Mass vs NH vs Conn. Trauma Stds

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Ken,

Trauma Centers in Mass are NOT ACS COT verified.  They are Designated by the  state DPH.  CT, on the other hand, designates trauma centers if and only if the hospital has been verified by the ACS COT VRC.  In fact, the state of CT is in the process of re-writing the Statewide Trauma System Plan, and has done so based on our consultation visit by the ACS COT Trauma Systems Consultation Program.  While you are correct in stating that there are few major difference between a Level I and Level II Trauma Centers, there are some, and they are, to list a few:
1.  EM MD's must be in the ED 24/7 in a Level I
2.  Level I's must have bypass available 24/7
3.  Level I's must have an OR microscope available 24/7
4.  Anesthesia services must be available and present in house 24/7 in a Level I center
CT and MRI must be available 24/7 and a CT tech must be in house 24/7 in a Level I center
5.  level I's must have a dedicated job description and line item salary for an Injury prevention Coordinator that is NOT the TPM.

I could go on, but you catch the drift.  For the purpose of the present case discussion, there should have been NO REASON, in my opinion, for that poor guy to get transferred to die.  I can assure you that if this case occured herre in CT, the receiving hospital would have PA/PI reviewed the case, and demanded a review and response from the sending hospital by phone an mail.  I would also be willing to bet that the DPH would have been notified and would be in the sending hospital by noon the day of the death.  it has happened and I have seen all of that come down here.  Trust me when I say that it was ugly - very, very ugly!

Ron

>>> <KMATTOX at aol.com> 8/19/2007 6:24 PM >>>
I know what was intended by the ACS regarding Level 1, Level 2, and Level 3  
trauma centers, but I am curious about Massachusetts, New Hampshire,  
Connecticut, Maine, etc.,    Is there a quality difference for  general surgery trauma 
cases, neurosurgery cases, etc. between a Level I and a  Level II trauma 
center as defined by the State Health Departments in the North  Eastern states.    
 In Texas we would consider a Level I and  a Level II trauma center to be 
identical except for commitment to research,  outreach, etc.   I am researching 
Andy's case and the quality  issues in various states in the NE and just how 
such cases get reviewed by the  trauma programs and what gets to the attention 
of the ACS, the Joint Commission,  and the state health dept.   In Texas when 
there is a variance among  trauma, psych, pediatric, OB, etc. cases the health 
department reviewer shows up  at the hospital for a quality review the next 
week.   They are then  obliged to send a report to Joint Commission if they 
think it is bad  enough.      From a JCAHO standpoint, the case that  Andy shared 
with us mandates a Sentinel Event Committee review at both the  sending and 
the receiving hospital.     
 
Kenneth L. Mattox, MD
Houston



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