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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.6 - Pediatric Trauma Program Manager (TPM)

Current through June 25, 2024
1. Secondary
					 pediatric trauma centers must have a registered nurse working in the role of
					 the TPM. The TPM of the adult trauma center may assume this additional role;
					 however, if a pediatric TPM is utilized, the pediatric TPM is to report and be
					 held accountable by the adult TPM. Working in conjunction with the pediatric
					 trauma medical director, the pediatric TPM is responsible for organization of
					 the pediatric trauma program and all systems necessary for the
					 multidisciplinary approach throughout the continuum of trauma care. The
					 pediatric TPM is responsible for working with the pediatric trauma team to
					 assure optimal patient care. There are many requirements for data coordination,
					 PI, education, and prevention activities incumbent upon this
					 position.
2. The pediatric
					 TPM/designee should offer or coordinate services for pediatric trauma
					 education. The pediatric TPM should liaison with local EMS personnel, the
					 Department, the Trauma Care Regions, 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.7 - Pediatric Trauma Team

Current through June 25, 2024
1. The team
					 approach is optimal in the care of the multiple injured pediatric patients.
					 There must be identified members of the pediatric trauma team. Policies shall
					 be in place describing the roles of all personnel on the pediatric trauma team.
					 The composition of the pediatric 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 and/or pediatric surgeon. All physicians and
					 mid-level providers on the pediatric trauma team responsible for directing any
					 phase of the resuscitation must be currently certified in ATLS. ATLS
					 requirement is waived for Board Certified Emergency Medicine and Board
					 Certified General Surgery Physicians.
2. Recommended composition of the pediatric
					 trauma team for severely injured pediatric patients may include:
a. Physicians and/or mid-level providers
					 (Physician Assistant/Nurse Practitioner)
b. Specialists
c. Laboratory Technicians as dictated by
					 clinical needs
d. Nursing, ED, OR,
					 ICU, etc
e. Auxiliary Support
					 Staff
f. Respiratory
					 Therapists
g. Security
					 Officers
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.8 - 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 pediatric 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 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
					 pediatric patient care. Suggested membership for the committee includes
					 representatives (if available in the community) from:
a. Administration
b. Orthopedics
c. Anesthesia
d. Pediatrics
e. Emergency Department
f. Prehospital Care Providers
g. General and Pediatric Surgery
h. Radiology
i. Intensive Care
j. Rehabilitation
k. Laboratory
l. Respiratory Therapy
m. Nursing
n. Trauma Program Manager/TPM
o. Operating Room
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.9 - Required Clinical Components

Current through June 25, 2024
1. Secondary
					 pediatric trauma centers must have published on-call schedules and have the
					 following medical specialists immediately available 24 hours/day to the injured
					 pediatric patient:
2. Pediatric
					 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.
3. Trauma/General or Pediatric Surgery. It is
					 desirable that a back up surgeon schedule is published. It is desirable that
					 the surgeon on-call is dedicated to the pediatric trauma center and not on-call
					 to any other hospital while on pediatric trauma call. A system should be
					 developed to assure notification of the on-call surgeon and compliance with
					 these criteria and their appropriateness must be documented and monitored by
					 the PI process. Response time for Alpha Alert/Activations is 30 minutes and
					 starts at patient arrival or EMS notification, whichever is shorter. Response
					 time for Bravo Alerts/Activations is 45 minutes from patient arrival.
4. Orthopedic Surgery. It is desirable that a
					 back up surgeon schedule is published. It is desirable that the surgeon on-call
					 is dedicated to the pediatric trauma center and not on-call to any other
					 hospital while on pediatric trauma call. A system should be developed to assure
					 notification of the on-call surgeon and compliance with these criteria and
					 their appropriateness must be documented and monitored by the PI process.
					 Response time for all trauma activations is 60 minutes from the time notified
					 to respond.
5. Anesthesia.
					 Anesthesia must be immediately available with a mechanism established to ensure
					 early notification of the on-call anesthesiologist. Anesthesia must be
					 available 24 hours/day. Anesthesia chief residents or certified nurse
					 anesthetist (CRNA) may fill this requirement. When residents or CRNAs are
					 utilized, the staff anesthesiologist on-call will be advised, promptly
					 available, and present for all operations. Hospital policy must be established
					 to determine when the anesthesiologist must be immediately available for airway
					 control and assisting with resuscitation. The availability of the
					 anesthesiologist and the absence of delays in airway control or operative
					 anesthesia must be documented and monitored by the PI process. The maximum
					 response time for all trauma patients is 30 minutes from the time notified to
					 respond.
6. The following
					 specialists must be on-call and promptly available:
a. Pediatrics
b. Radiology
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.10 - Qualifications of Surgeons on the Trauma Team

