regional trauma system that is data-based, confidential, and sensitive to the needs, limitations, and resources of this area. Our focus is on injury prevention, reducing the severity of injuries, and decreasing the number of deaths. Our objective is to optimize the quality of care and outcomes for all trauma patients. The patient is the focus of this organization. We also believe that education of trauma providers on all levels is essential

SYSTEM ACCESS
Suggestions for initial Objectives of System Access Component:

Identify all EMS and First Responders in each county
Identify what areas each EMS and First Responder agency provides services for
Identify mutual aid agreement that EMS may have with other areas
Identify backup or emergency systems
Consider public education regarding resources and accessing help

STRENGTHS: County EMS Meetings, RTAC (EMS/Hospital relations; Regional Coordination; NWTC (Educational facility), NEW HERC
WEAKNESSES: First responder system; Cost of programs; Funding Source
OPPORTUNITIES: NEW HERC, Grants
THREATHS: Funding-State/Federal; Aging workforce; Volunteerism

COMMUNICATION
Suggestions for initial Objectives of the Communications Component:

Review dispatch procedures, dispatch training, response time and communication devices used in each county
List the communication devices, operating frequencies, and the effective range of each device used by EMS services and facilities
List how two-way communication occurs between each EMS service and each receiving facility in the region
List all EMS, Aeromedical and First Responder services’ frequencies, helicopter transport services and hospitals within the RTAC
Identify dispatch call priority policies

STRENGTHS: MABAS system; WITRAC (Hospital/EMS); NEW RTAC
WEAKNESS: Radio changes; Hospital/EMS communication (follow-up, WARDS)
OPPORTUNITIES: Equipment become uniform; EMR/Pt. tracking; Dispatch EMD; after case follow-up (HIPAA)
THREATHS: Radio changes; equipment funding

MEDICAL OVERSIGHT
Suggestions for initial objectives of the Medical oversight Component:

Identify all EMS Medical Directors in the region with addresses, phone numbers and the agencies they provide services for in the RTAC
Review and/or develop regional protocols in use throughout the region
Review and/or develop regional protocols for alerting and activating helicopters in the region.

Currently not utilized at RTAC level. Completed at the County EMS level with EMS Councils. HERC and RTAC coordinators attend regularly.

DATA/PERFORMANCE IMPROVEMENT
Suggestions for initial objectives of the PI Component;

Determine process for reviewing data filters and specific occurrences as they arise (peer review)- have clearly stated goals and objectives
Develop feedback loop to all regional stakeholders
Improve communication, education, and quality of care for all trauma patients
Improve quality of care for the trauma patients in the RTAC

STRENGTHS: STEMI/ CVA programs; WARDS/State
WEAKNESS: HIPAA; Follow up contacts; Access to data; quality of data
OPPORTUNITIES: After care follow up; RTAC coordinator requesting access to WARDS and State Registry; EMS office with Chuck; RTAC chart reviews
THREATHS: Turnover of the trauma Registers

EDUCATION
Suggestions for initial objectives of the Education Component;

Determine educational offerings to pre-hospital agencies and hospitals for the year
Develop a tool to evaluate effectiveness of educational offerings
Explore options for lay public educational offerings regarding the trauma system

STRENGTHS: Regional programs (Active Shooter, WITrac, Falls)
WEAKNESS: Funding source
OPPORTUNITIES: Agencies that do not participate.
THREATHS: none

INJURY PREVENTIONSuggestions for initial Objectives of the Injury Prevention Component:

Determine Injury Prevention programs within the RTAC for the year
1. Address the burden of falls in the region.
2. Offer Stepping On Course and closely collaborate with the EMS Providers within the county
Develop a tool to evaluate the effectiveness of Injury Prevention offerings
1. Stepping On is an evidence based course so it has been proven to be effective
2. In terms of evaluating the effectiveness of program and collaboration with EMS Providers and education, this will be done using data collection through DHS as well as regional trauma registry.

Injury Prevention
STRENGTHS: ADRC (Brown County); Safe Kids (Car seat, Adolescent program)
WEAKNESS: ADRC communication between counties; Minimal involvement from hospitals in the Safe Kids program
OPPORTUNITIES: ADRC other counties involvement
THREATHS: Funding Source

2016-2017 Statewide RTAC Objectives/Strategies

The purpose of a Regional Trauma Advisory Council is to develop, implement, monitor and improve the regional trauma system. The functions and responsibility of the RTAC are delineated in DHS 118.06. RTAC programming efforts are funded through state tax dollars (GPR) by the State Trauma Program through Appropriation 101. This document also serves as Exhibit I to the 2016-2017 RTAC Contract.

Objective/Strategy Supporting Documentation Measure(s) of Success Contract Completion

1. Maintain RTAC infrastructure in a manner that supports participation by all representative members and is consistent with DHS 118.06.

This objective is intended to demonstrate compliance with the Administrative Rule for the Trauma Care System related to the structure of the RTAC.

Meetings are held at least 4 times per year. There is an Executive Council, a fiscal agent, a coordinating facility, etc. Agendas and minutes are communicated in a timely manner (ie, posted on RTAC web site, or by email, etc). An archived copy is maintained by the RTAC.

RTAC minutes provide the supporting documentation of the presence of an Executive Council, regular meetings (a minimum of 4 per fiscal year/contract) and that the membership is consistent with DHS 118.06. Target for contract completion is 100% compliance.

2. RTAC reviews regional trauma registry data collected under DHS 118.09.

This objective is intended to demonstrate the intent for compliance with the Administrative Rules for the Trauma Care System found in DHS 118.06 and 118.10.

Hospitals in the RTAC review and submit data to the Trauma Registry.

Evidence that Regional data is being reviewed and used will be demonstrated through identified process improvement and injury prevention projects. This will be documented in the RTAC minutes. Target for contract completion is 100% compliance.

3. RTAC has a functional Performance Improvement Program.

This objective is intended to demonstrate the effort to meet the intent for compliance with the Administrative Rules for the Trauma Care System found in DHS 118.06 and 118.10. The objective is to work through the PI process on a trauma related issue/concern and working towards loop closure.

RTAC minutes or subcommittee minutes provide documentation related to a performance improvement process/activity for at least one specific issue or process within the region. Project accomplishments will be presented in a report to the region. Target for contract completion is 100% compliance.

4. Develop and Revise Regional Trauma Plan

This objective is intended to demonstrate compliance with the Administrative Rule for the Trauma Care System DHS 118.06 (3)(L)2.

RTAC minutes provide the supporting documentation of the discussion or revision of the Regional Trauma Plan. The Plan will be filed with the state and updated annually. Target for contract completion is 100% compliance.

5. RTAC maintains/supports injury prevention related education and training in the region (may include hospitals and other organizations).

This objective is intended to demonstrate compliance with the Administrative Rule for the Trauma Care System DHS 118.06 (3)(k).

Injury prevention offerings and information is discussed at RTAC meetings.

RTAC minutes provide the supporting documentation of the presence of information sharing related to injury prevention activities in the region. Target for contract completion is 100% compliance.

6. RTAC participates in the regional Healthcare Coalition RTAC and HCC minutes provide documentation of RTAC participation in HCC activities.

Wisconsin DHS 118