reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.10 - Additional Non-Surgical Specialties

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
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The following non-surgical specialties shall be on-call and available 24 hours a day and shall be at the bedside within 60 minutes after Emergent consultation has been requested by the surgical trauma team leader based on institution-specific criteria:
A. Cardiology;
E
E
E
E
D
B. Pulmonary medicine;
E
E
E
E
D
C. Interventional Radiology (perform complex imaging studies, or interventional procedures);
E
E
E
D
NA
D. Interventional Angiography; and
E
E
E
D
D
E. Pediatrics.
E
E
D
D
NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.11 - Additional Non-Surgical Specialties

Current through Register Vol. 51, No. 14, July 12, 2024
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The following non-surgical specialties shall be on-call:
A. Gastroenterology;
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E
E
D
NA
B. Infectious Disease;
E
E
E
D
NA
C. Internal Medicine;
E
E
E
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D
D. Nephrology;
E
E
E
E
D
E. Neurology;
E
E
E
E
NA
F. Pathology;
E
E
E
E
NA
G Physiatry; and
D
D
D
D
NA
H. Psychiatry.
E
E
E
E
D
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.12 - Nursing Services

Current through Register Vol. 51, No. 14, July 12, 2024
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A. Responsibility shall be assigned within the department of nursing for trauma care. Oversight of trauma nursing care services shall be with the Department of Nursing.
NA
E
E
E
NA
B. A written plan shall exist and be approved by nursing that shall include the ability to immediately mobilize qualified staff for initial resuscitation.
E
E
E
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E
C. There shall be a written plan for providing adequate and appropriate nursing staff to meet the acuity needs of trauma patients in each unit.
E
E
E
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E
D. The nursing department shall participate in multidisciplinary quality management monitoring of trauma care.
E
E
E
E
E
E. There shall be an introductory education program for all nurses caring for Trauma patients that addresses the learning outcomes approved by the Maryland Trauma Quality Improvement Committee (TQIC). This introductory education program shall include 16 hours of content within 1 year of hire.
E
E
E
E
E
F. After completion of the introductory education mandated in this regulation, continuing education shall be current, meeting the following requirements:
E
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D
(1) 8 hours of trauma-related education every year for emergency and critical care, OR, and PACU nurses caring for trauma patients; or
(2) 4 hours of trauma-related education every year for nurses caring for trauma patients and are from other clinical areas.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.15 - Injury Prevention and Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
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A. The trauma center shall:
(1) Collaborate closely with MIEMSS in developing, monitoring, and evaluating the effectiveness of prevention and public education programs;
E
E
E
E
NA
(2) Conduct epidemiology research concerning injury control;
E
E
NA
NA
NA
(3) Collaborate with other hospitals or agencies in research; and
E
E
E
E
D
(4) Monitor progress of prevention programs in cooperation with State quality monitoring activities.
E
E
E
E
NA
B. The Trauma centers hall have:
(1) An organized and effective approach to injury prevention that prioritizes those efforts based on local trauma registry and epidemiologic data;
E
E
E
E
NA
(2) A dedicated injury prevention coordinator in the trauma center, separate from the TPM position who, in conjunction with the TPM, facilitates outreach and injury prevention strategies specific to the population of the Trauma Center;
E
NA
NA
NA
NA
(3) A designated injury prevention individual in the trauma center, separate from the TPM position, who, in conjunction with the TPM, facilitates outreach and injury prevention strategies specific to the population of the Trauma Center;
NA
E
E
D
NA
(4) Outreach activities and program development that address one of the major causes of injury in the community;
E
E
E
E
E
(5) Information resources; and
E
E
E
E
E
(6) Collaboration with existing national, regional, state and local programs.
E
E
E
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.16 - Trauma Research

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
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A. A trauma center shall have:
E
E
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NA
(1) An organized trauma research program with a designated physician director and documented research plan;
(2) Regular meetings of the research group; and
(3) Evidence of productivity through peer review.
B. The Trauma Center shall have:
(I) Proposals reviewed by an institutional review board;
E
E
D
D
NA
(2) Presentations at local, regional, or national meetings;
E
E
D
D
NA
(3) Publications in peer-reviewed journals on an average of seven per year; and
E
E
D
D
NA
(4) Clinical research trials designed to enhance the trauma system's ability to resuscitate, stabilize, and treat trauma patients in the most cost-effective manner.
E
E
D
D
NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.17 - Education

