Rules & Regulations of the State of Tennessee
Title 0720 - Health Facilities Commission
Chapter 0720-31 - Standards for Pediatric Emergency Care Facilities
Section 0720-31-.03 - ADMINISTRATION

1. Guarantee transfer and transport agreements;

2. Refer seriously and critically ill patients and special needs patients to an appropriate facility; and

3. Assure the support of agreements to receive or transfer appropriate patients.

1. Deaths;

2. Incident reports;

3. Child abuse cases;

4. Cardiopulmonary or respiratory arrests;

5. Admissions within 48 hours after being discharged from the emergency department.;

6. Surgery within 48 hours after being discharged from an emergency department;

7. Quality indicators requested by the Comprehensive Regional Pediatric Center or state/local Emergency Medical Services for Children authority regarding nursing care, physician care, pre-hospital care and the medical direction for pre-hospital providers of Emergency Medical Services systems;

8. Pediatric transfers; and

9. Pediatric inpatient illness and injury outcome data.

1. Provides transfer and transport agreements with other classifications of facilities;

2. Provides transport services when needed for receiving critically ill or injured patients within the regional network;

3. Provides necessary consultation to participating network hospitals;

4. Provides indirect (off-line) consultation, support and education to regional pre hospital systems and supports the efforts of regional and state pre-hospital committees;

5. Provides medical support to assure quality direct (on-line) medical control for all pre-hospital systems within the region;

6. Organizes and implements a network of educational support that:

7. Assists in organizing and providing support for regional, state and national data collection efforts for EMSC that:

1. Reviews all issues and indicators described under the four classifications of Pediatric Emergency Care Facilities emergency departments;

2. Provides feedback, quality review and information to all participating hospitals, emergency medical services and transport systems, and appropriate state agencies;

3. Develops quality indicators for the review of pediatric care which are linked to periodic continuing education and reviewed at all participating institutions;

4. Reviews all trauma-related deaths, including those that are primary admitted patients versus secondary transferred patients. This review should include a morbidity and mortality review;

5. Assures quality assessment in the Emergency Department and the Pediatric Intensive Care Unit to include collaborative quality assessment, morbidity and mortality review, utilization review, medical records review, discharge criteria, planning and safety review; and

6. Evaluates the emergency services provided for children for emphasis on familycentered philosophy of care, family participation in care, family support during emergency visits and transfers and family information and decision-making.

1. An emergency physician on duty in the emergency department;

2. A pediatric trauma surgeon promptly available within 30 minutes;

3. Two registered nurses with pediatric emergency, pediatric critical care or pediatric surgical experience as well as training in trauma care;

4. A cardiothoracic surgeon who is promptly available or a transfer agreement to Level 1 trauma center;

5. An orthopedic surgeon who is promptly available;

6. An anesthesiologist who is promptly available. An anesthesia resident post graduate year 3 capable of assessing emergency situations and initiating proper treatment or a certified registered nurse anesthetist credentialed by the chief of anesthesia may fulfill this requirement, but a staff anesthesiologist must be available within 30 minutes;

7. A neurosurgeon who is promptly available;

8. A pediatric respiratory therapist, laboratory technician and radiology technician;

9. A computer tomography technician in-house (or on-call and promptly available if the specific clinical needs of the hospital make this necessary and it does not have an adverse impact on patient care);

10. Available support services to the emergency department to include social services, chaplain support, and a child and sexual abuse team that are promptly available. These support services shall include family counseling and coordination with appropriate services to support the psychological, financial or other needs of families;

11. A pediatric nursing coordinator who is responsible for coordination of all levels of pediatric trauma/emergency activity including data collection, quality improvement, nursing education and may include case management;

12. The pediatric trauma committee chaired by the director of the pediatric trauma program with representation from pediatric surgery, pediatric emergency medicine, pediatric critical care, neurosurgery, anesthesia, radiology, orthopedics, pathology, respiratory therapy, nursing and rehabilitation therapy. This committee shall assure participation in a pediatric trauma registry. There must be documentation of the subject matter discussed and attendance at all committee meetings. Periodic review should include mortality and morbidity, mechanism of injury, review of the Emergency Medical Services system locally and regionally, specific care review, trauma center/system review, and identification and solution of specific problems including organ procurement and donation;

13. A trauma register function shall be provided in organizations that have 500-1000 trauma admissions/observations per year; and

14. A CRPC coordinator position whose responsibilities include: