Section 22-B2702. HOSPITAL ORGANIZATION - TRAUMA SERVICES

 

2702.1The staff credentialing committee of an adult trauma care facility shall specifically delineate all privileges of members of the staff providing trauma services.

 

2702.2Each trauma team shall be organized and directed by a general surgeon with expertise in and commitment to the care of the injured. All patients with multiple system or major injuries shall be evaluated by the trauma services team.

 

2702.3Each trauma team shall be available in-house twenty-four (24) hours per day with attending coverage as specified in this chapter.

 

2702.4The team leader during the resuscitation efforts shall be an emergency department physician, until the arrival of a trauma surgeon who shall then act as the team leader.

 

2702.5Each facility shall provide a team approach for responding to the needs of and giving optimal care to patients with multiple-system injuries. Each team leader shall be a qualified surgeon contributing specific care in the area of his or her specialty, and shall continually oversee and coordinate the operation of the team and care of its patients throughout their hospital stay.

 

2702.6The team leader shall be able to interpret and reconcile the recommendations of team members and consultants from a number of specialties and accept the responsibility for transmitting those recommendations to the hospital staff.

 

2702.7Each adult trauma care facility shall appoint a Trauma Service Director, who shall be a board certified surgeon with demonstrated special competence in trauma care.

 

2702.8The Trauma Service Director shall have oversight authority for the care of each trauma patient and administrative authority for the hospital's trauma program.

 

2702.9The Trauma Service Director shall be responsible for recommending appointment to and removal from the trauma service, along with the medical staff credentialing committee, and in consultation with the appropriate service chief.

 

2702.10The Trauma Service Director shall meet each of the specific qualifications for surgeons, including personal involvement in the care of the injured, education in trauma care, involvement in professional trauma organizations, and board certification.

 

2702.11In adult trauma care facilities, the Trauma Service Director shall have active involvement or participation as an instructor in the American College of Surgeons Advanced Trauma Life Support (ATLS) courses, participation in other Continuing Medical Education (CME) courses, and the provision of instruction to other health care personnel.

 

2702.12The Trauma Service Director shall have the appropriate specific responsibilities of evaluating newly appointed members of the trauma service and overseeing ongoing education for new and existing attending surgeons and physicians as appropriate.

 

2702.13The Trauma Service Director, or his or her designee, shall participate in the development of trauma-care systems at the community, state, or national levels.

 

2702.14The Trauma Service Director in Level I facilities shall be responsible for encouraging the staff to undertake clinical and basic research, with publication of their results.

 

2702.15The Trauma Service Director shall make presentations on trauma care to medical staff and other health care organizations providing trauma care.

 

2702.16The Trauma Service Director shall be responsible for quality improvement in each adult trauma care facility.

 

2702.17Each adult trauma care facility shall have designated specialists available twenty-four (24) hours per day for the care of major trauma patients.

 

2702.18Each adult trauma care facility shall be staffed by surgeons who are board certified in a surgical specialty recognized by the American Board of Medical Specialties.

 

2702.19Each trauma surgeon in an adult trauma care facility shall have an interest in and a commitment to trauma care, demonstrated by participation in the organization of trauma protocols, trauma teams, trauma call rosters, and trauma rounds.

 

2702.20General surgeons on the trauma team in adult trauma care facilities shall successfully complete the "American College of Surgeons Advanced Trauma Life Support Course."

 

2702.21Each surgeon member of the trauma team shall participate in a minimum of sixteen (16) hours of trauma related Continuing Medical Education (CME) courses per year. At least fifty percent (50%) of this CME shall be extramural, and both Category I and II CME may be counted toward satisfying this requirement.

 

2702.22A physician's participation in regional groups, such as state and regional trauma committees, and membership in regional organizations, shall constitute significant involvement in and commitment to trauma-related matters.

 

2702.23In each adult trauma care facility, the emergency physician shall be a member of the trauma team who participates in the care of the patient, and in all audits and critiques necessary for excellence in trauma care.

 

2702.24Emergency physicians shall be involved with surgeons in the development of trauma care systems as part of the overall development of emergency medical systems in the community. In addition, they shall be active in organizations contributing to the benefit of injured patients.

 

2702.25An anesthesiologist shall have the overall responsibility for preoperative airway control of the patient during resuscitation, and act as postoperative consultant in cardiorespiratory support and pain control. Anesthesiologists on the trauma team shall be appropriately certified, have the necessary educational background in care of the trauma patient, and engage in trauma quality improvement and in investigative, teaching, and community activities.

 

2702.26The emergency physician and anesthesiologist on the trauma team shall be board certified in their specialty as recognized by the American Board of Medical Specialties.

 

2702.27In each adult trauma care facility, the following medical specialists shall be available for consultation in the care of patients with multiple injuries:

 

(a)Cardiologist;

 

(b)Pulmonary medicine;

 

(c)Respiratory therapy;

 

(d)Nephrologists; and

 

(e)Dialysis team.

 

source

Notice of Final Rulemaking published at 46 DCR 8741 (October 29, 1999); as amended by Notice of Emergency and Proposed Rulemaking published at 51 DCR 3915 (April 16, 2004) [EXPIRED]; as amended by Final Rulemaking published at 51 DCR 7260 (July 23, 2004).