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
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A. A trauma center shall:
(1) Assist MIEMSS with developing, monitoring, and evaluating the effectiveness of out-of-hospital training programs; and
E
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E
NA
(2) Engage in public and professional education.
E
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E
NA
B. The hospital shall offer:
(1) Trauma education for:
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E
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D
(a) Hospital Nurses and physicians;
(b) Community Nurses and Physicians;
(c) Pre-hospital personnel; and
(d) Allied health personnel;
(2) A trauma critical care fellowship training program;
E
NA
NA
NA
NA
(3) A surgical residency program accredited by the Accreditation Council for Graduate Medical Education; and
E
E
NA
NA
NA
(4) Participation in undergraduate medical education.
E
E
NA
NA
NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.18 - Continuing Education Programs

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
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A hospital shall have:
A. Formal internal continuing education programs concerning the treatment and care of the trauma patients for:
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D
(1) Physicians;
(2) Nurses; and
(3) Allied health personnel;
B. Special training for personnel exclusively on trauma protocols and trauma care for all new physicians, nurses, and allied health personnel assigned to units where trauma care is provided; and
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C. A continuing education program concerning the care and treatment of trauma patients for physicians, nurses, and allied health personnel in the region.
E
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NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.19 - Policies and Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
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The following patient treatment and care documents shall be written, distributed, and monitored for quality:
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E
A. Resuscitation policy;
B. Transfusion and Massive Transfusion policy;
C. Infection control plan (can utilize hospital plan);
D. Trauma team activation policy;
E. Physician call schedule;
F. Subspecialty notification policy;
G. Inter-hospital transfer policy;
H. A policy providing that trauma patients may not be admitted or transferred by a primary care physician without the knowledge and consent of the trauma service, with monitoring of adherence by the QM program;
I. Helicopter safety policy; and
J. Organ procurement policy.
E
E
E
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E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.20 - Trauma Program Manager

Current through Register Vol. 51, No. 14, July 12, 2024
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A. There shall be a Trauma Program Manager (TPM) who is a registered nurse and who is responsible for the organization of services and systems necessary for a multidisciplinary approach to providing care to the injured patient in collaboration and conjunction with the Trauma Medical Director (TMD).
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NA
B. There shall be a defined organizational structure which delineates the roles and responsibilities of the TPM.
E
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NA
C. This must be a full-time (1.0 FTE) position dedicated to the management of the trauma program.
NA
E
E
E
NA
D. The institution's organization shall define the structural role of the TPM to include responsibility, accountability, and authority.
NA
E
E
E
NA
E. The TPM shall:
(1) Possess evidence of appropriate qualifications including academic and trauma-related education and clinical experience;
E
E
E
E
NA
(2) Have a job description developed by the hospital to reflect the role and responsibilities as defined by COMAR, and be shown on an organizational chart depicting the relationship between the TPM and other services, including the Department of Nursing;
E
E
E
E
NA
(3) Attend and participate in local, state and national trauma-related activities, including but are not limited to: EMS Advisory Councils, State trauma-related committees and events, National trauma-related activities and events;
E
E
E
E
NA
(4) Participate in trauma educational activities external to the institution's staff development programs;
E
E
E
E
NA
(5) As requested, participate in multidisciplinary trauma research;
E
E
D
D
NA
(6) Have sufficient administrative and budgetary commitment in order to support the needs of the Trauma Program inclusive of clerical and clinical nursing personnel that help fulfills needs of the concurrent performance Improvement, outreach and injury prevention;
E
E
E
E
NA
(7) Supervise the Trauma Registry staff and trauma clinical QM staff and have oversite for injury prevention and outreach;
NA
E
E
E
NA
(8) Identify an alternate supervisor to supervise the trauma registry if needed; and
E
NA
NA
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NA
(9) The TPM and/or TMD will have the oversight and approval of internal trauma-related education programs within each trauma center.
E
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E
NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.22 - Emergency Preparedness

