reglab/statecodes huggingface dataset:
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.1 - General

Current through June 25, 2024
A Level III trauma center is an acute care facility with
						the commitment, medical staff, personnel and specialty training necessary to
						provide initial resuscitation of the trauma patient. ly, a Level III trauma
						center is expected to provide initial resuscitation of the trauma patient and
						immediate operative intervention to control hemorrhage and to assure maximal
						stabilization prior to referral to a higher level of care. In many instances,
						patients will remain in the Level III Trauma Center unless the medical needs of
						the patient require secondary transfer. The decision to transfer a patient
						rests with the physician attending the trauma patient. All Level III Trauma
						Centers will work collaboratively with other trauma facilities to develop
						transfer protocols and a well-defined transfer sequence.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.2 - Hospital Departments/Divisions/Sections

Current through June 25, 2024
The Level III Trauma Center must have the following
						departments, divisions, or sections:
1. Emergency Medicine
2. Trauma/General Surgery
3. Orthopedic Surgery
4. Anesthesia
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.3 - Trauma Program

Current through June 25, 2024
1. There must be a
					 written commitment on behalf of the entire facility to the organization of
					 trauma care. The written commitment shall be in the form of a resolution passed
					 by an appropriate quorum of the members of the governing authority. Should the
					 business organization be other than a corporation, a letter explaining such
					 together with a written commitment of the hospital's chief executive officer to
					 the establishment of a trauma care program may be sufficient. The trauma
					 program must be established and recognized by the medical staff and hospital
					 administration. The trauma program must come under the direction of a
					 board-certified surgeon with special interest in trauma care. An administrative
					 structure should ideally include an administrator, medical director, trauma
					 program manager, trauma registrar and other appropriate staff. At minimum, an
					 identified hospital administrative leader should work closely with the trauma
					 medical director to establish and maintain the components of the trauma program
					 including appropriate financial support. The trauma program location in the
					 organizational structure of the hospital should be placed so that it may
					 interact effectively with at least equal authority with other departments
					 providing patient care. The trauma program should be multidisciplinary in
					 nature and the performance improvement evaluation of this care must extend to
					 all the involved departments.
2.
					 Compliance with the above will be evidenced by but not limited to:
a. Governing authority and medical staff
					 letter of commitment in the form of a resolution;
b. Written policies and procedures and
					 guidelines for care of the trauma patient;
c. Defined trauma team and written roles and
					 responsibilities;
d. Appointed
					 Trauma Medical Director with a written job description;
e. Appointed Trauma Program Manager with a
					 written job description;
f. A
					 written Trauma Performance Improvement plan;
g. Documentation of trauma center
					 representative attendance at the regional trauma advisory committee
					 meetings.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.4 - Trauma Service

Current through June 25, 2024
A trauma service is an organized structure of care for
						the patient. The must be established and recognized by the medical staff. The
						service includes personnel and resources necessary to ensure the appropriate
						efficient care delivery. The composition of the service will vary depending on
						the nature of the medical center, available resources and personnel and patient
						clinical need. The trauma service must come under the organization and
						direction of a surgeon who is board certified with special interest in trauma
						care. All patients with multiple system trauma or major injury must be
						evaluated by the trauma service. Injured patients may be admitted to individual
						surgeons.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.5 - Trauma Medical Director (TMD)

Current through June 25, 2024
1. Level III Trauma
					 Centers must have a physician director of the trauma program. The TMD plays an
					 important administrative role. The TMD must be a board-certified surgeon with
					 special interest in trauma care. The TMD will be responsible for developing a
					 performance improvement process and, through this process, will have overall
					 accountability for all trauma patients and administrative authority for the
					 hospital's trauma program. The TMD must be given administrative support to
					 implement the requirements specified by the state trauma plan. The TMD is
					 responsible for working with the credentialing process of the hospital and, in
					 consultation with the appropriate service chiefs, recommending appointment and
					 removal of physicians from the trauma team. He should cooperate with nursing
					 administration to support the nursing needs of the trauma patient and develop
					 treatment protocols for the trauma patients. The TMD in collaboration with the
					 Trauma Program Manager (TPM) should coordinate the budgetary process for the
					 trauma program
2. The TMD must be
					 currently certified by the American College of Surgeons Advanced Trauma Life
					 Support (ATLS), maintain personal involvement in care of the injured, maintain
					 education in trauma care, and maintain involvement in professional
					 organizations. The TMD, or his designee, must be actively involved with the
					 trauma system development at the community, regional and state level.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.6 - Trauma Program Manager (TPM)

