TOPIC

DISCUSSION

ACTION

1.      Call to order by Andrea Winthrop, MD

2.      Minutes, July 26, 2005                                                                                                

No Corrections needed.

Motion to approve made by Suzanne Martens;  seconded by Steven Andrews.

3.      Introductions

A.                    New Members

   There were 7 new members in attendance.  Welcome to everyone.

B. Representatives in Attendance

   Andrea polled attendees to determine representatives in attendance. The following counties were not represented:  Ozaukee, and Walworth.

4.   SERTAC Chair Announcements

Report by Andrea Winthrop.

A.                      STAC Meetings

   STAC meetings are open to the public.  The next meeting is Oct. 12^th at 9:00 a.m. in Madison at the Holiday Inn on E. Washington Ave.

   At the Oct. meeting ATLS requirements will be discussed and a presentation will be given regarding Rural Components to the Trauma System.

   Attendance by SERTAC members is strongly encouraged.

B.                                                                                                                                                                 Executive Council Meeting

Meeting held today at 2:15.

1.  Bylaws – Two deficiencies were identified.

a.  The Executive Council needs to have representation from rural areas, defined as communities with population < 14,000.  A volunteer was asked for.

b.  The bylaws require a Treasurer be named.  The Treasurer will be a voting member of the Executive Council, requiring regular attendance at the EC meetings.  The Treasurer will have signing authority and execute disbursements on behalf of SERTAC at the direction of the RTAC Coordinator as well as interact with the agency determined to be the Fiscal Agent. The term will be for the current 2005/2006 Grant year, ending June 30, 2006.

2.  Independent Contractor – The EC approved changing the RTAC Coordinator position to be an Independent Contractor.  The contract will be between SERTAC and the RTAC Coordinator.

3.  Budget – Discussions were held and approval given regarding budget items for the 2004, 2005, and 2006 Grant Years.  Funds have been identified for several educational programs, including TOPIC course for trauma nurses, Injury Scoring course for trauma registrars, and training for Out-of-Hospital EMS providers.

C. Surgeon Participation

Andrea will make presentations to hospital surgeon meetings in an effort to recruit surgeons from Level III hospitals to be active participants in SERTAC.

Anyone willing to serve as the Rural Representative should contact Amy.

Anyone willing to volunteer should contact Amy. A request was made to the general SERTAC membership for someone willing to be Treasurer.

Contact Andrea with requests for her to speak.

5.   STAC / RTAC Coordinators Meeting

STAC - Report by Marianne Peck

A.                      Registry

   Marianne is putting together an informational document addressing Procedures, Privacy and Security, among other issues.

   She requested that hospitals begin thinking about who will be entering data.  For Level III’s and IV’s, no data will be entered if the patient is transferred.  They will, however, have access to data from the field to the point of transfer.

   Testing at some hospitals will begin by the end of Oct.  Tentative timetable for Level III and IV implementation will be Feb. or March, 2006.

   Training is being explored:  possibly AAAM Injury Scoring and/or ATS Registry course.

B. Performance Improvement Legislation

   Draft language for this bill has been reviewed to ensure that only patient information and not hospital information is deemed to be “confidential”.  The bill is ready to go to the legislature.

   A Confidentiality Agreement will be required.

RTAC Coordinators Meeting - Report by Amy McCray

Held September 7, 2005.

A. Working Subcommittee

   Funding for RTAC’s will transfer to the State effective 7-01-06.  A working subcommittee has been established under Marianne Peck’s direction to address organizational issues.  Amy was invited (and accepted) to be a member of this committee.  The first meeting will be held following the STAC meeting held on Oct. 12.

B. Large Scale Exercise - 2006

   Planning will begin soon for multi-county large scale table-top exercises to be conducted beginning March, 2006. 

   The exercises are to include groups of 3 counties.  For SERTAC, we will plan for two 3-county and one 2-county exercises.

C. Tagging and Tracking Protocols

     The state’s goal is to move toward a consistent tagging and tracking system.

     Criteria for essential tagging and tracking components were identified and discussed.  The results will be communicated as recommendations for consideration by pre-hospital and hospital care providers.

D. Triage Tuesdays

   Discussions have begun on conducting “Triage Tuesdays”.  Once day each month EMS Providers and Hospitals perform triage activities for all patients, including medicals.  Triage tags are completed and attached to patients and hospitals engage in treatment and recordkeeping protocols based on the triage tags presented with the patients.

   The goal is to improve skills in preparation for having to implement the protocols in a real situation.

E. Next STAC and RTAC Coordinator Meetings

         STAC – Nov. 2,  10:00 am Madison

         RTAC Coordinators – Following STAC meeting

6.   RTAC  Coordinator

Report by Amy McCray

A.                    Questionnaire

   A survey was taken in July regarding meeting times and days.  The results were as follows:

   Total no. of respondents:  35

   Regularly attend HRSA mtgs.:  6

   Prefer mornings:  9

   Prefer afternoons:  25

   Prefer Tues.: 22;  Wed.: 9;  Thurs.:  4;  Any:  4

   Discussion resulted in decision to keep the current meeting day and time.