Current through Register Vol. 51, No. 14, July 12, 2024
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A. The Trauma Center shall have a hospital Emergency Preparedness/Disaster plan described in the hospital's policy and procedure manual or equivalent.
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B. The hospital disaster plan shall have a hazards vulnerability analysis to guide the response plan.
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E
C. The Hospital Incident Command System (HICS) shall be used as a management system for incident command, planning logistics, operations and finance/administrative functions.
E
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E
D. A tiered - approach depending on the magnitude of the event and alternatives for care shall be identified.
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E. The Trauma Center shall be represented on the hospital's Emergency Preparedness/Disaster Committee.
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NA
F. The Trauma Center hospital shall:
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E
(1) Participate in local, state and/or national disaster management meetings, plans and exercises; and
(2) Conduct hospital drills that test the individual hospital's disaster plan at least twice a year, including actual plan activations that can substitute for drills.
E
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E
E
E
G. A written plan for supporting Trauma Center incident debriefing shall be accessible for all staff members.
E
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E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.23 - Criteria for the Number and Level of Trauma Centers To Be Designated or Reverified

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS shall use the following criteria when designating or reverifying trauma centers from among those applicant hospitals that apply for designation or reverification:
(1) Standards in this chapter;
(2) Patient volume;
(3) Geographic coverage;
(4) Population;
(5) Competing applications; and
(6) New applications.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.24 - Injury Severity Criteria

Current through Register Vol. 51, No. 14, July 12, 2024
For the purposes of Regulation .20D(2)-(3) of this chapter, a patient with severe injury shall have:
A. An injury severity score (ISS) greater than or equal to 13;
B. A penetrating injury with systolic blood pressure of less than or equal to 90 millimeters of mercury;
C. A thoracic injury classified as one or more of the following International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM) codes:
(1) 861.21-Lung contusion, without open wound to thorax;
(2) 861.31-Lung contusion, with open wound into thorax; or
(3) 807.4-Flail chest;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.01 - Bum Center Organization

Current through Register Vol. 51, No. 14, July 12, 2024
A. A Burn center shall:
(1) Maintain a designated unit or units for specialized acute burn care;
(2) Be a hospital designated as a Level II or higher trauma center;
(3) If an in-State hospital, have one of the following issued by the Maryland Health Care Commission:
(a) A certificate of need; or
(b) An exception from the requirement for a certificate of need;
(4) Demonstrate commitment to the optimal care of the hospital's burn injured patients by the hospital's board of directors, administration, medical staff, and nursing staff by formulating a board of director's resolution, updated yearly, stating that:
(a) The hospital agrees to meet the burn center designation standards;
(b) The hospital has a commitment to the infrastructure and the financial, human, and physical resources necessary to support the hospital's burn center designation; and
(c) The hospital has a commitment to the quality management (QM) process of the burn patient;
(5) Complete transfers to in-State hospitals, or to out-of-State hospitals listed in the Maryland Emergency Medical Services Interhospital Transfer Resource Manual, in accordance with the guidelines contained in the Maryland Emergency Medical Services Interhospital Transfer Resource Manual without the need for separate transfer agreements;
(6) Have a written transfer agreement in place for transfer of a patient to an out-of-State hospital not listed in the Maryland Emergency Medical Services Interhospital Transfer Resource Manual, if the hospital transfers to such out-of-State hospital more than five times a year;
(7) Have a written transfer agreement in place for transfer of a patient to a rehabilitation hospital if the hospital transfers to such a rehabilitation hospital more than two times a year;
(8) Have and maintain current accreditation by the Joint Commission;
(9) Use the resources of the burn center for patients with burn injuries and those suffering from burn-like diseases; and
(10) Have administrative and budgetary commitment in order to support the needs of the burn center, inclusive of clerical and clinical nursing personnel, that helps fulfill needs of the concurrent PI, outreach, injury prevention, and research.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.02 - Organizational Structure

Current through Register Vol. 51, No. 14, July 12, 2024
A. Documentation of Policies and Procedures.
(1) A burn center shall formally establish and maintain an organized burn service that is responsible for coordinating the care of the burn patient.
(2) A burn center shall maintain an organizational chart relating personnel within the burn unit to other hospital staff; a combined leadership model for trauma and burn center is acceptable.
(3) A burn center shall maintain an appropriate policy and procedure manual that:
(a) Is reviewed annually by the burn center director and the burn nursing leader; and
(b) Addresses:
(i) Administration of the burn center;
(ii) Staffing and programs of the burn center;
(iii) Criteria for admission to the burn unit by the burn service;
(iv) Usage of the burn unit beds by other medical or surgical services;
(v) Criteria for discharge and follow-up care;
(vi) Availability of beds and the transfer of burn patients to other medical or surgical units within the hospital; and
(vii) Care of patients with burns in areas of the burn center other than the burn units.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.03 - Bum Center Director