Current through June 25, 2024
1. Level III trauma
					 centers must have a registered nurse working in the role of Trauma Program
					 Manager (TPM). Working in conjunction with the TMD, the TPM is responsible for
					 organization of the program and all systems necessary for the multidisciplinary
					 approach throughout the continuum of trauma care. The TPM is responsible for
					 working with the trauma team to assure optimal patient care. There are many
					 requirements for data coordination and performance improvement, education and
					 prevention activities incumbent upon this position.
2. The TPM or his/hers designee should offer
					 or coordinate services for trauma education. The TPM should liaison with local
					 EMS personnel, the Department, Trauma Care Regions(s) and other trauma
					 centers.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.7 - Trauma Team

Current through June 25, 2024
The team approach is optimal in the care of the multiple
						injured patients. There must be identified members of the trauma team. Policies
						should be in place describing the roles of all personnel on the trauma team.
						The composition of the trauma team in any hospital will depend on the
						characteristics of that hospital and its resources. In some instances, a tiered
						response may be appropriate. If a tiered response is employed written policy
						must be in place and the system monitored by the PI process. The team leader
						must be a qualified general surgeon. All physicians and mid-level providers
						(Physician Assistant/Nurse Practitioner) on the trauma team responsible for
						directing the initial resuscitation of the trauma patients must be currently
						certified in The American College of Surgeons Advanced Trauma Life Support
						(ATLS). ATLS requirements are waived for Board Certified Emergency Medicine and
						Board Certified General Surgery Physicians. Composition of the trauma team for
						severely injured patients includes:
1.
					 Emergency Physicians and/or mid-level providers (Physician Assistant/Nurse
					 Practitioner)*
2. General/Trauma
					 Surgeons*
3. Physician
					 Specialists
4. Laboratory
					 Technicians as dictated by clinical needs
5. Nursing: ED*, OR, ICU, etc.
6. Auxiliary Support Staff
7. Respiratory Therapists
8. Security Officers
* Mandatory for all Alpha
						Alerts/Activations.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-4.1.8 - Multidisciplinary Trauma Committee

Current through June 25, 2024
1. The purpose of
					 the committee is to provide oversight and leadership to the entire trauma
					 program. The exact format will be hospital specific and may be accomplished by
					 collaboration with another designated trauma center in the region. The major
					 focus will be on PI activities, policy development, communication among all
					 team members, development of standards of care, education and outreach
					 programs, and injury prevention. The committee has administrative and
					 systematic control and oversees the implementation of the process which
					 includes all program related services, meets regularly, takes attendance,
					 maintains minutes and works to correct overall program deficiencies to optimize
					 patient care. Membership for the committee includes representatives (if
					 available in the community) from:
a.
					 Emergency Medicine
b. General
					 Surgery
c. Orthopedics
d. Neurosurgery
e. Anesthesia
f. Operating Room
g. Intensive Care
h. Respiratory Therapy
i. Radiology
j. Laboratory
k. Rehabilitation
l. Pre-hospital Care Providers
m. Administration
n. Pediatrics
o. Nursing
p. Trauma Program Manager
q. Trauma Medical Director (Chairman; must be
					 present >50%)
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-12-32-4.2.2 - Qualifications of Surgeons on the Trauma Team

