TOPIC

DISCUSSION

ACTION

1.      Call to order by Andrea Winthrop, MD

2.      Minutes, September 27, 2005                                                                                     

No Corrections needed.

Motion to approve made by Suzanne Martens; seconded by Betsy Rambo.

3.      Introductions

A.                    New Members

   There were 8 new members in attendance.  Welcome to everyone.

B. Representatives in Attendance

   We welcome 2 new representatives from Walworth Co.  We now have representation from all 8 counties in our region.

4.   SERTAC Chair Announcements

Report by Andrea Winthrop.

A.                      STAC Meetings

   STAC meetings are open to the public.  The next meeting is Nov. 2^th at 9:00 a.m. in Madison at the Holiday Inn on E. Washington Ave.

   The Wis. Trauma Society Conference will be held Nov. 4-5^th, featuring Sen. Brown.

   A reminder for hospitals to forward to Marianne Peck the Registry person’s name as well the Trauma liaison.

B.                                                                                                                                                                 Executive Council Meeting

Meeting held today at 2:00.

1.  Discussion Items included:  fiscal agent, RTAC Coordinator employee status, disbursement process, funding, budgets, treasurer and rural representative.

2.  Funding:  The funding source for RTAC’s will change July 1, 2006 from HRSA Grants to the State.

3.  Budget:  Budgets for 2004, and preliminary budgets for 2005 and 2006 grant years were approved, however some items will need to be revised.

4.  Treasurer:  Betsy Rambo was voted in as the new SERTAC Treasurer.  Congratulations and thank you to Betsy.  Betsy is the EMS/Trauma Coordinator at St. Agnes Hospital in Fond du Lac.

5.  Rural Representative:  Tony Scholten was voted in as the new Rural Representative.  Congratulations and thank you to Tony.  Tony is the EMS Coordinator at St. Joseph’s Community Hospital of West Bend.

6.  Executive Council Members:  Both the Treasurer and Rural Representative are voting members of the Executive Council.

C. Surgeon Participation

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

Contact Andrea with requests for her to speak.

5.   STAC / RTAC Coordinators Meeting

STAC - Report by Marianne Peck

A. Working Subcommittee

   The working subcommittee will be working on the following:

   1.  Site Reviews

   2.  PI template

   3.  Confidentiality agreement between hospitals

   4.  Regional Trauma Plan template

   Meetings are open, with participation from non-committee members is welcomed.

B. Required Attendance Clarification

   For clarification, hospital representatives are required to attend RTAC meetings (SERTAC), not STAC meetings (held in Madison).  There had been some confusion regarding this matter.

RTAC Coordinators Meeting - Report by Amy McCray

A. There was no RTAC Coordinator meeting.

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. Financials

   Budget items were approved, but revision will be necessary.

7.   Outstanding Items

A. Previously discussed:  Treasurer and Rural Rep.

8.   New Discussion Items

A. Physician assignment and reporting during in disaster.  Will be discussed in Medical Oversight subcommittee.

9.   Hospital / Pre-Hospital Open Discussion

A.     Surgeon Consultations –

Question:  Some surgeons are shared between multiple hospitals.  Do they have to be physically present for trauma cases or can they be consulted by telephone?

Answer by Andrea:  Topic review:  Surgeons must be involved in the decision-making.  Per the State Trauma Plan and ACS guidelines, surgeons are required to respond in some way for all major resuscitation Trauma Activations (hospital).  The hospital can dictate what activates a trauma call.  The surgeon response time is 30 minutes however, this should not delay transferring the patient to a facility with a higher level of care.  If the surgeon cannot respond within 30 minutes, an alternative for Level III’s is to have a back-up surgeon on call but they must respond in the same manner as the primary surgeon.

Conclusion:  the hospital needs to identify the process for the surgeon to respond.  Telephone conference is one option for the surgeon to be involved in the clinical decision making, but response in person is optimal. 

B.     Intensivists

Question:  As part of Trauma team, is it recommended for them to become ATLS certified?