Current through Register Vol. 51, No. 14, July 12, 2024
A. General.
(1) A burn center director is authorized to direct and coordinate all medical services for patients admitted to the burn service.
(2) Medical care for patients in the burn center shall be provided by the burn center director or qualified physicians approved by the director and shall conform to burn center care protocols.
(3) Privileges for physicians participating in the burn service shall be approved by the burn center director and determined by the medical staff credentialing process.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.04 - Appointment and Qualifications of Attending Burn Staff Surgeons

Current through Register Vol. 51, No. 14, July 12, 2024
A. A burn center director may appoint qualified attending burn staff surgeons to participate in the care of patients in the burn service.
B. An attending burn staff surgeon shall meet the requirements in Regulation .05 of this chapter.
C. The burn medical director shall serve on the medical staff as the burn chief of service.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.06 - Provider Coverage for Burn Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. Emergency department attending physicians may provide coverage for acute resuscitation when the burn surgeon is not on-site. In the absence of the burn surgeon, the emergency department physician shall have the authority to provide initial resuscitation and treatment of the burn injured patient.
B. Burn unit coverage (i.e., hospitalists, intensivists, etc.) shall:
(1) Be assigned to the burn service;
(2) Be available within 15 minutes, 24 hours a day;
(3) For the adult burn center, be current in ATLS® or ABLS®; and
(4) Have a liaison to the burn QM program with 50 percent attendance.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.07 - Nursing Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. Clinical Nurse Managers for Burn Units.
(1) A burn center shall have a clinical nurse manager who is administratively responsible for the burn unit.
(2) A nurse manager shall:
(a) Be a registered nurse;
(b) Have a baccalaureate or higher degree in nursing;
(c) Have at least two of the following qualifications:
(i) An active role in burn QM program and processes;
(ii) An active role in nursing research;
(iii) An active role in burn prevention;
(iv) 12 months or more of experience in acute burn care;
(v) 2 years or more of experience in intensive care unit or surgical care unit appropriate to the specific unit; or
(vi) 6 months or more managerial experience; and
(d) Participate in QM, burn research, and burn prevention.
(3) A burn center shall have an organizational chart relating the nurse manager to the burn service and other members of the burn team.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.08 - Rehabilitation Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A burn center shall:
A. Have a rehabilitation program, including physical therapy, occupational therapy, and speech therapy, that is designed for the burn patient and identifies specific goals;
B. Require therapists to be appropriately licensed or registered in their specific disciplines;
C. Base staffing upon both inpatient and outpatient activity with at least one full-time equivalent (FTE) burn therapist for the burn unit;
D. Assign a therapist to the burn center for both inpatients and outpatients, either:
(1) Permanently; or
(2) On a rotating basis for at least 1 year;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.09 - Other Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. A burn center shall:
(1) Have a social service consultation available to the burn service; and
(2) Assign a social worker to the burn center for both inpatients and outpatients, either:
(a) Permanently; or
(b) On a rotating basis for at least 1 year.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.10 - Quality Management (QM) Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. Policies and Procedures.
(1) A burn service shall have a QM program that is multidisciplinary.
(2) A burn center director is responsible for the QM program.
(3) A burn unit multidisciplinary committee shall:
(a) Oversee the QM program;
(b) Meet at least monthly; and
(c) Maintain sufficient documentation to:
(i) Verify problems;
(ii) Identify opportunities for improvement;
(iii) Take corrective actions; and
(iv) Demonstrate evidence of loop closure.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.11 - Other Programs

Current through Register Vol. 51, No. 14, July 12, 2024
A. Medical Staff Education.
(1) A burn center shall have an educational program for the medical staff.
(2) If residents rotate on the burn service, a burn service director or the director's designee shall provide an orientation program for new residents.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.12 - Equipment

Current through Register Vol. 51, No. 14, July 12, 2024
A burn unit shall have:
A. At least four burn unit beds with critical care capacity; and
B. The following equipment in the adult burn center:
(1) Weight measurement devices for kilogram measurement;
(2) Difficult airway equipment capable for surgical intervention;
(3) Emergency carts with age-appropriate equipment; and
(4) Temperature control/measurement devices for:
(a) The patient;
(b) Intravenous fluids; and
(c) Blood products.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.13 - Other Services