Current through June 25, 2024
1. Basic to
					 qualification for trauma care for any surgeon is Board Certification in a
					 surgical specialty recognized by the American Board of Medical Specialties, the
					 Advisory Board for Osteopathic Specialties, the American Dental Association,
					 the Royal College of Physicians and Surgeons of Canada, or other appropriate
					 foreign board. Many boards require a practice period. Such an individual may be
					 included when recognition by major professional organizations has been received
					 in their specialty. The board certification criteria apply to the general
					 surgeons, orthopedic surgeons, and neurosurgeons.
2. Alternate criteria in lieu of board
					 certification are as follows:
a. Non-board
					 certified general surgeon must have completed a surgical residency
					 program.
b. He/she must be licensed
					 to practice medicine.
c. He/she
					 must be approved by the hospital's credentialing committee for surgical
					 privileges.
d. The surgeon must
					 meet all criteria established by the TMD to serve on the trauma team.
e. The surgeon's experience in caring for the
					 trauma patient must be tracked by the PI program.
f. The TMD must attest to the surgeons'
					 experience and quality as part of the recurring granting of trauma team
					 privileges.
g. The TMD, using the
					 trauma PI program, is responsible for determining each general surgeon's
					 ability to participate on the trauma team.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-12-32-4.2.3 - Qualifications of Emergency Physicians

Current through June 25, 2024
1. For those
					 physicians providing emergency medicine coverage, board certification in
					 Emergency Medicine is desirable. However, career emergency medicine physicians
					 who are board certified in a specialty recognized by the American Board of
					 Medical Specialties, a Canadian Board or other equivalent foreign board meets
					 the requirements.
2. Alternative
					 criteria for the non-boarded physician working in the Emergency Department are
					 as follows:
a. He/she must be licensed to
					 practice medicine.
b. He/she must
					 be approved by the hospital's credentialing committee for emergency medicine
					 privileges.
c. The physician must
					 meet all criteria established by the trauma and emergency medical director to
					 serve on the trauma team.
d. The
					 physician's experience in caring for the trauma patient must be tracked by the
					 PI program.
e. The TMD and
					 emergency medical director must attest to the physician's experience and
					 quality as part of the recurring granting of trauma team privileges.
f. Residency in Emergency Medicine is
					 desirable.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-12-32-4.3.1 - Emergency Department

Current through June 25, 2024
1. The facility
					 must have an emergency department, division, service or section staffed so
					 those trauma patients are assured immediate and appropriate initial care. The
					 emergency physician and/or mid level providers must be in-house 24 hours/day,
					 immediately available at all times, and capable of evaluating trauma patients
					 and providing initial resuscitation. The emergency medicine physician will
					 provide team leadership and care for the trauma patient until the arrival of
					 the surgeon in the resuscitation area. The emergency department must have
					 established standards and procedures to ensure immediate and appropriate care
					 for the adult and pediatric trauma patient. The medical director for the
					 department, or his designee, must participate with the Multidisciplinary Trauma
					 Committee and the trauma PI process.
2. The director of the emergency department,
					 along with the TMD, may establish trauma-specific credentials that should
					 exceed those that are required for general hospital privileges (i.e., ATLS
					 verification).
3. There should be
					 an adequate number of RN's staffed for the trauma resuscitation area in-house
					 24 hours/day. Emergency nurses staffing the trauma resuscitation area must be a
					 current provider of TNCC and participate in the ongoing PI process of the
					 trauma program. There must be a written plan ensuring nurses maintain ongoing
					 trauma specific education. Nurses must obtain TNCC within 18 months of
					 assignment to the ER.
4. The list
					 of required equipment necessary for the ED can be found on line at
http://msdh.ms.gov/msdhsite/_static/49.html
.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-12-32-4.3.2 - Surgical Suites/Anesthesia

