California
Trauma Care System Requirements.
22 CCR 100139.01
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22 CCR 100139.01
22 CCR 100139.01
ยง 100139.01. Trauma Care System Requirements.
(a)
A local EMS agency (LEMSA) may develop and implement a trauma care system.
(b)
Plan Requirement. A LEMSA that is implementing a new trauma care system program must develop a trauma care system plan in accordance with Section 100139.03 of this article and submit the plan to the Emergency Medical Services Authority (EMSA) for approval prior to implementation. For an EMSA-approved trauma care system, the LEMSA shall annually submit a trauma system status report in accordance with Section 100139.04 of this article. Each trauma care system plan and trauma system status report shall, at a minimum, comply with the provisions of Division 2.5 of the Health and Safety Code and the requirements set forth in this chapter. A LEMSA may establish additional requirements in addition to those mandated by statute and state minimum standards.
(c)
Planning Responsibilities. For the development, implementation, and ongoing evaluation of its trauma care system plan under this subchapter, the LEMSA is responsible for, at a minimum:
(1)
System Design Justification. A data-informed justification for the proposed trauma care system. The justification shall include an assessment of trauma system needs using LEMSA-defined measures of access to care, quality of patient care, outcomes, mortality rates, and system efficiency. The needs assessment shall incorporate, at a minimum, the following American College of Surgeons-recommended performance indicators to support its trauma system design:
(A)
Number of Level I and Level II trauma centers per 1,000,000 population;
(B)
Percentage of population within sixty (60) minutes of a Level I or Level II trauma center;
(C)
EMS transport times;
(D)
Percentage of severely injured patients who are treated at a trauma center;
(E)
Trauma-related mortality rate within the jurisdiction;
(F)
Frequency and nature of interhospital transfers (re-triage of trauma patients);
(G)
Percentage of time trauma centers are on diversion status.
(2)
Trauma Care Committee. Establishing a trauma care committee, as set forth in Section 100139.02 of this article.
(3)
Program Objectives. Determine trauma care system goals and objectives.
(4)
Designation and Oversight. Designate and review trauma centers, pediatric trauma receiving centers, and trauma receiving hospitals in accordance with Articles 4 and 5 of this subchapter.
(5)
Capabilities.
(A)
Base Hospital Designation. Designating base hospital(s) within the trauma care system, if applicable.
(B)
Helicopter Landing Sites. If necessary, requiring trauma centers to have helicopter landing sites. Any helicopter landing site shall be approved by the Division of Aeronautics, Department of Transportation, pursuant to Title 21, California Code of Regulations, Division 2.5.
(C)
Communications. Ensuring trauma patient transport vehicles are equipped with two-way telecommunications equipment capable of communicating with hospitals, in accordance with its local communication policies.
(D)
Transport Resources. Ensuring sufficient transport resources to transport trauma patients to an appropriate level trauma center, including air transport and re-triage plans.
(E)
Personnel Training. Ensuring that all prehospital emergency medical care personnel rendering trauma patient care within the trauma care system are trained in the local trauma triage and patient care policies and procedures.
(6)
Policies. Developing and implementing policies, procedures and protocols for the treatment and transport of trauma patients. This shall include, at a minimum:
(A)
Prehospital Trauma Care Requirements. A local field trauma triage policy. The policy shall require early notification from EMS providers to trauma centers, pediatric trauma receiving centers, and trauma receiving hospitals regarding the impending arrival of a trauma patient.
(B)
Patient Destination. Destination policies of adult and pediatric trauma patients.
(C)
Re-triage. EMS system policies and procedures designed to expedite and optimize the re-triage of trauma patients from non-trauma centers or lower-level of care trauma-designated hospitals to higher-level of care trauma centers, pediatric trauma receiving centers, or trauma receiving hospitals, when clinically appropriate. Re-triage policies shall be developed and implemented in collaboration with general acute care hospitals (GACHs) and EMS providers.
(7)
System Coordination Agreements. Developing and implementing agreements necessary for the coordinated treatment and transport of trauma patients within the trauma care system and region, including:
(A)
Coordination with Neighboring Local EMS Systems.
(B)
Designated Trauma Center Agreements.
(C)
Inter-LEMSA Agreements.
(8)
Disaster Preparedness. Incorporating the trauma care system and its designated trauma centers, pediatric trauma receiving centers, and trauma-receiving hospitals into its regional disaster preparedness/response plans for adults and children.
(9)
Public Education and Outreach. Implement programs for promoting public education specific to trauma care, including injury prevention.
(10)
Financial Transparency. Collecting and reporting any fees collected from trauma centers, pediatric trauma receiving centers, and trauma-receiving hospitals in accordance with Section 1798.164, subdivision (b) of the of Health and Safety Code.
(11)
Data Collection, Quality Improvement, and Evaluation. Collecting and reporting trauma patient care data, establishing and maintaining a QI process, and performing trauma care system evaluation in accordance with Article 5 of this subchapter.
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