Kentucky Trauma Symposium Lexington Kentucky November 11 2010 Andrew Bernard MD Chair Kentucky Trauma Advisory Committee Objectives Trauma system overview Kentucky Trauma Registry ID: 363848
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Kentucky Trauma Registry
Kentucky Trauma SymposiumLexington, Kentucky November 11, 2010
Andrew Bernard, M.D.
Chair, Kentucky Trauma Advisory CommitteeSlide2
ObjectivesTrauma system overview
Kentucky Trauma RegistryPotential usesSlide3
Rural Trauma is DEADLY
Rural /Urban: death risk 15:1MVC deaths inversely to population density Preventable deaths 30% higher if ruralSlide4Slide5
Trauma System Components
Verified Trauma CentersTraining- EMT’s, nurses, and doctorsProtocols
-EMS & hospital treatment & transport Data collection and surveillance
Performance Improvement (PI)Injury prevention
Trauma
system legislation in 2008.Slide6
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4Slide7
ED Length of StayMarcum and Wallace Slide8
Kentucky’s 1st Level 4 Trauma Center Verification Visit
September 13, 2010; Marcum and Wallace Memorial Hospital, IrvineSlide9
September 13, 2010; Marcum and Wallace Memorial Hospital, Irvine
Verification Team
Lisa
Fryman, RNDick Bartlett, KHAJ.D. RichardsonAndrew BernardSlide10
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.eduSlide11
Kentucky Trauma RegistrySlide12Slide13
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………Slide14Slide15Slide16Slide17
CDM
“TraumaBase”
Kentucky Trauma Database
KIPRC
Injury Dashboard
Performance Improvement
Education
Injury PreventionSlide18
Julia
CostichKIPRCCollege of Public HealthEddie NapierKIPRCKentucky Trauma RegistrarSlide19
Kentucky Registry Report 9-21-10Slide20
First Report13423 records from 2008 and 2009
5 basic questions initially investigated:patients moving up the system – evidence of 'right patient, right place, right time’ED discharge characteristicsoverview of data from new level 4’sIn/out-of-state movementduration in referring facility vs. community hospitalSlide21
Items InvestigatedICD9 (diagnosis) and AIS distributionsmortality rate
time spent in hospitaltotal time prior to hospitalizationage (> 55, <15) influencespre-hospital transport (Ambulance or Helicopter) characteristicsmechanism of injuryCounty of residence compared to county of injuryhypotension in the EDED disposition to OR or ICUSlide22
Conclusions-First Report
Appropriate movement in some patient groups.Evidence of the impact that hypotension plays in mortality. Apparent reduction in mortality for certain diagnoses for patients transferred in.Slide23
Who should be contributing to the registry?Slide24
Kentucky EMS Information System (KEMSIS)New software being implemented
Testing 1Q or 2Q 2011 A few agencies to test the system Then expandkemsis@KCTCS.eduSlide25Slide26Slide27Slide28
How can the registry help me?Local PIEMS
HospitalRegional PILeverage revenue and fundingPublic education/media/marketingFocus your prevention effortsResearchSlide29
How can I help the registry?Trauma centers: legislatedNon-trauma hospitals:
External force ICD 9 codes ‘e-codes’800-999EMS: prepare for KEMSISSlide30
ConclusionsTrauma systems save lives
Hospitals, EMS, protocols, data, training, PIKentucky has a trauma outcome problemRuralImmature systemYou are the answerWe need complete, accurate dataWe need to ask questionsSlide31
ThanksTAC membersLisa
Fryman, UK Trauma CoordinatorSlide32
Thanks
Dick Bartlett, KHASlide33
Andrew BernardChair, KY TAC (Trauma Advisory Committee)
acbern00@uky.edu859-913-3613 cell