(1)
Hospitals seeking voluntary designation and all designated Trauma Centers
desiring to remain designated, shall apply for designation by submitting the
following information to the Department at least 30 days prior to the date of
the scheduled site visit:
(a) a completed and
signed application and appropriate fees for trauma center
verification;
(b) a letter from the
hospital administrator of continued commitment to comply with current trauma
center designation standards as applicable to the applicant's designation
level;
(c) the data specified under
R426-9-700
are current;
(d) Level I and Level
II Trauma Centers must submit a copy of the Pre-review Questionnaire (PRQ) from
the American College of Surgeons in lieu of the application in 1a
above;
(e) Level III and Level IV
and Level V trauma centers must submit a complete Department approved
application.
(2)
Hospitals desiring to be designated as Level I and Level II Trauma Centers must
be verified by the American College of Surgeons (ACS) within three (3) months
of the expiration date of previous designation and must submit a copy of the
full ACS report detailing the results of the ACS site visit. A Department
representative must be present during the entire ACS verification or
consultation visit. Hospitals desiring to be Level III or Level IV Trauma
Centers must be designated by hosting a formal site visit by the
Department.
(3) Hospitals not
previously designated as a Level I or a Level II trauma center, applying for
designation after December 31, 2016, will be considered for designation
implementing the point system suggested by the American College of Surgeons as
follows and using data from the Utah Trauma Registry:
(a) population as defined by the federal
Office of Management and Budget total Metropolitan Statistical Area (MSA);
(i) total MSA population of less than 600,000
receives 2 points,
(ii) total MSA
population of 600,000 to 1,200,000 receives 4 points,
(iii) total MSA population of 1,200,000 to
1,800,000 receives 6 points,
(iv)
total MSA population of 1,800,000 to 2,400,000 receives 8 points,
(v) total MSA population of greater than
2,400,000 receives 10 points.
(b) Median Transport Times (combined air and
ground --scene only no transfer);
(i) median
transport time of less than 10 minutes received 0 points,
(ii) median transport time of 10 -- 20
minutes receives 1 points,
(iii)
median transport time of 21 -- 30 minutes receives 2 points,
(iv) median transport time of 31 -- 40
minutes receives 3 points,
(v)
median transport time of greater than 41 minutes receives 4 points.
(c) Department/System
Stakeholder/Community Support;
(i) Department
support for a trauma center(if none exist)or an additional trauma center in the
MSA -- 5 points,
(ii) Department
position that no additional trauma centers are needed -- negative 5
points,
(iii) Trauma System
Advisory Committee (or equivalent body) statement of support for a trauma
center (if none exist) or an additional trauma center in the MSA -- 5
points,
(iv) community support
demonstrated by letters of support from 25- 50% of city and county governing
bodies within the MSA --1 points,
(v) community support demonstrated by letters
of support from over 50% of city and county governing bodies within the MSA --2
points.
(d) Severely
injured patients (ISS more than 15) discharged from acute care facilities not
designated as Level I, II, or III trauma centers;
(i) discharges of 0-200 severely injured
patients receives 0 points,
(ii)
discharges of 201 -- 400 severely injured patients receives 1 points,
(iii) discharges of 401 -- 600 severely
injured patients receives 2 points,
(iv) discharges of 601 -- 800 severely
injured patients receives 3 points,
(v) discharges of greater than 800 severely
injured patients receives 4 points.
(e) Level I Trauma Centers;
(i) for the existence of each verified Level
I trauma center already in the MSA assign 1 negative point,
(ii) for the existence of each verified Level
II trauma center already in the MSA assign 1 negative point,
(iii) for the existence of each verified
Level III trauma center already in the MSA assign 0.5 negative
points.
(f) Numbers of
severely injured patients (ISS more than 15) seen in trauma centers (Level I
and II) already in the MSA. The expected number of high-ISS patients is
calculated as: 500 x (Number of Level I and Level II centers in the MSA) =
(Expected Number of high ISS patients);
(i)
if the MSA has more than 500 severely injured patients above the expected
number assign 2 points,
(ii) if the
MSA has 0 - 500 severely injured patients above the expected number assign 1
point,
(iii) if the MSA has 0 - 500
fewer severely injury patients than the expected number assign 1 negative
point,
(iv) if the MSA has more
than 500 fewer severely injured patients than the expected number assign 2
negative points.
(g) The
following scoring system shall be used to allocate trauma centers within the
MSAs:
(i) MSAs with scores of 5 points or
less shall be allocated 1 Level I or II trauma center;
(ii) MSAs with scores of 6 - 10 points shall
be allocated 2 Level I or II trauma centers;
(iii) MSAs with score of 11 - 15 points shall
be allocated 3 Level I or II trauma centers;
(iv) MSAs with scores of 16 - 20 points shall
be allocated 4 Level I or II trauma centers.
(h) If the number of trauma centers allocated
by the model is greater than the existing number of Level I or II trauma
centers in the MSA, efforts should be undertaken to recruit and designate
additional trauma centers.
(i) If
the number of Level I and II trauma centers allocated by the model is less than
or equal to the number currently designated, the Department should not
designate additional Level I or II trauma centers in the MSA.