The Central RTCC

1
The Central RTCC

• James W. Davis MD, FACS
• Chief of Trauma, CRMC
• Professor of Clinical Surgery UCSF/Fresno

2
The Credit Belongs to Everyone

• Some deserve special recognition
• Lynn Bennink CRMC Fresno
• Linda Diaz Merced EMS
• Debbie Becker Fresno EMS
• Chuck Baucom Merced EMS
• Clarence Teem Tuolumne EMS

3
The Request

• Regional Representation
• Short and Long term goals
• Successes and Challenges
• How Central Region can foster California State
  Trauma System

4
The Central Region

• Central California covers approximately 32,000 sq
  miles or 20 of California.
• Rural in nature with large areas of agriculture
• Bounded by the Sierra Nevada mountain range
• The region serves a population of approximately
  3.5 million or 10 of California population.
• consists of 12 counties (25 of the counties in
  California),
• 5 LEMSAs (2 regional and 3 single counties),
• 1 level I Trauma Center
• 3 level II Trauma Centers

5
The Central Region
Modesto-two level II Trauma Centers
Fresno-one level 1 Trauma Center
Kern-one Level II Trauma Center
6
CRTCC History and Process

• August 2008, Meeting
• All interested parties from the State Summit
• Executive Steering Committee formed
• Early Decision Process Driven
• Bylaws
• Mission Vision
• Goals
• Membership

7
CRTCC Bylaws

• Guiding Principles
• Inclusive, not exclusive
• Collaborative
• KISS
• Bulk of efforts from EMS Administrators
• Clarence Teem
• Chuck Baucom

8
Mission Statement, CRTCC

• To participate in the development of standardized
  regional trauma care, as well as the
  establishment and maintenance of a coordinated
  regional trauma system to promote optimal trauma
  care for all people within the region.

9
Vision

• All inclusive system of trauma care throughout
  the central region of California
• Pre-hospital
• Destination criteria
• Uniform standards of care
• Facility
• Adequate numbers and quality of trauma centers
• Rehabilitation
• Education and Prevention
• Region-wide performance improvement

10
Accomplishments

• Bylaws completed and approved
• Formal regional response to EMSA draft on
  Intensive Care Services for the Pediatric Trauma
  Patient
• Gap analysis completed
• General Membership meeting held with diverse
  representation
• Subcommittees formed with goals established for
  each
• Presentation to the Hospital Council CEO group

11
Goals

• Prehospital subcommittee
• Standardized triage and destination criteria
• Ambulance utilization
• Facility subcommittee
• Gap analysis
• Work with prehospital subcommittee on destination
  criteria

12
Goals (cont.)

• Education/Prevention subcommittee
• Website
• Prevention consortium to look at available
  resources
• PI subcommittee
• Peer review
• Benchmark data
• Quality indicators
• To meet Semi-annually/quarterly

13
Challenges

• We have had GREAT collaboration but we lack
  Legislative Authority
• This is VOLUNTARY buy-in
• Large region, face to face meetings are hard
• Teleconferencing
• Lack of adequate number of trauma centers and
  physicians
• the San Joaquin Valley has 51 fewer specialists
  than the rest of the state

14
How we can foster a statewide system

• Collaboration with other regions
• Only region in the state that borders every
  region
• Standardized destination and triage criteria
• Transfer agreements and arrangements
• Address gaps in trauma care (gap analysis)
• Rural trauma course
• telemedicine
• Participate in statewide trauma registry

15
  William Butler Yeats (1919)The Second Coming

• Turning and turning in the widening gyre
• The falcon cannot hear the falconer
• Things fall apart the centre cannot hold
• Mere anarchy is loosed upon the world,
• The blood-dimmed tide is loosed, and everywhere
• The ceremony of innocence is drowned
• The best lack all conviction, while the worst
• Are full of passionate intensity.

16
Conclusion

• Californians deserve and must have an effective
  state-wide trauma system
• This Center will hold
• Anarchy in trauma care will NOT be loosed upon
  the world (or state)