Current through June 25, 2024
1. The surgical
					 team must be on-call with a well-defined mechanism for notification to expedite
					 transfer to the operating room if the patient's condition warrants. The process
					 should be monitored by trauma PI program.
2. The OR nurses should participate in the
					 care of the trauma patient and be competent in the surgical stabilization of
					 the major trauma patient.
3. The
					 surgical nurses are integral members of the trauma team and must participate in
					 the ongoing PI process of the trauma program and must be represented on the
					 Multidisciplinary Trauma Committee.
4. The OR supervisor must be able to
					 demonstrate a prioritization scheme to assure the availability of an operating
					 room for the emergent trauma patient during a busy operative
					 schedule.
5. Anesthesia must be
					 promptly available with a mechanism established to ensure notification of the
					 on-call anesthesiologist. The Level III trauma center must document conditions
					 when the anesthesiologist must be immediately available for airway emergencies
					 and operative management of the trauma patient.
6. Anesthesiologists on the trauma team must
					 have successfully completed an anesthesia residency program approved by the
					 Accreditation Council for Graduate Medical Education, the American Board of
					 Osteopathic Specialties, or the American Osteopathic Board and should have
					 board certification in anesthesia.
7. Anesthesia requirements may be fulfilled
					 by Certified Registered Nurse Anesthetists (CRNAs) and/or anesthesia residents
					 who are capable of assessing emergent situations in trauma patients and of
					 providing an indicated treatment, including initiation of surgical anesthesia.
					 When the CRNA is used to meet this requirement, the staff Anesthesiologist will
					 be advised and promptly available at all times and present for operations.
					 Trauma centers must document conditions when the anesthesiologist must be
					 immediately available for airway emergencies and operative management of the
					 trauma patient. The availability of the anesthesiologist and the absence of
					 delays in operative anesthesia must be documented and monitored by the PI
					 process. The anesthesiologist participating on the trauma team should have the
					 necessary educational background in the care of the trauma patient; participate
					 in the Multidisciplinary Trauma Committee and the trauma PI process.
8. The list of required equipment necessary
					 for Surgery and Anesthesiology can be found on line at
http://msdh.ms.gov/msdhsite/_static/49.html
.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-12-32-4.3.3 - Post Anesthesia Care Unit (PACU)

Current through June 25, 2024
1. A Level III
					 trauma center must have a PACU available 24 hours/day to the postoperative
					 trauma patient. Hospital policy must be written to assure early notification
					 and prompt response. Frequently, it is advantageous to bypass the PACU and
					 directly admit to the ICU. In this instance, the ICU may meet these
					 requirements.
2. PACU nurses must
					 show evidence of completion of a structured in-service program. There must be a
					 written plan ensuring nurses maintain ongoing critical care education. PACU
					 staffing should be in sufficient numbers to meet the critical need of the
					 trauma patient.
3. The list of
					 required equipment necessary for the PACU can be found on line at
http://msdh.ms.gov/msdhsite/_static/49.html
.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-12-32-4.3.4 - Intensive Care Unit (ICU)

Current through June 25, 2024
1. The ICU must
					 have a surgical director or surgical co-director who is responsible to set
					 policy and administration and establish standards of care to meet the unique
					 needs of the trauma patient. He/she is responsible for the quality of care and
					 administration of the ICU. The trauma medical director must work to assure
					 trauma patients admitted to the ICU will be admitted under the care of a
					 general surgeon or appropriate surgical subspecialists. In addition to overall
					 responsibility for patient care by the primary surgeon, it is desirable to have
					 in-house physician coverage for the ICU at all times. This may be provided by a
					 hospitalist or emergency physician.
2. Level III Trauma Center should provide
					 staffing in sufficient numbers to meet the needs of the trauma patient. There
					 must be a written plan ensuring nurses maintain ongoing critical care
					 education. ICU nurses are an integral part of the trauma team and as such,
					 should be represented on the Multidisciplinary Trauma Committee and participate
					 in the PI process of the trauma program.
3. ICU nurses must show evidence of
					 completion of a structured in-service program. There must be a written plan
					 ensuring nurses maintain ongoing trauma specific education.
4. The list of required equipment necessary
					 for the ICU can be found on line at
http://msdh.ms.gov/msdhsite/_static/49.html
.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.1 - Respiratory Therapy Service

Current through June 25, 2024
The service must be staffed with qualified personnel
						on-call 24 hours/day to provide the necessary treatments for the injured
						patient.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.2 - Radiological Service