Current through Register Vol. 51, No. 14, July 12, 2024
A burn center shall have available the following services for burn patients 24 hours a day:
A. Renal dialysis;
B. Radiographs;
C. Angiography;
D. Ultrasonography;
E. Nuclear medicine scanning;
F. CT scanning;
G. Clinical laboratory services; and
H. Blood bank services.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.14 - Operating Rooms

Current through Register Vol. 51, No. 14, July 12, 2024
A burn center shall have an operating room available to the burn service 24 hours a day for appropriate and timely treatment.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.15 - Emergency Services

Current through Register Vol. 51, No. 14, July 12, 2024
An emergency department shall have written protocols for treating acutely burned patients that are consistent with the burn treatment protocols.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.16 - Allograft Service

Current through Register Vol. 51, No. 14, July 12, 2024
A burn center shall:
A. Maintain a written policy stating:
(1) That allograft tissues are to be obtained only from those tissues banks that adhere to the standards of the American Association of Tissue Banks, if applicable; and
(2) Compliance with U.S. Food and Drug Administration regulations published in 21 CFR Part 1270 Human Tissue Intended for Transplantation;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.17 - Burn Center Referral Criteria

Current through Register Vol. 51, No. 14, July 12, 2024
A burn injury requiring referral to a burn center includes:
A. A partial thickness or full thickness burn greater than 10 percent total body surface area (TBSA) in patients younger than 10 years old;
B. A partial thickness or full thickness burn greater than 20 percent TBSA in other age groups;
C. A partial thickness or full thickness burn that involves the face, hands, feet, genitalia, perineum, and major joints;
D. All full thickness burns greater than 5 percent TBSA in any age group;
E. An electrical/lightening injury;
F. A chemical injury;
G. An inhalation injury;
H. Frostbite and cold injury;
I. A burn injury in patients with preexisting medical disorders that could:
(1) Complicate management;
(2) Prolong recovery; and
(3) Affect mortality;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.18 - Injury Prevention and Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
The burn center shall:
A. Collaborate closely with MIEMSS and other State agencies in developing, monitoring, and evaluating the effectiveness of prevention and public education programs;
B. Conduct epidemiology research concerning burn injury control;
C. Collaborate with other hospitals, MIEMSS, or other agencies in burn injury prevention initiatives and research;
D. Have an organized and effective approach to burn injury prevention that prioritizes those efforts based on burn registry and epidemiologic data;
E. Have a designated burn injury prevention coordinator, separate from the BPM position, who, in conjunction with the BPM, facilitates outreach and injury prevention strategies specific to the population of the burn center; and
F. Collaborate with existing national, regional, State and local programs.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.19 - Bum Research

Current through Register Vol. 51, No. 14, July 12, 2024
A burn center shall have:
A. An organized burn-related research program with a designated physician director;
E
B. A written research plan developed and reviewed yearly;
E
C. A dedicated master's prepared researcher, separate from the BPM;
D
D. Regular meetings of the research group;
E
E. Evidence of productivity through peer review;
E
F. Proposals reviewed by an institutional review board;
E
G. Presentations at local, regional, or national meetings; and
E
H. Publications in three or greater peer-reviewed journals.
E
Note: E = Essential; D = Desired
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.20 - Burn Program Manager

Current through Register Vol. 51, No. 14, July 12, 2024
A. There shall be a burn program manager (BPM) who is a registered nurse and is responsible for the organization of services and systems necessary for a multidisciplinary approach to providing care to the injured patient in collaboration and conjunction with the burn medical director (BMD).
B. This shall be a full-time (1.0 FTE) position dedicated to the management of the burn center.
C. Where the burn center has 1.0 FTE for the burn and trauma manager, it shall have a dedicated 1.0 FTE QM nurse coordinator.
D. The institution's organization shall define the structural role of the BPM to include responsibility, accountability, and authority as reflected in the organizational chart.
E. The BPM shall:
(1) Provide evidence and maintenance of qualifications including academic and burn-related education and clinical experience;
(2) Comply with a job description developed by the hospital that reflects the role and responsibilities as defined by COMAR, and an organizational chart depicting the relationship between the BPM and other services, including the Department of Nursing/Trauma and Burn Nursing;
(3) Ensure participation in local, State, and national burn-related activities, including but not limited to EMS Advisory Councils, State burn-related committees and events, and national burn-related activities and events;
(4) Participate in burn educational activities external to the institution 's staff development programs;
(5) Maintain and provide evidence of 8 hours annually of internal and 8 hours external burn-related CE; and
(6) Supervise burn registry staff, burn clinical performance improvement staff, injury prevention staff, and outreach staff.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.06 - Adult and Pediatric Burn Center Standards › Section 30.08.06.21 - State Burn Registry