Current through June 25, 2024
1. Basic to
					 qualifications for trauma care for any surgeon is Board Certification in a
					 surgical specialty recognized by the American Board of Medical Specialists, the
					 Advisory Board of Osteopathic Specialists, 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 recognized 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
					 certifications are as follows:
a. Non-board
					 certified general surgeons 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 pediatric trauma medical director to serve
					 on the pediatric trauma team.
e.
					 The surgeon's experience in caring for the pediatric trauma patient must be
					 tracked by the PI program.
f. The
					 pediatric trauma medical director must attest to the surgeon's experience and
					 quality as part of the recurring granting of pediatric trauma team
					 privileges.
g. The pediatric trauma
					 medical director, using the pediatric trauma PI plan is responsible for
					 determining each general surgeon's ability to participate on the pediatric
					 trauma team.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.11 - 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 physicians must
					 meet all criteria established by the pediatric trauma and emergency medical
					 director to serve on the pediatric trauma team.
d. The physician's experience in caring for
					 the pediatric trauma patient must be tracked by the PI program.
e. The pediatric trauma and emergency medical
					 director must attest to the physician's experience and quality as part of the
					 recurring granting of pediatric 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.12 - Facility Standards-Emergency Medicine

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
					 facility should have a dedicated pediatric emergency area so pediatric patients
					 are assured immediate and appropriate initial care. The emergency physician
					 must be in-house 24 hours/day, immediately available at all times, and capable
					 of evaluating pediatric trauma patients and providing initial resuscitation.
					 The emergency medicine physician will provide team leadership and care for the
					 pediatric 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 pediatric trauma patient. The
					 medical director for the department, or designee, must participate with the
					 Multidisciplinary Trauma Committee and the pediatric trauma PI
					 process.
2. The director of the
					 emergency department, along with the pediatric trauma medical director, 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 RNs
					 staffed for the pediatric trauma resuscitation area in-house 24 hours/day.
					 Emergency nurses staffing the pediatric trauma resuscitation area must be a
					 current provider of TNCC and participate in the ongoing PI process of the
					 trauma program. Nurses must obtain TNCC within 18 months of assignment to the
					 ER. There must be a written plan ensuring nurses maintain ongoing trauma
					 specific education.
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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.13 - Facility Standards-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 pediatric patient's condition
					 warrants. The process should be monitored by the pediatric trauma PI
					 program.
2. The OR nurses should
					 participate in the care of the pediatric trauma patient and be competent in the
					 surgical stabilization of the major pediatric trauma patient. The surgical
					 nurses are integral members of the pediatric trauma team and must participate
					 in the ongoing PI process of the pediatric trauma program and must be
					 represented on the Multidisciplinary Trauma Committee.
3. The OR supervisor must be able to
					 demonstrate a prioritization scheme to assure the availability of an operating
					 room for the emergent pediatric trauma patient during a busy operative
					 schedule.
4. Anesthesia must be
					 promptly available with a mechanism established to ensure notification of the
					 on-call anesthesiologist. The secondary pediatric trauma center must document
					 conditions when the anesthesiologist must be immediately available for airway
					 emergencies and operative management of the pediatric trauma patient.
5. Anesthesiologists on the pediatric trauma
					 team must have successfully completed an anesthesia residency program approved
					 by the Accreditation Council for Graduate Medical Education, the American Board
					 of Osteopathic Specialists, or the American Osteopathic Board and should have
					 board certification in anesthesia.
6. Anesthesia requirements may be fulfilled
					 by Certified Registered Nurse Anesthetists (CRNAs) and/or anesthesia residents
					 who are capable of assessing emergency situations in pediatric 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. Secondary pediatric trauma centers must document
					 conditions when the anesthesiologist must be immediately available for airway
					 emergencies and operative management of the pediatric 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 pediatric trauma team should have the
					 necessary educational background in the care of the pediatric trauma patient
					 and must participate in the Multidisciplinary Trauma Committee and the
					 pediatric trauma PI process.
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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.14 - Facility Standards-PACU

Current through June 25, 2024
1. A secondary
					 pediatric trauma center must have a PACU available 24 hours/day to the
					 postoperative pediatric 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 pediatric 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.15 - Facility Standards-ICU