Current through June 25, 2024
1. A
					 board-certified radiologist should administer the department and participate
					 actively in the trauma PI process. The radiologist is a key member of the
					 trauma team and should be represented on the Multidisciplinary Trauma
					 Committee. A certified radiological technician must be available in-house 24
					 hours/day to meet the immediate needs of the trauma patient for general
					 radiological procedures. Sonography should be available to the trauma team. If
					 the radiology technician and the specialty technician are on-call from home, a
					 mechanism must be in place to assure the technicians are available. The
					 performance improvement process must verify that radiological services are
					 promptly available. Written policy should exist delineating the
					 prioritization/availability of the CT scanner for trauma patients. The use of
					 teleradiology is acceptable. It is anticipated that facilities may cross-train
					 personnel for other roles. This is acceptable as long as there is no response
					 delay.
2. The PI process must
					 ensure that trauma patients are accompanied by appropriately trained licensed
					 providers and that the appropriate resuscitation and monitoring are provided
					 during transportation to and while in the radiology department.
3. The radiologist must ensure the
					 preliminary interpretations are promptly reported to the trauma team and the PI
					 Program must monitor all changes in interpretation.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.3 - Clinical Laboratory Service

Current through June 25, 2024
1. The clinical
					 laboratory service shall have the following services available in-house 24
					 hours/day:
a. Access to a community central
					 blood bank and adequate storage facilities. Sufficient quantities of blood and
					 blood products should be maintained at all times. Blood typing and cross-match
					 capabilities must be readily available.
b. Standard analysis of blood, urine, and
					 other body fluids includes microsampling when appropriate.
c. Blood gas and Ph determinations (this
					 function may be performed by services other than the clinical laboratory
					 service, when applicable).
d.
					 Alcohol screening is required and drug screening is highly
					 recommended.
e. Coagulation
					 studies.
f. Microbiology
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.4 - Acute Hemodialysis

Current through June 25, 2024
There must be a written protocol to transfer the patient
						to a facility that provides this service if this service if it is not available
						at the Level III Trauma Center.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.5 - Burn Care

Current through June 25, 2024
There must be a written protocol to transfer the patient
						to a Burn Center that provides this service if this service if it is not
						available at the Level III Trauma Center. Policies and procedures shall be in
						place to assure the appropriate care is rendered during the initial
						resuscitation and transfer of the patient.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.6 - Rehabilitation/Social Services

Current through June 25, 2024
1. The
					 rehabilitation of the trauma patient and the continued support of the family
					 members are an important part of the trauma system. Each facility will be
					 required to address a plan for integration of rehabilitation into the acute and
					 primary care of the trauma patient, at the earliest stage possible after
					 admission to the trauma center. Hospitals will be required to identify a
					 mechanism to initiate rehabilitation services and/or consultation in a timely
					 manner as well as policies regarding coordination of the Multidisciplinary
					 Rehabilitation Team. Policies must be in place to address the coordination of
					 transfers between acute care facilities and approved rehabilitation facilities,
					 and shall include a feedback mechanism for the acute care facilities to update
					 the health care team on the patient's progress and outcome for inclusion in the
					 trauma registry. The rehabilitation services should minimally include;
					 Occupational Therapy, Physical Therapy, and Speech Pathology.
2. The nature of traumatic injury requires
					 that the psychological needs of the patient and family are considered and
					 addressed in the acute stages of injury and throughout recovery. A Level III
					 Trauma Center may utilize community resources as appropriate to meet the needs
					 of the trauma patient.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.7 - Prevention/Public Outreach

Current through June 25, 2024
1. Level III Trauma
					 Centers must work cooperatively with referral facilities to develop and
					 implement an outreach program for trauma care in the region. The Level III
					 Trauma Center will work to plan, facilitate and provide professional education
					 programs for the pre-hospital care providers, nurses and physicians, from
					 referral facilities in their region. Prevention programs should be specific to
					 the needs of the region. The trauma registry data should be utilized to
					 identify injury trends and focus prevention needs.
2. Outreach is the act of providing resources
					 to individuals and institutions that do not have the opportunities to maintain
					 current knowledge and skills.
3. he
					 Level III Trauma Center is responsible for working with the other centers to
					 develop education and prevention programs for the public and professional
					 staff. The plan must include implementation strategies to assure information
					 dissemination to all residents in the region.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.8 - Transfer Guidelines

