State Trauma Advisory Council Meeting Friday, March 10, 2006 12:30-3:30 p.m.
MDH Snelling Office Park - Red River Room
Members Present: John Bowar, M.D., J. Kevin Croston, M.D., Robert Dahm, Jane Gisslen, R.N., William Heegaard, M.D., Tom Hock, R.N., P.A., Mark Larkins, M.D., Mark Lindquist, M.D., Dennis Miley, Gary Pearson, Jeffrey Schiff, M.D., Marc Swiontkowski, M.D., Linda Vogel, R.N.
Members Absent:Timothy LeMieur, M.D. and Mike Wilcox, M.D.
MDH Consultant: David Larson, M.D.
MDH Staff: Cirrie Byrnes, Tim Held, Mark Schoenbaum
Call to Order, Welcome and Introductions – Chair Kevin Croston, M.D. called the meeting to order by at 12:35 p.m.
Approval of December 5, 2005 STAC Meeting Minutes
Mr. Dahm moved acceptance of the meeting minutes as they stand. Dr. Jeff Schiff seconded; the motion passed unanimously.
No update. Governor Pawlenty called Commissioner Dianne Mandernach away just prior to the meeting. She sent her regrets and that she will plan to attend the next meeting.
Staff Report (Tim Held)
HRSA Update: The federal Health Services and Resources Administration’s (HRSA) Trauma- EMS Program was recently zeroed out of the federal budget. Minnesota’s current $40,000 HRSA trauma grant closes on July 31, 2006. The remaining two years of the grant ($40,000/year) will not be renewed.
Model Trauma System Planning and Evaluation Tool (MTSPET): HRSA’s Trauma-EMS program recently published the MTSPET and distributed it to the states. It is an overhaul of the early 1990s’ federal model trauma plan in two particular areas. First, it contains national quality benchmarks for states’ use in planning and measuring all aspects of their systems. Second, it integrates trauma system planning into the public health model. It should be a good document for Minnesota to use once the system gets launched. Mr. Held will obtain copies for STAC members.
Reimbursements: Parking receipts are needed for members seeking parking reimbursement. Exception is for meter parking—no receipt necessary.
Trauma Registry: The state Web-based trauma registry is now in the pilot phase. The go-live date is set for April 15.
Special Study Report
Dr. Marc Swiontkowski reported on “A National Evaluation of the Effect of Trauma-Center Care on Mortality” research study. This paper comes out of the National Study on the Cost and Outcomes of Trauma (NSCOT), a multimillion dollar, five-year project funded by the Center for Disease Control. Other papers will be coming out on this over the next two to four years, including related material for children and the elderly.
Mr. Held presented a newly developed Communication Plan and asked for feedback. Mr. Miley mentioned that related to “Expected Outcomes” it would be interesting to know what percentage of hospitals (especially rural) participate in other states’ trauma systems. Mr. Dahm requested that the Minnesota Department of Public Safety be acknowledged as a partner. Dr. Schiff requested that the Academy of Pediatrics also be added as a partner, and asked that under “Messages” the word “occurrences” be added to the statement “trauma is predictable.” These changes will be made.
Ad Hoc Operations Committee Report and Recommendations
Mr. Miley presented the draft council operations document. Dr. Bill Heegaard mentioned that under Membership, item 5 “emergency department” should replace “emergency room.” There was also discussion about the inaccurate language regarding the certifying bodies which are listed for several of the council’s physician specialties. This language is in Minnesota Statute, so these changes will need to be made via an MDH “house-cleaning bill” at a later date.
The proposed Executive Committee will consist of the Chair and Vice Chair, but will involve council members as much as possible, based on interest, expertise and availability. Dr. Marc Swiontkowski brought up the need for STAC members to at least annually complete written conflicts of interest statements. Mr. Schoenbaum said that the state has a form that would lend itself well to addressing this issue. Mr. Miley moved acceptance of the document with the amendment that the annual conflict of interest statement be added. Dr. Heegaad seconded; the motion passed unanimously.