Current through June 25, 2024
1. The ICU must
					 have a surgical director or a surgical co-director who is responsible to set
					 policy and administration and establish standards of care to meet the unique
					 needs of the pediatric trauma patient. He/she is responsible for the quality of
					 care and administration of the ICU. The pediatric trauma medical director must
					 work to assure pediatric trauma patients admitted to the ICU will be admitted
					 to the care of the general surgeon or appropriate surgical subspecialists. In
					 addition to overall responsibility for pediatric 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. Secondary pediatric trauma centers should
					 provide staffing in sufficient numbers to meet the needs of the pediatric
					 trauma patient. There must be a written plan ensuring nurses maintain ongoing
					 critical care education. ICU nurses are an integral part of the pediatric
					 trauma team and as such, should be represented on the Multidisciplinary Trauma
					 Committee and participate in the PI process of the pediatric trauma
					 program.
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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.16 - Clinical Support Services-Respiratory Therapy

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
						pediatric 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.17 - Clinical Support Services-Radiological Services

Current through June 25, 2024
1. A board-certified radiologist should
					 administer the department and participate actively in the pediatric trauma PI
					 process. The radiologist is a key member of the pediatric trauma team and
					 should be represented on the Multidisciplinary Trauma Committee. A certified
					 radiologist technician must be available in-house 24 hours/day to meet the
					 immediate needs of the pediatric trauma patient for general radiological
					 procedures. Sonography should be available to the pediatric 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 PI
					 process must verify that radiological services are promptly available. Written
					 policy should exist delineating the prioritization/availability of the CT
					 scanner for pediatric 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 pediatric
					 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 pediatric 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.18 - Clinical Support Services-Laboratory Services

Current through June 25, 2024
The clinical laboratory service shall have the following
						services available in-house 24 hours/day:
1. 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.
2. Standard analysis of blood, urine, and
					 other body fluids includes micro-sampling when appropriate.
3. Blood gas and pH determination (this
					 function may be performed by services other than the clinical laboratory
					 service, when applicable).
4.
					 Alcohol screening is required and drug screening is highly
					 recommended.
5. Coagulation
					 studies.
6. Microbiology.
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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.19 - Clinical Support Services-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 secondary pediatric 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.20 - Clinical Support Services-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 secondary pediatric 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. The transfer protocols must include
						a feedback loop so that the primary provider has a good understanding of the
						patient outcome.
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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.21 - Clinical Support Services-Rehabilitation/Social Services

Current through June 25, 2024
1. The rehabilitation of the pediatric trauma
					 patient and the continued support of the family members are important parts 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 pediatric
					 trauma patient at the earliest stage possible after admission to the secondary
					 pediatric trauma center. Secondary pediatric trauma centers will be required to
					 identify a mechanism to initiate rehabilitation services and/or consultations
					 in a timely manner, as well as to develop 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 must
					 include Physical Therapy and Social Service. It is desirable to have
					 Occupational and Speech Therapy.
2.
					 The nature of traumatic injury requires that the psychological needs of the
					 pediatric trauma patient and family are considered and addressed in the acute
					 states of injury and throughout recovery. A secondary pediatric trauma center
					 may utilize community resources as appropriate to meet the needs of the
					 pediatric 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.22 - Clinical Support Services-Prevention/Public Outreach

Current through June 25, 2024
1. Secondary pediatric trauma centers must
					 work cooperatively with referral facilities to develop and implement an
					 outreach program for pediatric trauma care in the region. The secondary
					 pediatric 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.
					 The secondary pediatric trauma center is responsible for working with 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.23 - Clinical Support Services-Transfer Guidelines

Current through June 25, 2024
The secondary pediatric trauma center will have transfer
						guidelines in place with tertiary pediatric trauma centers, as well as all
						specialty referral centers (such as burns, spinal cord injury and
						rehabilitation) when these services are not available at the secondary
						pediatric trauma center. Secondary pediatric trauma centers should work in
						collaboration with the referral trauma facilities in the system and develop
						interfacility transfer guidelines. These guidelines must address criteria to
						identify high-risk pediatric patients that could benefit from a higher level of
						trauma care. All designated facilities will agree to provide services to the
						pediatric trauma patient 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 6 - Pediatric Trauma Centers › Subchapter 2 - Secondary Pediatric Trauma Center › Rule 15-12-32-6.2.24 - Clinical Support Services-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, the data is confidential as provided by Mss. Code
					 Ann.§
											41-59-77.
					 Tertiary pediatric trauma facilities may be responsible for direct assistant to
					 primary and secondary pediatric trauma centers, referring facilities in
					 providing data for inclusion in the registry. All pediatric admissions that
					 meet Trauma Registry inclusion criteria shall be reviewed by the PI
					 process.
2. Each trauma center must
					 develop an internal Pediatric 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 evidence 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 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.1 - General

