Rules & Regulations of the State of Tennessee
Title 0720 - Health Facilities Commission
Chapter 0720-22 - Trauma Centers
Section 0720-22-.02 - DEFINITIONS

(1) "ACS-COT" means American College of Surgeons Committee on Trauma.

(2) "Advisory Council" means the Tennessee Trauma Care Advisory Council.

(3) "ATLS" means Advanced Trauma Life Support.

(4) "Board" means the Board for Licensing Health Care Facilities.

(5) "Commissioner" means the Commissioner of the Tennessee Department of Health.

(6) "Comprehensive Regional Pediatric Center (CRPC)" means a facility that shall be capable of providing comprehensive specialized pediatric medical and surgical care to all acutely ill and injured children. The center shall be responsible for serving as a regional referral center for the specialized care of pediatric patients or in special circumstances provide safe and timely transfer of children to other resources for specialized care. Rules and regulations governing CRPCs are delineated in Chapter 0720-31.

(7) "D" means desired.

(8) "Data" means the original information contained on the report required by the regulations, including, but not limited to, both identifying and non-identifying information.

(9) "Department" means the Tennessee Department of Health.

(10) "E" means essential.

(11) "Facility" shall have the same meaning as defined in T.C.A. § 68-11-201(15).

(12) "FAST" means focused abdominal sonography for trauma.

(13) "Health care practitioner" means a physician, surgeon, or other health care professional licensed under T.C.A. Title 63 or Title 68 who is engaged in diagnosing and/or treating patients within the trauma care system.

(14) "Identifying information" means any information that could lead to the identification of a patient who has been diagnosed or treated within the trauma care system.

(15) "Levels of Care" means the type of trauma service provided by the facility as shown by the degree of commitment in personnel and facilities made to the delivery of that service.

(16) "Level I" means a hospital capable of providing care for the acutely injured patient and which meets all requirements in these regulations defined as Level of Care I.

(17) "Level II" means a hospital capable of providing care for the acutely injured patient and which meets all requirements in these regulations defined as Level of Care II.

(18) "Level III" means a hospital capable of providing care for the acutely injured patient and which meets all requirements in these regulations defined as Level of Care III. The Level III facility generally serves communities without all the resources usually associated with Level I or II facilities. Planning for care of the injured in small communities or suburban settings usually calls for transfer agreements and protocols for the most severely injured patients. Designation of the Level III facility may also require innovative use of the region's resources. For example, if there is no neurosurgeon in a large, sparsely populated region it may require that a general surgeon be prepared to provide the emergency decompression of mass lesions and arrangement for patient transfer to the most appropriate Level I or II hospital after the surgeon has carried out the patient's life-saving operation. Staffing of the Level III hospital is another example of the innovative use of a region's resources. It will be impractical to require a general surgeon to be in-house in many instances. With modern communication systems it seems reasonable that the surgeon should be promptly available and in a great majority of instances meet the patient in the emergency room on arrival. When a Level III hospital first receives notification of a critically injured patient, it can activate on-call personnel to respond promptly to the hospital. The intent of this flexibility should be clear: to provide the best possible care even in the most remote circumstances.

(19) "Level IV" means a hospital capable of providing care for the acutely injured patient and which meets all requirements in these regulations defined as Level of Care IV. The hospital shall have treatment protocols for resuscitation, transfer protocols on record, shall submit trauma data elements to the state trauma registry as outlined in the Tennessee Trauma Data Dictionary, and participate in system performance improvement. The Level IV facility will maintain a good working relationship with the nearest Level I, II, or III trauma center.

(20) "Medical Record" means medical histories, records, reports, summaries, diagnoses, prognoses, records of treatment and medication ordered and given, entries, x-rays, radiology interpretations, and other written, electronic, or graphic data prepared, kept, made or maintained in a facility that pertains to confinement or services rendered to patients admitted or receiving care.

(21) "Person" means any member of the "medical, scientific, and academic research community."

(22) "PGY" means postgraduate year.

(23) "Physician Extender" means a health care professional, such as an advanced practice registered nurse or a physician assistant, whose skills have been enhanced by an appropriate course of trauma specific training e.g. ATLS education.

(24) "Policies and Procedures Manual" means the document(s) maintained in the offices of the Tennessee Trauma Registry giving specific written instructions for the implementation of policies and procedures utilized by the registry and which may be updated from time to time.

(25) "Trauma Center" shall have the same definition as provided in T.C.A. § 68-59-102(6).

(26) "Trauma Registry" means a central registry compiled of injury incidence information supplied by designated trauma centers and Comprehensive Pediatric Emergency Centers for the purpose of allowing the Board to analyze data and conduct special studies regarding the causes and consequences of traumatic injury.