American College of Surgeons Trauma

American College of Surgeons

An independent seven-member team of the American College of Surgeons (ACS) Committee on Trauma (COT) has concluded its external review of Floridas current trauma system. The four-day assessment was organized to provide the Florida Department of Health (DOH) with recommendations to improve Florida's trauma system. Individuals who participated on this assessment team had no relationship with Florida by birth, education and training, or employment.

"This ACS site visit represents a milestone in Florida's Trauma System development. For more than five years, the trauma community has been asking for this systems consultation, and now, the Department has delivered," said State Surgeon General and Secretary of Health Dr. John Armstrong. "It is time for the trauma community to come together and use these recommendations to make Florida's trauma system even better. The people of Florida need a trauma system that is inclusive, sustainable and focused on safe, effective, and efficient care for injured patients in Florida."

"Make peace," said Robert J. Winchell, MD, FACS, Team Leader, who reminded stakeholders to find ways to collaboratively develop the system. The systems consultation team identified 18 preliminary key recommendations, including the following:

Convene a small, multi-disciplinary work group to analyze all existing statutes and regulations pertaining to the trauma system

Establish a transparent, broadly accepted process for initial full designation and ongoing re-designation of trauma centers based upon system participation, center performance, and participation in quality improvement programs

Require that all acute care facilities participate in the inclusive and integrated trauma system as a condition of licensure.

Evaluate the content, implementation, and method of enforcement of trauma transport protocols (TTPs) to assure uniformity and efficiency of patient flow both within trauma regions as well as statewide

Collaborate with the Florida Department of Transportation, Highway Safety Office to initiate and conduct a National Highway Traffic Safety EMS Reassessment

The committee identified several assets in the current system including long-standing legislative support, substantial funding and committed Department leadership. A final report from the systems consultation team is expected to be released in early March. Below is the PowerPoint presentation and the listing of key recommendations.

Florida Exit Presentation
Text Equivalent of Presentation
ACS Participant Evaluation
ACS Key Recommendations

American College of Surgeons (ACS) Questionnaire

TABLE OF CONTENTS

Tab 1	Introduction List of Acronyms
Tab2	Florida Demographics Florida Quick Facts Trauma TSA Chart
Tab 3	Florida Trauma System Historical Overview Florida Trauma System Historical Overview Trauma TSA Chart Florida Trauma System by Trauma Service Area
Tab 4	Florida Trauma System Accomplishments and Outcomes 2006-2011
Tab 5	Florida Trauma Systems American College of Surgeons Consultation Visit Pre-Review Questionnaire and Responses
	Section 1 Assessment	Page
	Injury Epidemiology	1
	Indicators as a Tool for System Assessment	6
	Section 2 Policy Development
	Statutory Authority and Administrative Rules	8
	System Leadership	11
	Coalition Building and Community Support	17
	Lead Agency and Human Resources within the Lead Agency	18
	Trauma System Plan	21
	System Integration	22
	Financing	23
	Section 3 Trauma System Assurance
	Prevention and Outreach	25
	Emergency Medical Services	27
	Definitive Care Facilities	30
	System Coordination and Patient Flow	40
	Rehabilitation	42
	Disaster Preparedness	44
	System-wide Evaluation and Quality Assurance	49
	Trauma Management Information Systems	51
	Research	57

