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

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

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

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 LEMSA’s (2 regional and 3 single counties), 1 level I Trauma Center 1 level I Trauma Center 3 level II Trauma Centers

The Central Region Fresno-one level 1 Trauma Center Modesto-two level II Trauma Centers Kern-one Level II Trauma Center

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

CRTCC Bylaws Guiding Principles: –Inclusive, not exclusive –Collaborative –KISS Bulk of efforts from EMS Administrators –Clarence Teem –Chuck Baucom

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.

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

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

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

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

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

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

William Butler Yeats (1919) The Second Coming 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.

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)