Current through Register Vol. 51, No. 14, July 12, 2024
A. The burn center shall maintain the State Burn Registry (BR).
B. The State Burn Registry shall include, at a minimum, all of the data elements compliant with the Maryland Trauma Registry Data Dictionary for Burn Registry and American Burn Association National Burn Repository (NBR), including:
(1) Demographic data;
(2) Injury data;
(3) Hospital data;
(4) Description of injury;
(5) Diagnosis;
(6) Comorbidities;
(7) Procedure codes;
(8) Complications;
(9) Outcome; and
(10) Outpatient module, which includes outpatient information, Lund and Browder, treatment, complications, and comorbidities.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.01 - General Criteria

Current through Register Vol. 51, No. 14, July 12, 2024
Unless otherwise indicated in this subtitle, MIEMSS shall use the following criteria when designating or reverifying specialty referral centers from among those applicant hospitals that apply for designation or reverification and when contracting with out-of-State specialty referral center hospitals:
A. Applicable standards in this subtitle;
B. Patient volume;
C. Geographic coverage;
D. Population;
E. Demonstrated expertise of the professional staff in the specific specialty care area;
F. Active research program focused on specific specialty care area;
G. Competing applications; and
H. New applications.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.02 - Exceptions

Current through Register Vol. 51, No. 14, July 12, 2024
The criteria listed in Regulation .01 of this chapter do not apply to burn, perinatal, neonatal, or designated primary stroke specialty referral centers.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.03 - Additional Considerations

Current through Register Vol. 51, No. 14, July 12, 2024
When applying the criteria, MIEMSS may consider:
A. Applicable guidelines and professional standards;
B. Patient outcome standards; and
C. Published results of peer-reviewed research.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.04 - Compliance with Standards

Current through Register Vol. 51, No. 14, July 12, 2024
An applicant hospital shall comply with the applicable standards for specialty referral centers in this subtitle.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.05 - Patient Volume

Current through Register Vol. 51, No. 14, July 12, 2024
A. When considering an applicant hospital, MIEMSS shall take into account the number and distribution of specialty referral centers that will allow designated or contract specialty referral centers to:
(1) Minimize duplication of services;
(2) Achieve and sustain the volumes necessary for:
(a) Optimal outcome,
(b) Cost efficiency,
(c) Maintenance of expertise,
(d) Quality care,
(e) Research, and
(f) Physician and nurse education; and
(3) Minimize the potential adverse effect on quality of care that may result if patient volumes are reduced,
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.06 - Geographic Coverage

Current through Register Vol. 51, No. 14, July 12, 2024
When considering an applicant hospital, MIEMSS shall:
A. Minimize duplicative services within close proximity; and
B. Consider the number, geographic distribution, and resource capabilities of other specialty referral centers.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.07 - Population

Current through Register Vol. 51, No. 14, July 12, 2024
When considering an applicant hospital, MIEMSS shall take into account the applicant hospital's geographic specialty patient catchment area given the current and projected population density within an area.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.08 - Professional Staff Expertise

Current through Register Vol. 51, No. 14, July 12, 2024
When considering an applicant hospital, MIEMSS shall take into account the education and specialty training of the following hospital staff:
A. Physicians;
B. Nurses; and
C. Technicians and support staff.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.09 - Active Research Program

Current through Register Vol. 51, No. 14, July 12, 2024
When considering an applicant hospital, MIEMSS may give preference to the applicant with an established and ongoing clinical research program focusing on the specific specialty care area.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.10 - Competing Applications

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS may give preference to an applicant hospital with a designated trauma center which supports or is supported by the presence of a specialty referral center.
B. If there are two or more applicants for the same type of specialty referral center in the same geographic coverage area where patient volumes or population would likely be insufficient to support both applicants, based on the criteria in Regulations .04-.09 of this chapter, MIEMSS shall:
(1) Give preference to the applicant with an established specialty referral program that can demonstrate that its past experience and performance:
(a) Are indicative of quality patient care,
(b) Are consistent with professional standards, and
(c) Result in optimal patient outcome; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.07 - Specialty Referral Center Designation Criteria › Section 30.08.07.11 - New Applicants

