Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0056 - Trauma Program, Wyoming › Chapter 4 - FACILITY STANDARDS › Section 4-4 - Trauma Receiving Facilities

Current through July 13, 2024
Trauma Receiving Facilities (TRF) are generally licensed
				  rural facilities, clinics, or medical assistance facilities with a commitment
				  to the resuscitation and stabilization of the trauma patient and written
				  transfer protocols in place to assure those patients who require a higher level
				  of care are appropriately transferred for definitive care. These facilities may
				  not be staffed by a physician, but may be staffed by a licensed mid-level
				  practitioner (e.g., nurse practitioner or licensed/certified physician's
				  assistant). The major trauma patient shall be resuscitated and transferred to a
				  higher level of care from the emergency department as appropriate. This
				  categorization does not contemplate the availability of surgeons, operating
				  rooms or intensive care services.
(a)
				Facility Organization.
(i) Trauma Program.
				There must be a commitment on behalf of the entire facility to the organization
				of trauma care. A trauma program shall be established and recognized by the
				institution. The trauma program shall come under the overall organization of a
				physician who is committed and willing to provide off-line administration of
				the program. In a facility staffed by physician's assistants or nurse
				practitioners, it most likely will be their supervising physician.
(ii) Trauma Program Director. There shall be
				a qualified physician director of the trauma program. In this instance, the
				physician shall work with all members of the trauma team to develop a quality
				improvement process for the facility. Through this process, he shall have
				overall responsibility for the quality of trauma care rendered at the facility.
				The director shall be given administrative support to implement the
				requirements specified by the Wyoming Trauma Plan. The director shall 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 should be currently certified in ATLS and
				participate in CME related to trauma care.
(iii) Trauma Team. The facility shall have a
				policy describing the role of all personnel on the trauma team. The composition
				of the trauma team in any facility will depend on the characteristics of the
				facility and its staff. The team leader shall be a qualified physician or a
				qualified mid-level practitioner.27 Suggested
				composition of the trauma team may include:
(A) Laboratory technician;
(B) Nurses;
(C) Physician assistants;
(D) Physicians;
(E) Prehospital care providers;
(F) Radiology technicians;
(G) Respiratory therapists; and
(H) Social services/pastoral care.
(iv) Trauma Nurse Coordinator. A
				TRF shall have a person to conduct many of the administrative functions
				required by the trauma program. Specifically, this person, with the physician
				director, shall coordinate optimal patient care for all injured patients. Many
				requirements for data collection and coordination, quality improvement,
				education and prevention activities are incumbent upon this position.
(v) Multi Disciplinary Trauma Committee.
(A) The purpose of the committee is to
				provide oversight and leadership to the entire trauma program. The major focus
				shall be quality improvement activities, policy development, communication
				among all team members, development of standards of care, education and
				outreach programs, and work with appropriate groups for injury prevention. In a
				TRF, this does not need to be a separate distinct body; however, the functions
				of this committee may be performed in conjunction with other ongoing committees
				in the facility.
(B) Suggested
				membership for the Committee includes representatives (if available in the
				community) from:
(I)
				Administration;
(II) Emergency
				Department;
(III) Medical
				Records;
(IV) Pediatrics;
(V) Prehospital care providers;
(VI) Radiology/Laboratory;
(VII) Rehabilitation;
(VIII) Respiratory therapy; and
(IX) Trauma Nurse Coordinator.
(C) The clinical managers or
				designees of the organizational areas involved with trauma care shall play an
				active role with the committee.