Friday, August 1, 2008

Andrew Young School Forum Will Examine State, Regional Trauma Systems

During the second of three scheduled forums on trauma care hosted by the Andrew Young School of Policy Studies at Georgia State University, the focus will move outside of Georgia.
As policy makers grapple with how to coordinate and fund a statewide trauma network, the Andrew Young School forum will feature presentations by trauma experts from Maryland and Richmond, Va., where coordinated services are already in place.

The forum is scheduled from 7 a.m. to 9:30 a.m. Aug. 6 at the Andrew Young School, 14 Marietta Street.

Expected attendees include health care professionals and advocates as well as state lawmakers.
“We want to make sure we give them information that’s relevant and facilitates discussion among the various groups,” said Tom Wade, director of program development for the Public Performance and Management Group of the Andrew Young School, who chairs the steering committee organizing the forums.

Scheduled presenters include Mary Beachley, the chief of the Health Facilities and Special Programs division of the Maryland Institute for Emergency Medical Services Systems; and Jerry Overton, the CEO of the Richmond Ambulance Authority in Richmond, Va.

Also scheduled to speak are Dennis Ashley, the chairman of the Georgia Trauma Care Network Commission; state Rep. Sharon Cooper (R-Marietta), the chairwoman of the House Health and Human Services committee; Gage Ochsner, the chief of trauma services at Memorial Medical Center in Savannah, and Dan Miears, a trauma survivor and advocate.

The Trauma Care Network Commission, which was established to oversee the coordination of trauma care efforts, recently doled out a one-time appropriation from the General Assembly of about $57 million. It’s expected that lawmakers will continue looking for a permanent funding source for the trauma network when they convene next year.

“I do think that it is a mistake to say we don’t have a [trauma] system,” Patrick O’Neal, the director of preparedness for the Georgia Division of Public Health, told the group at the first forum in June. “We do have somewhat of a system, but it’s anything but what we need in terms of an optimal system.”

Health advocates say a permanent funding source is needed to ensure cohesion and coordination in the network, and the Institute of Medicine, in a series of reports issued earlier this year, recommended a coordinated and regionalized trauma system.

In a brief prepared for the Georgia Health Policy Center, Patricia Ketsche, an associate professor of health administration at the J. Mack Robinson College of Business, discussed the Institute of Medicine recommendations.

“In many regions of the country and in Georgia, a variety of agencies and organizations comprise the trauma system,” she wrote. “These distinct organizations lack a formal mechanism to ensure the exchange of information between those who receive the initial call, providers of EMS care and transportation, hospital emergency departments and trauma centers, and public health agencies.”

A 2007 report by a joint House-Senate study committee on trauma care in Georgia noted that only 30 percent of trauma cases are treated in designated trauma centers, contributing to a trauma-related death rate 20 percent above the national average. Meeting the national average, the report said, would save 700 or more lives every year.

Fifteen of the state’s 152 acute care hospitals are trauma centers, and only four of those – facilities in Atlanta, Augusta, Macon and Savannah – are Level 1 centers able to provide the highest level of care.

“In 2003, American hospitals told a half-million in-bound ambulances, ‘don’t go to me, go someplace else.’ They were diverted,” Arthur Kellermann, associate dean for health policy at Emory School of Medicine and a Grady doctor, told the first forum. “The reason is a mismatch of supply and demand,” he said.

Kellermann compared a scarcity of bed space and bursting-at-the-seams emergency departments to the proposition of parking planes on the runways of Hartsfield-Jackson International Airport and diverting all incoming flights.

“That’s what we do when we pack people in the ER. We’re the runway of the hospital,” he said.
The third and final forum in the series will be scheduled this fall, and delve into the financing of a statewide trauma network and making such a network accountable for dollars spent.

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