Answer by Marianne Peck:  It’s recommended that they attend ATLS however will have to wait for rules to come out to see if any formal change is made in certification recommendations.

C.     Training

Question:  Should pre-hospital personnel have additional training for situations where extended inter-facility transport times become necessary as a result of things such as poor winter weather?

Answer by Dan Williams:  It is necessary to provide the same level of care during transport as is provided in the hospital.  The transportation service needs to be qualified and the hospital needs to identify appropriate transporting services.

There are Critical Care courses available nationally.  Inter-facility Transport Guidelines are being considered at the State level.

D.     Surgeon Acceptance

Comment:  Betsy Rambo made presentation to the surgeons.  The information she provided was not well received.

E.      Flight for Life

Comment:  Delays in requesting Flight has been an issue at St. Mary’s in Ozaukee Co.  It was suggested that this be a good topic for the PI subcommittee to explore.

10. Subcommittee Reports

A. Medical Oversight

Report by Ron Pirrallo

   1.   Physician Reporting in Disaster

Many physicians have privileges at more than one facility.  It is necessary to provide a guideline regarding where to report during a disaster.

     The following recommendations apply to both physicians and nurses:

      Assumption:  No Communications are possible.

      a.   If scheduled to work at a facility in the next 24 hour period, report to that facility.

      b.   If not scheduled to work in the next 24 hours, report to the hospital with the highest trauma level resources (assumes highest percentage of patients will be taken there).

      c.   If all hospitals nearest the disaster location are all the same trauma level designation, report to the hospital at the “ground zero” location.

B. Education

Report by Todd VanLangen.

     1. Educational Course - PHTLS

     It was decided $5,000 was insufficient to offer the PHTLS to all SERTAC pre-hospital personnel.  Instead, a PHTLS Instructor course, limited to 22 participants, will be offered.  Eventually, a broader benefit will be realized as the instructors teach others in the region.  All participants in the instructor course must currently be PHTLS certified. Information on cost for the instructor course will be obtained.

     2. WEEPP Training

   Train-the-Trainer sessions have been held in Washington, Ozaukee, Sheboygan, Milwaukee and Racine counties.  Sessions have been scheduled for Kenosha and Walworth counties with make-up sessions being considered.  It is anticipated that all Train-the-Trainer sessions will be completed by the end of Nov.

Attendance at T-t-T sessions have been very disappointing;  approximately 50% or less have participated. 

The number of EMS providers that have completed the training at their services is equally disappointing.  Surprisingly, only very few (approx. 6) have submitted the documentation necessary to obtain the $1400 reimbursement. 

It is questionable that 100% compliance will be attainable.  Several factors were discussed.

C.     Performance Improvement

Report by Ram Nirula

1.   Approach will be non-threatening. Benchmarks will be       established based on aggregate data.

2.   Will look at transportation times: pre-hospital and                         inter-facility.

D. Registry

Report by Dan Burns.

     1. The committee received handouts on “FAQ on Wis. Trauma Care Registry” & “List of Collector Software Reports”.  The committee will review for the next meeting.

     2. The State has hired an IT Project Manager, who will be at the next STAC meeting.

     3. Beta-testing will begin at St. Joseph’s in Marshfield, where they already have “Collection” in place.  Testing will then move to non-Collector facilities.  Level III’s and IV’s will begin reporting approx. March 06.

     4. Group training for data collection will be available.

Ron will inquire as to Regional Disaster Plan Process requirements are:  HRSA Region 7

For next meeting, present questions, issues and suggestions re: incorporating the information into the Data Reg. Cmte. work and PI.

10. Next Executive Council Meeting

Prior to SERTAC mtg.:  Tues. Nov. 15, 2005

Location:  West Allis Memorial Hospital; Meeting Room A

NOTE:  Meeting starts at 2:15pm 

11. Next  SERTAC Meeting

Tues. Nov. 15, 2005, 3:15 - 5:15 pm 

Location:  West Allis Memorial Hospital

8901 W. Lincoln Ave.,  West Allis;  Lavender Room

Agenda and minutes will be included with meeting reminder.