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MICHIGAN DEPARTMENT OF COMMUNITY HEALTH BUREAU OF HEALTH POLICY, PLANNING AND ACCESS EMS AND TRAUMA SERVICES SECTION
STATEWIDE TRAUMA SYSTEM
Filed with the Secretary of State on October 2, 2009
These rules take effect immediately after filing with the Secretary of State unless adopted under sections 33, 44, or 45a(6) of 1969 PA 306. Rules adopted under these sections become effective 7 days after filing with the Secretary of State.
(By authority conferred on the department of community health by sections 9227 and 20910 of 1978 PA 368, MCL 333.9227 and 333.20910; 2004 PA 580, 2004 PA 581, 2004 PA 582, and Executive
Reorganization Order Nos. 1996-1 and 2003-1, MCL 333.20917a, 333.20908, 33320910, 330.3101, and
445.2011.
R 325.129 is amended as follows: PART 1. GENERAL PROVISIONS
R 325.129 Powers and duties of department.
Rule 5. (1) The department, with the advice of the emergency medical services coordinating committee and statewide trauma care advisory subcommittee, contingent upon sufficient funding being appropriated, shall do all of the following:
(a) Implement an “all-inclusive” trauma system throughout the state. This type of system allows for the care of all injured patients in an integrated system of health care in the pre-hospital and healthcare facility environments by personnel that are well trained and equipped to care for injured patients of any severity. The system allows for a healthcare facility to participate in the system to the extent or level that it is willing to commit the resources necessary for the appropriate management of the trauma patients and prohibits the department from limiting the number of health care facilities that seek to qualify for any given level of trauma designation under this system. It also ensures that all trauma patients are served by a system of coordinated care, based on the degree of injury and care required.
(b) Establish a statewide trauma quality improvement process using a statewide database, which is compatible with trauma, emergency departments, and pre-hospital data systems, monitor the statewide trauma system; ensure the coordination and performance of the regional trauma networks; and set minimum standards for system performance and trauma patient care.
(c) Assign a dedicated state EMS/trauma medical director and supporting resources consistent with the criteria in the 2004 Michigan trauma systems plan, pursuant to MCL 333.20910.
(d) Implement and maintain a statewide plan for a trauma system for this state that addresses all of the following:
(i) State leadership.
(ii) Public information and prevention.
(iii) Human resources.
(iv) Communications.
(v) Medical direction.
(vi) Triage.
(vii) Transport.
(viii) Trauma care facilities.
(ix) Inter-healthcare facility transfers.
(x) Rehabilitation.
(xi) Evaluation of trauma patient care and the trauma system.
(e) Ensure integration of the trauma and Emergency Medical Systems (EMS), including all pre-hospital and organ procurement organization components.
(f) Develop a statewide process to establish regional trauma networks comprised of local Medical Control Authorities (MCAs) in a manner that integrates into existing regional emergency preparedness, EMS, or medical control systems.
(g) Develop a statewide process for the verification of trauma resources.
(h) Develop a statewide process for the designation of trauma facilities.
(i) Develop an appeals process for facilities contesting their designation.
(j) Establish state trauma recommendations and approve regional trauma triage protocols which are established and adopted by the local medical control authority.
(k) Establish regional trauma networks, consistent with the current emergency preparedness regions, to provide system oversight of the trauma care provided in each region of the state. Regional trauma networks shall be comprised of collaborating local medical control authorities (MCAs) in a region. The collaborating MCAs in a region shall apply to the department for approval and recognition as a regional trauma network. The department, with the advice and recommendation of the statewide trauma care advisory subcommittee and emergency medical services coordinating committee, shall review the appropriateness of the regional structure every 3 years. The establishment of the regional trauma networks shall not limit the transfer or transport of trauma patients between regional trauma networks.
(l) Implement Tiered Triage Protocols. Major trauma patients requiring the resources of a Level I Regional Trauma Research Facility or Level II Regional Trauma Facility shall be identified by adult and pediatric field triage criteria established by the regional trauma networks. Protocols, which are established and adopted by local medical control, may be developed based on the standards incorporated by reference in these rules, Resources for Optimal Care Of The Injured Patient 2006 ; Committee On Trauma American College of Surgeons, available at a cost of $25.00 from the American College of Surgeons, 633 N. Saint Clair St. Chicago, Illinois 60611-3211, and those contained in R 325.135. A copy is also available at cost from the EMS & Trauma Systems Section, 201 Townsend Street, Lansing, MI 48913.
(m) ) Verify the trauma care resources of all healthcare facilities in this state over a 3-year period.
(n) Establish a mechanism for periodic re-designation of all healthcare facilities.
(o) Develop a comprehensive statewide data collection system that shall be phased in over a 5-year period.
(p) Formulate recommendations for the development of performance improvement plans by the regional trauma networks, consistent with those in R 325.135.
(q) Develop a process for trauma system performance improvement, which will include responsibility for monitoring compliance with standards, maintaining confidentiality, and providing periodic review of
trauma facility standards. The following standards are incorporated by reference in these rules, as specified in R 325.129(2)(l) and R 325.135.
(r) Develop a process for the evaluation of trauma system effectiveness based on standards that are incorporated by reference in these rules, as specified in R 325.129(2)(l) and R 325.135.
(s) Coordinate and integrate appropriate injury prevention initiatives and programs.
(t) Support and fund the components of the state trauma system and the regional trauma networks and provide adequate staffing and resources to carry out its responsibilities and functions.
(u) Conduct an accurate assessment of the training and education needs and resources of trauma care personnel throughout the state.
(2) In developing a statewide trauma system, the department shall consider all of the following factors:
(a) Efficient implementation and operation.
(b) Decrease in morbidity and mortality.
(c) Cost effective implementation.
(d) Incorporation of national standards.
(e) Availability of funds for implementation.
(3) The 2004 Michigan Trauma Systems Plan may be periodically updated by the statewide trauma advisory subcommittee and the emergency medical services coordinating committee.