APPENDICES

Tab 6	Florida and US Top Leading Causes of Death Charts
Tab 7	2005 Comprehensive Assessment of the Florida Trauma System 2005 Comprehensive Assessment of the Florida Trauma System - Appendices
Tab 8	2011-2015 Florida Trauma System Strategic Plan
Tab 9	Trauma System Statutes and Regulations
Tab 10	EMS Statutes and Regulations
Tab 11	Injury Prevention Statutes and Regulations
Tab 12	Creation Document of the Former Florida Trauma System Plan Advisory Committee (2009-2011)
Tab 13	Creation Document of the Former Florida Trauma System Plan Advisory Committee (2012-2015)
Tab 14	Florida Trauma System Organizational Structure Overview and Responsibilities Charts
Tab 15	Emergency Medical Services (EMS) Advisory Council
Tab 16	Florida Injury Prevention Advisory Council
Tab 17	Brain and Spinal Cord Injury Advisory Council
Tab 18	Injury Prevention Constituent Group
Tab 19	Division/Bureau/Trauma Program Tables of Organization
Tab 20	FY 2011-2012 Trauma Registry Annual Report
Tab 21	2011 Trauma Service Area Analysis and Appendices 2011 Trauma Service Area Analysis and Appendices - Part A 2011 Trauma Service Area Analysis and Appendices - Part B 2011 Trauma Service Area Analysis and Appendices - Part C 2011 Trauma Service Area Analysis and Appendices - Part A 2011 Trauma Service Area Analysis and Appendices - Part E 2011 Trauma Service Area Analysis and Appendices - Part F 2011 Trauma Service Area Analysis and Appendices - Part G 2011 Trauma Service Area Analysis and Appendices - Part H 2011 Trauma Service Area Analysis and Appendices - Part I 2011 Trauma Service Area Analysis and Appendices - Part J 2011 Trauma Service Area Analysis and Appendices - Part K
Tab 22	Florida Trauma System Organizational Structure Overview and Responsibilities Charts
Tab 23	Job Description and Resumes or CV of the following trauma system leadership positions: Victor Johnson, Director, Division of Emergency Preparedness and Community Support John Bixler, RN, BSN, Section Administrator, Emergency Medical Services Vacant, Bureau Chief, Emergency Medical Oversight Joe Nelson, DO, Emergency Medical Services Director Lisa VanderWerf-Hourigan, M.S., Interim Trauma Program Director Karanbir Gill, M.D., FACS, State Trauma Medical Director Janet Collins, Program Administrator Contract Management Consultant Government Analyst Project Analyst Project Analyst
Tab 24	TBI-SCI Rehabilitation Standards (Adult) TBI-SCI Rehabilitation Standards (Pediatric)
Tab 25	Ventilator-Dependent Rehabilitation Standards (Diaphragmatic Pacer)
Tab 26	Trauma Systems Payout by Centers
Tab 27	Recent Trauma System Financial Report GGA Report Trauma Budget FY 2012-Ver. 5
Tab 28	Inventory of Injury Prevention Activities, Projects, and Programs Conducted by Florida's Verified Trauma and Burn Centers
Tab 29	OPPAGA Report, April 2003
Tab 30	Florida Trauma Transport Protocol Manual December 2004
Tab 31	Adult Trauma Scorecard Methodology incorporated by reference in Rule 64J-2-004
Tab 32	Pediatric Trauma Scorecard Methodology incorporated by reference in Rule 64J-2-005
Tab 33	Inter-facility Transfer Guidelines
Tab 34	Florida Hospital, Trauma Centers, and Aeromedical Resources Map
Tab 35	State Designated Acute Care and Rehabilitation Centers and List
Tab 36	Trauma Center Standards Overview
Tab 37	Trauma Center Standards, DH Pamphlet 150-9
Tab 38	Includes the list of acute care hospitals, bed capacity, and other information regarding licensure as an acute care hospital with AHCA
Tab 39	Emergency department visits and discharge chart includes all hospitals (not just the acute care facilities) and odes not contain the ISS. Additionally, patients are traced by discharge date rather than admissions
Tab 41	Enhancing the Traumatic Brain Injury System of Care (Strategic Plan)
Tab 42	BSCIP Designated Facilities Map
Tab 43	Acute Care Nursing Standards
Tab 44	Adult and Pediatric Inpatient Rehabilitation Standards
Tab 45	Adult Care Standards
Tab 46	Acute Care Psychology Standards
Tab 47	Rehabilitation Centers and their CARF Accreditation Status-Adult Rehabilitation Centers and their CARF Accreditation Status-Pediatric
Tab 48	After Action Report
Tab 49	Emergency Rooms and Trauma Centers Connected to the FETTN
Tab 50	SEOC/ESF Org Chart from CEMP
Tab 51	ESF8 Org Chart
Tab 52	ESF8 Core Mission Matrix (CEMP ESF8 Appendix) noting supporting agencies Agency's Role in Carrying out Mission ESF8 Incident Management Team Org Chart SEOC/ICS and ESF Integration
Tab 53	Trauma Registry Data Release Policy and Procedures
Tab 54	2009-2013 Florida Injury Prevention Strategic Plan
Tab 55	Florida Emergency Medical Services Strategic Plan July 2012-June 2014
Tab 56	2011 Trauma Center Research Report and Florida Trauma System Research and Data Report March 2008
Tab 57	Florida Public Health and Healthcare Preparedness 2012-2014 Strategic Plan

Onsite Documentation Provided to the ACS:

Coalition Building and Community Support

Definitive Care Facilities

Disaster Preparedness

Emergency Medical Services

Financing

Indicators as a Tool for System Assessment

Injury Epidemiology

State Technical Assessments Team Recommendations for DOH Office of Injury Prevention

Participant Presentations and Documentation

Systems Consultation PowerPoint Presentation Feb. 2, 2013

Text Equivalent of Systems Consultation PowerPoint Presentation Feb. 2, 2013

Prevention and Outreach

Rehabilitation

Research

Statutory Authority and Administrative Rules

System Coordination and Patient Flow

System Leadership

System-wide Evaluation and Quality Assurance

Trauma Management Information System

Trauma System Plan