Current through June 25, 2024
The Level III trauma center will have transfer guidelines
						in place for Level I and Level II Trauma Centers, as well as for specialty
						referral centers (such as burn, pediatrics, spinal cord injury and
						rehabilitation) when these services are not available at the trauma center.
						Level III Trauma Centers should work in collaboration with the referral trauma
						facilities in their region and develop interfacility transfer guidelines. These
						guidelines must address criteria to identify high-risk trauma patients that
						could benefit from a higher level of trauma care. All designated facilities
						will agree to provide services to the trauma victim regardless of his/her
						ability to pay.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.9 - Performance Improvement/Evaluation

Current through June 25, 2024
1. A key element in
					 trauma system planning is evaluation. All licensed hospitals which have
					 organized emergency services or departments will be required to participate in
					 the statewide trauma registry for the purpose of supporting peer review and
					 performance improvement activities at the local, regional and state levels.
					 Since these data relate to specific trauma patients and are used to evaluate
					 and improve the quality of health care services, this data is confidential as
					 provided in Miss. Code Ann.§
											41-59-77.
					 Level I and II trauma facilities may be responsible for direct assistance to
					 Level III Trauma Center, referring facilities in providing data for inclusion
					 in the registry.
2. Each trauma
					 center must develop an internal Performance Improvement plan that minimally
					 addresses the following key components:
a. An
					 organizational structure that facilitates performance improvement
					 (Multidisciplinary Trauma Committee).
b. Clearly defined authority and
					 accountability for the program.
c.
					 Clearly stated goals and objectives one of which should be reduction of
					 inappropriate variations in care.
d. Development of expectations (criteria)
					 from evidenced based guidelines, pathways and protocols. These should be
					 appropriate, objectively defined standards to determine quality of
					 care.
e. Explicit definitions of
					 outcomes derived from institutional standards.
f. Documentation system to monitor
					 performance, corrective action and the result of the actions taken.
g. A process to delineate privileges
					 credentialing all trauma service physicians.
h. An informed peer review process utilizing
					 a multidisciplinary method.
i. A
					 method for comparing patient outcomes with computed survival
					 probability.
j. Autopsy information
					 on all deaths when available.
k.
					 Review of prehospital care.
l.
					 Review of times and reasons for trauma bypass.
m. Review of times and reasons for trauma
					 transfers.
n. Audit of all trauma
					 deaths.
o. Morbidity and Mortality
					 review.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 4 - Level III Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-4.4.10 - Education

Current through June 25, 2024
Level III Trauma Centers must have internal trauma
						education programs for physicians, mid-level providers, nurses, and
						pre-hospital providers (when employed by the hospital).
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-5.1.1 - General

Current through June 25, 2024
1. Level IV Trauma Centers are generally
					 licensed, small, rural facilities with a commitment to the resuscitation of the
					 trauma patient and written transfer protocols in place to assure those patients
					 who require a higher level of care are appropriately transferred. These
					 facilities may be staffed by a physician, or a licensed mid-level practitioner
					 (i.e., Physician Assistant or Nurse Practitioner) or Registered Nurse. The
					 major trauma patient will be resuscitated and transferred.
2. This designation does not contemplate that
					 Level IV Trauma Centers will have resources available for emergency surgery for
					 the trauma patient.
3. Level IV
					 Trauma Centers may meet the following standards in their own facility or
					 through a formal affiliation with another trauma center.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-5.1.2 - Hospital Departments/Divisions/Sections

Current through June 25, 2024
The Level IV Trauma Center must have the following
						departments, divisions, or sections: Emergency Medicine
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-5.1.3 - Trauma Program/Service

