Building Collaboratives: Engaging State Health Authority

Dennis W. Ashley, MD., FACS, FCCM Chair, Georgia Trauma Care Network Commission

Director Trauma Services and Critical Care Medical Center of Central Georgia

Professor of Surgery Mercer University School of Medicine

Our Reality

State Trauma Services Study Committee 2006 Findings:

•Georgia trauma death rate is 20 percent worse than the national average

•Only 30 percent of trauma injuries are treated at designated trauma centers

•Traumatic death rates in rural Georgia are much higher than in the urban areas of Georgia

•Annually, Georgia’s trauma care providers (hospitals, surgeons and EMS) deliver $250 million in uncompensated trauma care

Legislation

SB 60 • Passed in 2007 • Established a nine

member commission, Georgia Trauma Care Network Commission (GTCNC)

Authority

SB 60 provided the Commission AUTHORITY to: • “Establish, maintain, and administer a statewide trauma care network

(trauma system)”; • “Coordinate the best use of existing trauma facilities”; • “Direct patients to the best available facility for treatment of

traumatic injury”; and • Oversee Fund dispersal into the entire Georgia trauma system, fairly

and effectively;

In 2007

Milestones

• 1981 Floyd Medical Center designated as Georgia’s first trauma center

• 23 hospitals have been designated at some point over the last 30 years

• 2001 Accomplished the first re-designation of trauma centers in the state

• 2010 the 4th round of re-designations

Milestones

2002 Standardized State Trauma Registry

Data Milestones

Organization Milestones

• 1986 Trauma Coordinators Georgia Committee for Trauma Excellence (GCTE)

• 2011 Trauma Medical Directors Conference Call

Funding Milestones

ACS System Review

• Limited budgetary support within EMS/Trauma • Significant tasks of center designation and registry support • Limited resources for system development and process improvement • Limited resources for data analysis

• Self described “network” of trauma centers, little true system integration

• “Islands of excellence in a sea of chaos” • Significant issues with hospital diversion • Significant issues with medical specialty coverage

• Limited resources for system development and process improvement

• Limited resources for data analysis

Introduction of TQIP

• January 2011: Trauma Commission retreat • February 2011: Trauma Commission meeting Dr. Avery Nathens • March 2011: Trauma Medical Directors conference call

Memorial in Savannah and Grady in Atlanta participating

• March 2011: Georgia Committee for Trauma Excellence • July 2011: Requirement AND funding for TQIP

participation added to FY 2012 Trauma Centers

Funding for TQIP

Uncompensated Care Readiness Costs

Trauma Center Funding

Contracts

• Each trauma center executes a contract with the American College of Surgeons

Title Goes Here

OPEN

• RECORDS

• ACT

Outcomes

• Georgia Committee on Trauma • TQIP subcommittee • Receive State reports • Evaluate and provide feedback to Trauma

Commission • Identify opportunities for performance

improvement and performance based payments

State Report

Individual Centers

State Report

Georgia Trauma Centers

Georgia Trauma Centers

Level I AMC – Atlanta CHOA Egleston – Atlanta Grady - Atlanta MCCG – Macon MCG Health– Augusta Memorial – Savannah Level III Taylor Regional – Hawkinsville Clearview Regional– Monroe Level IV Lower Oconee – Glenwood Morgan Memorial – Madison Wills Memorial – Washington Emanuel – Swainsboro

Level II Athens Regional – Athens CHOA Scottish Rite - Atlanta Floyd Medical – Rome Gwinnett Medical – Lawrenceville Hamilton Medical – Dalton Archbold Memorial – Thomasville Medical Center – Columbus North Fulton – Roswell Kennestone – Marietta

Designated Burn Center Doctors Hospital (JM Still) – Augusta Crestview (Grady)– Atlanta

www.georgiatraumacommission.org

Why we do it!