Ad Hoc Trauma Designation Work Group Report and Recommendations
Linda Vogel, R.N., presented the draft trauma designation applications developed by the Ad Hoc Work Group. She highlighted the proposed clarifications and modifications to the original language in the state trauma plan. The STAC discussed each recommendation, adding the following language to the Level III application: “Institutional Organization,” 3 (c), add two (2) consecutive pre-hospital confirmed blood pressures…”; 3 (d) that the surgeon response to ED be met 80 percent or 85 percent of the time (check with the American College of Surgeons for which one they use, and apply it here); in addition, a note should be made that the 30 minute surgeon response criteria was a result of a general surgeon survey conducted in December 2004; “Required Documentation” for radiology should clarify that a radiologist meet the criteria; and finally, that the hospital should conduct a performance improvement audit of all trauma patient transfers occurring after 24 hours. These changes will be made to the documents.
Mr. Miley suggested that rural hospital administrators provide input to these documents before the STAC formally approves them. In particular, the changes should be noted and explained, and the application needs to leave a positive effect (not appear to be overwhelming). Dr. Croston asked that the Mr. Miley chair this Ad Hoc effort with his peers and report back to the STAC on their suggestions. Mr. Miley will work with Mr. Held to identify other key constituents who should participate on this Ad Hoc Work Group. Mr. Miley moved provisional acceptance of the applications as discussed and amended. The motion passed unanimously.
10 minute break
Staff Report from Director of Office of Rural Health and Primary Care
Mr. Schoenbaum introduced Chris Ballard as the new Trauma Designation Coordinator. He will work closely with Mr. Held. Both will work within the Office of Rural Health and Primary Care.
MnTrauma Presentation / Demonstration by ImageTrend
Mr. David Zaiman, ImageTrend representative, gave a presentation and demonstration on the new web-based trauma registry.
Election of Officers:A motion was made, seconded and passed unanimously that Mr. Miley be appointed Vice Chair of the State Trauma Advisory Council.
Formation of a Standing Data/PI Work Group: Dr. Croston appointed Dr. Schiff chair of this committee. Other STAC members to serve include Mr. Pearson, Dr. Croston and Dr. Heegaard. Dr. Croston and Mr. Held will seek other interested content area experts for the Work Group, including an EMSRB/MNSTAR expert.
No-Fault Auto Insurance Repeal: Dr. Croston noted the devastating fiscal impact to hospitals and EMS providers that would result from a repeal of Minnesota’s No-Fault Auto Insurance, which has been suggested at the Legislature. Colorado is a good case study to demonstrate this point. The STAC decided that Dr. Croston and Mr. Held will draft an informational sheet that can be provided to Commissioner Mandernach as a resource. The draft will be brought to the STAC for approval before being sent to the Commissioner.
Integration of State Trauma System into ExistingState Disaster Planning: Dr. Croston mentioned the importance of integrating the state trauma system into the various state disaster planning efforts. Mr. Held will invite staff from the MDH Office of Emergency Preparedness to present at the next STAC meeting. Mr. Dahm offered to assist in arranging to have staff from the DPS-Homeland Security and Emergency Management present at a later date. There may be a time in the future when the STAC may want to develop a subcommittee to address how to best integrate into these efforts. In the meantime, discussions on this will be a standing agenda item.
Next Meeting Dates:
The remaining meeting dates for 2006 will be June 6, September 12, November 7 and December 5 (a decision about meeting both in November and December will be determined later). All meetings will be from 12:30 p.m.-3:30 p.m. and are scheduled at MDH’s Snelling Office Park location.
Wrap Up, Next Meeting Agenda Items:
Disaster planning, a revisit of the no-fault issue, and reports from the various committees and work groups will be on the June 6, 2006 agenda.
Adjournment: The meeting was adjourned at 3:35 p.m.