Current through June 25, 2024
1. There must be a
					 written commitment letter from the Board of Directors and the medical staff on
					 behalf of the entire facility which states the facility's commitment to
					 compliance with the Mississippi Trauma Care Regulations. The written commitment
					 shall be in the form of a resolution passed by an appropriate quorum of the
					 members of the governing authority. Should the business organization be other
					 than a corporation, a letter explaining such together with a written commitment
					 of the hospital's chief executive officer to the establishment of a trauma care
					 program may be sufficient. A trauma program must be established and recognized
					 by the organization. Compliance with the above will be evidenced by:
a. Board of Director's and medical staff
					 letter of commitment;
b. Written
					 policies, procedures and guidelines for care of the trauma patient;
c. A defined Trauma Team with written roles
					 and responsibilities;
d. Appointed
					 Trauma Medical Director with a written job description;
e. A written Trauma Performance Improvement
					 Plan;
f. Appointed Trauma Program
					 Manager with a written job description;
g. Documentation of trauma center
					 representative's attendance at the Trauma Care Region meetings.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-5.1.4 - Trauma Medical Director (TMD)

Current through June 25, 2024
1. The Level IV
					 Trauma Center must have a physician director of the trauma program. In this
					 instance, the physician is responsible for working with all members of the
					 trauma team, and overseeing the implementation of a trauma specific performance
					 improvement process for the facility. Through this process, he/she should have
					 overall responsibility for the quality of trauma care rendered at the facility.
					 The director must be given administrative support to implement the requirements
					 specified by the Mississippi Trauma Plan. The director should assist in the
					 development of standards of care and assure appropriate policies and procedures
					 are in place for the safe resuscitation and transfer of trauma patients. The
					 physician director must have current verification in ATLS. ATLS requirements
					 are waived for Board Certified Emergency Medicine and Board Certified General
					 Surgery Physicians.
2. Compliance
					 with the above will be evidenced by:
a.
					 Chairing and participating in the committee where trauma performance
					 improvement is presented;
b.
					 Administrative support can be documented in the organizational chart which
					 depicts the reporting relationship between the trauma program medical director
					 and administration;
c. Trauma
					 specific policies, procedures and guidelines approved by the TMD.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-5.1.5 - Trauma Program Manager (TPM)

Current through June 25, 2024
1. The trauma
					 center must have a person to act as a liaison to the regional evaluation
					 process to conduct many of the administrative functions required by the trauma
					 program. It is not anticipated that this would be a full-time role.
					 Specifically, this person is responsible, with the TMD, for coordinating
					 optimal patient care for all injured victims. This position will ideally serve
					 as liaison with local EMS personnel, the Trauma Care Region, and other trauma
					 centers.
2. Compliance with the
					 above will be evidenced by:
a. Attendance at
					 and participation in the committee where trauma performance improvement is
					 presented;
b. A written job
					 description of roles and responsibilities to the trauma program which include:
					 management of the trauma program, monitoring of clinical activities on trauma
					 patients, providing staff with trauma related education, implementation of
					 trauma specific performance improvement and supervision of the trauma
					 registry;
c. Documentation of
					 collaboration with TMD in the development and implementation of trauma specific
					 policies, procedures and guidelines.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-5.1.6 - Trauma Team

Current through June 25, 2024
1. The team
					 approach is optimal in the care of the multiple injured patients. The trauma
					 center must have a written policy for notification and mobilization of an
					 organized trauma team to the extent that one is available. The Trauma Team may
					 vary in size and composition when responding to the trauma activation. The
					 physician leader or mid-level provider on the trauma team is responsible for
					 directing all phases of the resuscitation in compliance with ATLS protocol.
					 Suggested composition of the trauma team includes, if available:
a. Physicians and/or mid-level
					 providers
b. Laboratory
					 Technicians
c. Nursing
d. Ancillary Support Staff
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-5.1.7 - Multidisciplinary Trauma Committee