Current through June 25, 2024
Primary pediatric trauma centers are facilities with a
						commitment to the resuscitation of the pediatric trauma patient and have
						written transfer protocols in place to assure those patients who require a
						higher level of care are appropriately transferred. All designated Trauma
						Centers shall, as a minimum, be designated as a Primary Pediatric Trauma Center
						as a condition of designation in the Mississippi Trauma Care System. The list
						of required equipment for Primary Pediatric Trauma Centers 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.2 - Hospital Departments/Divisions/Sections

Current through June 25, 2024
The Primary Pediatric 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.3 - 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 adult and pediatric 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 which includes pediatric trauma
					 indicators;
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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.4 - Trauma Medical Director (TMD)

Current through June 25, 2024
1. The Primary
					 Pediatric 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, both adult and pediatric. 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.5 - Trauma Program Manager (TPM)

Current through June 25, 2024
1. The Primary
					 Pediatric 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 fulltime role.
					 Specifically, this person is responsible, with the TMD, for coordinating
					 optimal patient care for all injured victims, both adult and pediatric. 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. 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.6 - 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.7 - 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. Required membership for the committee includes
					 representatives (if available in the community) from:
a. Administration
b. Emergency Department
c. Prehospital Care Providers
d. Radiology
e. Rehabilitation
f. Laboratory
g. Respiratory Therapy
h. Nursing
i. Trauma Program Manager
j. The clinical managers (or designees) of
					 the departments involved with trauma care should play an active role with the
					 committee.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.8 - Required Clinical Components/Facility Standards-Emergency Medicine

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.
3. 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 Primary Pediatric Trauma Center; however it is a
					 desirable characteristic. 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.
4. 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.
5. 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.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.9 - Clinical Support Services-General

Current through June 25, 2024
1. It is not
					 anticipated that a Primary Pediatric 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.10 - Clinical Support Services-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 primary pediatric 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. The transfer protocols must include
						a feedback loop so that the primary provider has a good understanding of the
						patient outcome.
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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.11 - Clinical Support Services-Prevention/Public Outreach

Current through June 25, 2024
1. The Primary Pediatric 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
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.12 - Clinical Support Services-Transfer Guidelines

Current through June 25, 2024
All pediatric trauma facilities will work together to
						develop transfer guidelines indicating which patients should be considered for
						transfer and procedures to ensure the most expedient, safe transfer of the
						patient. The transfer guidelines shall make certain that feedback is provided
						to the facilities and assure that this information becomes part of the trauma
						registry. All designated facilities will agree to provide service to the trauma
						patient regardless of their 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 6 - Pediatric Trauma Centers › Subchapter 3 - Primary Pediatric Trauma Center › Rule 15-12-32-6.3.13 - Clinical Support Services-Performance Improvement/Evaluation

Current through June 25, 2024
1. The trauma center must develop and
					 implement a trauma specific performance improvement plan. Key elements in
					 trauma system planning are evaluation, measurement and improvement of
					 performance. The goal is to decrease variation in care and improve patient
					 outcomes. All pediatric admissions that meet Trauma Registry inclusion criteria
					 shall be reviewed by the hospital and Trauma Region PI process.
2. Compliance with the above will be
					 evidenced by:
a. Review of compliance with EMS
					 Triage Guidelines and Protocols;
b.
					 Compliance with written Trauma Team Activation Criteria;
c. Compliance with the principles of
					 ATLS;
d. Peer Review of all trauma
					 deaths to determine timeliness and appropriateness of care and preventability
					 of death;
e. Review of trauma
					 related morbidities for appropriateness of care and preventability;
f. Nursing Audit (clinical review of nursing
					 documentation and quality of care rendered to trauma patients);
g. Review of timeliness and appropriateness
					 of all transfers out;
h. Review of
					 prehospital trauma care;
i. Review
					 of times/reasons for trauma-related bypass;
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 7 - Burn Centers › Subchapter 1 - Hospital Organization › Rule 15-12-32-7.1.1 - General

Current through June 25, 2024
The burn center must be an acute care facility licensed
						in Mississippi. The burn center must have a medical and an administrative
						commitment to the care of patients with burns. There must be a written
						commitment on behalf of the entire facility to the organization of burn care.
						The written commitment shall be in the form of a resolution passed by an
						appropriate quorum of the members of the governing authority. The burn center
						must have written guidelines for the triage, treatment, and transfer of burned
						patients from other facilities. The burn center must maintain an organizational
						chart relating personnel within the burn center and the hospital. The burn
						center must maintain current accreditation by the Joint Commission (TJC) or
						other recognized accrediting organization(s). The list of required equipment
						for Burn Centers can be found on-line at
						http://msdh.ms.gov/msdhsite/static/49.html.
Miss. Code Ann.
						§
												41-59-5