Post on 18-Dec-2015
transcript
Kentucky Trauma Registry
Kentucky Trauma SymposiumLexington, Kentucky November 11, 2010
Andrew Bernard, M.D.Chair, Kentucky Trauma Advisory Committee
Rural Trauma is DEADLY
• Rural /Urban: death risk 15:1
• MVC deaths inversely to population density
• Preventable deaths 30% higher if rural
Trauma System Components
• Verified Trauma Centers• Training- EMT’s, nurses, and doctors• Protocols-EMS & hospital treatment & transport • Data collection and surveillance• Performance Improvement (PI)• Injury prevention
Trauma system legislation in 2008.
Kentucky’s 1st Level 4 Trauma Center Verification Visit
September 13, 2010; Marcum and Wallace Memorial Hospital, Irvine
September 13, 2010; Marcum and Wallace Memorial Hospital, Irvine
Verification TeamLisa Fryman, RNDick Bartlett, KHAJ.D. RichardsonAndrew Bernard
Kentucky Trauma Advisory Committee Membership (18 Members)
Member Representing Organization Phone Email
Bill Barnes KMA Livingston Hospital 270-988-3298 wbarnes@tririvershc.com
Dick Bartlett KHA KHA 502-992-4305 Rbartlett@kyha.com
Andrew Bernard ACS, KY COT UK 859-323-6346 acbern00@email.uky.edu
Mary Fallat Pediatric Trauma Pediatric Surgery, UofL 502-629-8638 mary.fallat@louisville.edu
Terence Farrell Level II (Seeking) Pikeville Medical Center 606-218-3944 terence.farrell@pikevillehospital.org
Glen Franklin Level I (UofL) UofL 502-852-1895 glen.franklin@louisville.edu
Lisa Fryman Level I (UK) UK 859-257-1231 lisa.fryman@uky.edu
Linda Gayheart At Large Citizen, Hindman 606-785-0606 gayheart@tvscable.com
Chuck Geveden Transportation Cabinet Office of Highway Safety 502-564-3730 chuck.geveden@ky.gov
William Hacker KY Dept of Public Health Commissioner of Health 502-564-3970 WilliamD.Hacker@ky.gov
Sharon Mercer KY Board of Nursing KBN 502-429-3307 sharone.mercer@ky.gov
Earl Motzer Level IV (Seeking) James B Haggin Hospital 859-734-5441 emotzer@hagginhosp.org
Bob Hammonds KY Board of EMS KBEMS 859-256-3181 Bob.hammonds@kctcs.edu
Charlotte O’Neal KY Emergency Nurses Association Frankfort Reg Med Ctr 502-226-7992 Charlotte.O'Neal@HCAHealthcare.com
Chris Pund KY Am Coll of Emerg Physicians Marshall Emerg Serv Assoc 859-335-9041 cpund@mesaer.com
Russell Travis KY Board of Medical Licensure KBML 859-224-2006 htravis@mac.com
Carol Wright Level III (Taylor Regional) Taylor Regional Medical Ctr 270-932-2221 cmwright@trhosp.org
Julia Costich KY Injury Prevention/Research Ctr KIPRC 859-218-2026 jfcost0@email.uky.edu
EMS Data Can Answer:
• Where did it occur?• How?• Who responded?• Who transported?• Where?• What happened in route?• Were the decisions/actions correct?• What was disposition? In state? Out? • Much more………
CDM“TraumaBase”
Kentucky
Trauma
DatabaseKIPRC
1. Injury Dashboard2. Performance Improvement3. Education4. Injury Prevention
First Report• 13423 records from 2008 and 2009 • 5 basic questions initially investigated:
1. patients moving up the system – evidence of 'right patient, right place, right time’
2. ED discharge characteristics
3. overview of data from new level 4’s
4. In/out-of-state movement
5. duration in referring facility vs. community hospital
Items Investigated
• ICD9 (diagnosis) and AIS distributions• mortality rate• time spent in hospital• total time prior to hospitalization• age (> 55, <15) influences• pre-hospital transport (Ambulance or Helicopter)
characteristics• mechanism of injury• County of residence compared to county of injury• hypotension in the ED• ED disposition to OR or ICU
Conclusions-First Report
1. Appropriate movement in some patient groups.
2. Evidence of the impact that hypotension plays in mortality.
3. Apparent reduction in mortality for certain diagnoses for patients transferred in.
Kentucky EMS Information System (KEMSIS)
• New software being implemented• Testing 1Q or 2Q 2011 • A few agencies to test the system • Then expand• kemsis@KCTCS.edu
How can the registry help me?
• Local PI– EMS– Hospital
• Regional PI• Leverage revenue and funding• Public education/media/marketing• Focus your prevention efforts• Research
How can I help the registry?
• Trauma centers: legislated• Non-trauma hospitals:
– External force ICD 9 codes – ‘e-codes’– 800-999
• EMS: prepare for KEMSIS
Conclusions
• Trauma systems save lives• Hospitals, EMS, protocols, data, training, PI• Kentucky has a trauma outcome problem
– Rural– Immature system
• You are the answer• We need complete, accurate data• We need to ask questions