Current through June 25, 2024
1. The purpose of
					 the committee is to provide oversight and leadership to the entire trauma
					 program. The exact format will be hospital specific and may be accomplished by
					 collaboration with another designated trauma center in the system. The major
					 focus will be on PI activities, policy development, communication among all
					 team members, development of standards of care, education and outreach
					 programs, and injury prevention. The committee oversees the implementation of
					 the process which includes all program related services, meets regularly, takes
					 attendance, maintains minutes and works to correct overall program deficiencies
					 to optimize patient care. Membership for the committee includes representatives
					 (if available in the community) from:
a.
					 Emergency Medicine
b. Respiratory
					 Therapy
c. Radiology
d. Laboratory
e. Rehabilitation
f. Pre-hospital Care Providers
g. Administration
h. Nursing
i. Trauma Program Manager
j. Trauma Medical Director (Chairman, must be
					 present >50%)
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-12-32-5.2.1 - Required Components

Current through June 25, 2024
1. The trauma
					 center must maintain published on-call schedules for physicians and/or
					 mid-level providers on-call to the facility.
2. Emergency Medicine (In-house 24
					 hours/day). Emergency Physician and/or mid-level provider (Physician
					 Assistant/Nurse Practitioner) must be in the specified trauma resuscitation
					 area upon patient arrival.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-12-32-5.3.1 - Emergency Department

Current through June 25, 2024
1. The facility
					 must have an emergency department staffed so trauma patients are assured
					 immediate and appropriate initial care. There must be a designated physician
					 director
.
It is not anticipated that a physician will be
					 available on-call to an emergency department in a Level IV Trauma Center;
					 however it is a desirable characteristic of a Level IV. The on-call
					 practitioner must respond to the emergency department based on local written
					 criteria. A system must be developed to assure early notification of the
					 on-call practitioner. Compliance with this criterion must be documented and
					 monitored by the Trauma Performance Improvement process.
2. All physicians and mid-level providers
					 (Physician Assistant/Nurse Practitioner) on the trauma team responsible for
					 directing the initial resuscitation of the trauma patients must be currently
					 certified in The American College of Surgeons Advanced Trauma Life Support
					 (ATLS). ATLS requirements are waived for Board Certified Emergency Medicine and
					 Board Certified General Surgery Physicians. Rural Trauma Course (RTC) may be
					 substituted for ATLS at Level IV Trauma Centers.
3. Emergency nurses staffing the trauma
					 resuscitation area must be a current provider in TNCC. Nurses must obtain TNCC
					 within 18 months of assignment to the ER. Adequate numbers of nurses must be
					 available in-house 24 hours/day, to meet the need of the trauma patient. The
					 nurse may perform other patient care activities within the hospital when not
					 needed in the emergency department.
4. Compliance with the above will be
					 evidenced by:
a. Published on-call list of
					 practitioners to the Emergency Department;
b. Written trauma specific education plan for
					 nurses;
c. Documentation of nursing
					 staffing patterns to assure 24-hour coverage.
d. The list of required equipment necessary
					 for the ED can be found on line at
http://msdh.ms.gov/msdhsite/_static/49.html
.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-5.4.1 - General

Current through June 25, 2024
1. It is not anticipated that Level IV Trauma
					 Centers have any of the following services available:
a. Respiratory Therapy Services
b. Radiology Services
c. Clinical Laboratory Services
d. Acute Hemodialysis
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-5.4.2 - Burn Care

Current through June 25, 2024
There must be a written protocol to transfer the patient
						to a Burn Center that provides this service if this service if it is not
						available at the Level IV Trauma Center. Policies and procedures shall be in
						place to assure the appropriate care is rendered during the initial
						resuscitation and transfer of the patient.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 5 - Level IV Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-12-32-5.4.3 - Prevention/Public Outreach

Current through June 25, 2024
1. The Level IV
					 Trauma Center is responsible for working with other trauma centers and the
					 Trauma Care Region to develop education and prevention programs for the public
					 and professional staff.
2.
					 Compliance with the above will be evidenced by documentation of collaborative
					 efforts of trauma specific education and injury prevention programs with other
					 trauma centers and/or the Trauma Care Region.
Miss. Code Ann.
						§
												41-59-5