Current through Register Vol. 51, No. 14, July 12, 2024
An applicant hospital that, under this subtitle, has not previously been designated as a specialty referral center by MIEMSS or contracted with MIEMSS as a specialty referral center shall:
A. Be subject to the specialty referral center designation criteria; and
B. Demonstrate that its proposed specialty referral center can generate sufficient patient volume without adversely affecting patient volumes at other existing, designated, or contract specialty referral centers.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter, the following term has the meaning indicated.
B. Term Defined. "Level I pediatric trauma center (level I PTC)" means a hospital that is capable of and committed to providing comprehensive pediatric trauma care to children younger than 15 years old, meets the standards of this chapter, and is an:
(1) In-State hospital designated by MIEMSS and approved by the EMS Board to provide comprehensive pediatric trauma care services; or
(2) Out-of-State hospital that has entered into an agreement with MIEMSS and been approved by the EMS Board to provide comprehensive pediatric trauma services to Maryland patients.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.02 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital's board of directors, administrators, and medical and nursing staffs shall demonstrate commitment to the optimal care of injured pediatric patients by:
(1) Formulating a board of director's resolution stating that:
(a) The hospital agrees to meet the Maryland Pediatric Trauma Center designation standards; and
(b) The hospital has a commitment to the infrastructure and the financial, human, and physical resources necessary to support the hospital's designation as a pediatric trauma center;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.03 - Medical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have a credentialing process. Each physician and all advance practice professionals (APPs) shall be credentialed by the hospital for the appropriate specialty, including pediatric trauma care.
B. The hospital shall have a process for delineation and reevaluation of privileges that includes:
(1) A pediatric trauma panel, which shall be limited to those with demonstrated skills, commitment, experience, and interest in pediatric trauma care;
(2) Appointment and reappointment to the pediatric trauma admitting or consulting staff that is coordinated by the medical staff office; and
(3) The delineation of privileges for the pediatric trauma admitting or consulting staff approved by the pediatric TMD based on the following criteria:
(a) Maintenance of good standing in the primary specialty;
(b) Evidence of the required continuing medical education in trauma;
(c) Documented attendance at multidisciplinary meetings, morbidity and mortality (M&M) rounds, and hospital peer-review conferences that deal with the care of injured patients; and
(d) Satisfactory performance in managing pediatric trauma patients based on performance assessment and outcome analysis.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.04 - Nursing Service

Current through Register Vol. 51, No. 14, July 12, 2024
A. The oversight and responsibility for pediatric trauma nursing care shall be assigned within the Department of Nursing.
B. There shall be a plan for providing adequate and appropriate nursing staff to meet the acuity needs of pediatric trauma patients in each unit of care.
C. The nursing department shall participate in the interdisciplinary QM monitoring of pediatric trauma care.
D. There shall be an education program for all nurses providing care for pediatric trauma patients addressing the specific care needs of the patients and their families.
E. The education program developed and approved by the trauma quality improvement committee (TQIC) shall include:
(1) An introductory 16-hour trauma nursing curriculum that:
(a) Addresses resuscitation and definitive care for pediatric trauma patients; and
(b) Covers the continuum of care; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.05 - Pediatric Emergency Department (PED)

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have an ED dedicated to pediatric care, including:
A. A designated and dedicated ED physician director and nurse manager;
B. A sufficient number of registered nurses and other clinicians who:
(1) Have the necessary knowledge and skills to provide care during trauma resuscitation;
(2) Are present to manage projected caseloads; and
(3) Immediately reinforce the number of staff upon notice of multiple admissions;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.06 - Pediatric Operating Room (OR)

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have an OR adequately staffed and immediately available and equipped to care for injured children of all ages.
B. The OR shall have supplies, equipment, medications, and staff approved by the TMD to ensure availability of optimal resources.
C. The OR shall have equipment and supplies for microvascular and microneural surgery.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.07 - Pediatric Post Anesthesia Care Unit (PACU)

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have a PACU adequately staffed, immediately available, and equipped to care for injured children.
B. The PACU shall:
(1) Be available to pediatric trauma patients with an appropriately trained registered nurse and other essential staff 24 hours a day to care for the multiply injured child;
(2) Have equipment for continuous monitoring of temperature, hemodynamics, and gas exchange; and
(3) Have available pediatric resuscitation equipment and medications.