B. Hospital Designations

   We are proud to announce that all hospitals in our region have designated as Trauma Facilities.  A huge thank you to Rebecca Long for working with the two hospitals who originally chose to be “Unclassified”.

C.   Website

   The website is ready to go online as soon as they receive payment.  The host is to be determined.

D. Financials

   Budget items were presented to the Executive Council for approval. 

7.   Outstanding Items

A. Laminated Cards - Amy

     Laminated Triage and Transport cards have been printed and are ready for distribution.

     Laminated START / Jump START cards have been received and will be distributed to all EMS Provider personnel.  It was suggested and agreed to provide a copy to each of the hospitals if there are sufficient copies.

B. Future Action Items

         1.  Announcement of EC Rural Representative.

         2.  Announcement of EC Treasurer.

Education committee will assist in distribution.

Amy will distribute at remaining WEEPP training sessions and ship to EMS providers who previously completed training.

8.   New Discussion Items

A. Hospitals – Requests for Information

   Level III and IV hospital representatives were asked to identify key issues which they would like to receive and share information.  They are as follows:

         1.  Surgeon response.

         2.  ATLS Requirements.

         3.  Trauma Coordinators Roles / Responsibilities

         4.  Trauma Committee composition.

         5.  Trauma Team composition.

         5.  FTE’s needed for Trauma Coordinators

         6.  Trauma Activation Criteria

         7.  Trauma Registrar

         8.  UB 92 Billing Codes

Dr. Heidi Harkins inquired regarding the “on-call” surgeon response requirement.  Discussion was held regarding whether the actions would unnecessarily delay patient transfers. 

Andrea pointed out that surgeon involvement in patient care decision-making is imperative and that it is necessary to have surgeons enroute in the event surgical intervention is necessary.

It was clarified that patient transfer is Not to be delayed while waiting for a surgeon to arrive at the hospital.  If the patient transfer takes place prior to surgeon arrival, the surgeon can be “called off”. 

Anyone developing protocols is asked to share with the group via Amy. 

Please note that any such information is to be kept confidential between the hospitals members of our RTAC. 

Also please note that shared information is, in most cases, in draft form.

Cinda will send out volume information regarding Trauma Activation..

9.   Subcommittee Reports

A.     Performance Improvement

Report by Steven Andrews, MD.

   1.   PI Legislation Language

   The committee reviewed the bill sponsored by Sen. Brown and is pleased with it..

   Data from trauma deaths will be reviewed if a medical examiner is available as a resource.

B. Medical Oversight

Report by Andrea Winthrop

   1.   Hospital Dialog

   Andrea will make herself available to speak to    hospital personnel as requested.

     2. Interfacility transfers from Level III’s and IV’s to Level I.  Important Issues are:

         a.   Request transfers early on

         b.   Initiate communication between hospitals

         c.   Initiate mode and time of transfer

         d.   Reduce number of imaging studies in effort to     expedite transfer, namely: 

               - Do Not Delay transfer to complete imaging           series, and

               - If imaging studies are completed, be sure to           transfer those images with the patient in disk   or original film format, along with a           radiologist report (either verbal or dictated).

     The Subcommittee recommends that SERTAC support a letter presented jointly by Froedtert and Children’s Hospital be drafted and distributed.

     3. Hypothermia

     It was recommended that Hypothermia be included as one of the criteria for Trauma Activation (prehospital). SERTAC also recommends that all trauma centers in the RTAC develop a guideline for hypothermia.

     4. Information Sharing

     It was recommended that Level III’s share documents with other Level III’s.

C. Education

Report by Todd VanLangen.

     1. Educational Course

     $5,000 has been budgeted to host an educational program.  The committee has decided to offer one or two PHTLS courses in March or April 2006.  There would be no fee for participants.

     2. WEEPP Training

   Train-the-Trainer sessions have been held in Washington, Ozaukee, Sheboygan, and Milwaukee counties.  Sessions have been scheduled for Racine, Kenosha and Walworth counties.

At the next meeting the committee will develop mechanisms to perform PI.

A local Medical Examiner will be asked to participate on the PI Committee.

Approval was given to such support.  Awaiting feedback from FMLH re administrative approval. Will then forward to CHW.

Steve Andrews FFL will evaluate this further from the prehospital standpoint.

Planning will proceed.

10. Next Executive Council Meeting

Prior to SERTAC mtg.:  Tues. Oct. 25, 2005

Location:  Cafeteria across from Education Room 1

NOTE:  Meeting starts at 2:15p. 

11. Next  SERTAC Meeting

Tues. Oct. 25, 2005, 3:15 - 5:15 pm 

Location:  The Wisconsin Heart Hospital,  10000 W. Blue Mound Rd., Wauwatosa, Education Room 1

Agenda and minutes will be included with meeting reminder.