CHAPTER 453

FORMERLY

HOUSE SUBSTITUTE NO. 2

TO

HOUSE BILL NO. 433

AN ACT TO AMEND CHAPTER 97. TITLE. 16. DELAWARE CODE RELATING 10 A STATEWIDE TRAUMA CARE SYSTEM.

BE 1T ENACTEDBY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE.

Section 1. Amend §9702(13). Title 16, Delaware Code, by redesignating subsection (13) as subsection (14) and all subsequent subsections accordingly and inserting a new subsection (13) to read as follows:

"(13) 'Inclusive Statewide Trauma Cure System' means a Trauma System in which all current and future providers of hospital and/or prehospital health care services may participate, at a level commensurate with the scope of their resources, as outlined in subsection (18) of this title.

Section 2. Amend §9702(18). Title 16. Delaware Code by redesignating subsection (18) as subsection 120) and inserting subsections (18) and 119) to read as follows:

'(18) 'Trauma Facility'. means an acute care hospital which has received and maintains current State of Delaware designation as tt Trauma Center. Categories of trauma facilities in Delaware are as follows:

Regional Level I Trauma Center: A regional resource Trauma Center that has the capability of providing leadership and comprehensive, definitive care for every aspect of injury from prevention through rehabilitation.

Regional Level 2 Emma Center: A regional Trauma Center with the capability to provide initial care for all trauma patients. Most patients would continue to he cared for in this Center; there may be some complex cases which would require transfer for the depth of services of a Regional Level I or Specialty Center.

Community Trauma Center: An acute care hospital that provides assessment, resuscitation, stabilization and triage of all trauma patients, arranging for A timely transfer of those patients requiring the additional resources of a Regional Trauma or Specialty Center and delivering definitive care to those whose needs match the resources of the Community Trauma Center.

Participating Hospital: An acute care facility which transfers trauma patients with moderate or severe injuries to Trauma Centers after initial resuscitation. When necessary, this facility may provide care to trauma patients with minor injuries. Participating hospitals contribute data to the Delaware Trauma System Registry and Quality Improvement Program.

(19) 'Trauma Patient' means any person with actual or potential bodily damage subsequent to an event which exposed the body to an external force or energy."

Section 3. Amend §9704, Title 16, Delaware Code, by adding thereto a new subsection (d) to read as billows:

"(d) Except for those activities and responsibilities for basic life support, which is under the jurisdiction of the State Fire Prevention Commission, the Office of Emergency Medical Services shall have jurisdiction over the development, implementation and maintenance of a statewide trauma system."

Section 4. Amend §9704, Title 16, Delaware Code, by adding thereto a new subsection (e) to read as follows:

"(e) A Memorandum of Agreement shall be established between the Office of Emergency Medical Services of the Division of Public Health and the State Fire Prevention Commission to foster inclusion and coordination of Basic Life Support Services within the Statewide Trauma System."

Section 5. Amend §9704, Title 16, Delaware Code, inserting a new subsection (f) to read as follows:

"(f) The Director of Public Health shall establish a standing Trauma System Committee and ad hoc committees as deemed appropriate to assist in oversight of the Inclusive Statewide Trauma Care System. The standing Trauma System Committee shall convene at least quarterly. Membership on the standing Trauma System Committee will include, but not be limited to, a representative of each of the following constituencies to be selected from the three counties within the State:

a. trauma rehabilitation professionals

b. practicing Trauma Surgeons

c. practicing Emergency Department physicians

d. The Association of Delaware Hospitals

e. Advanced Life Support prehospital providers

f. Basic Life Support prehospital providers

g. The State Fire School

h. practicing trauma subspecialty physicians

i. practicing Pediatric Surgeons or Pediatricians

j. practicing Registered Nurses involved in Trauma Patient Care

k. Emergency Medical dispatchers

I. hospital administration

m. The Delaware State Police Aviation Section

n. a representative from the State Fire Prevention Commission."

Section 6. Amend §9704, Title 16, Delaware Code, by adding thereto a new subsection (g) to read as follows:

"(g) The Trauma System Committee shall be an advisory group to the Director of Public Health on the following issues:

A. Rules governing the operation of Delaware's Inclusive Statewide Trauma Care System, which will be based upon national references such as the American College of Surgeons' Resources for Optimal Care of the Trauma Patient: 1993.

B. Recommendations for corrective action based on the reviews of the following:

1.) statewide trauma care system operations, including the monitoring for adherence to adopted policies, procedures, protocols and standards, the availability of appropriate resources and the periodic review of trauma hospital participation (designation) criteria.

2.) the delivery of emergency medical and hospital services by trauma care service providers to trauma patients.

C. Recommendation for modifications of the policies, procedures and protocols of trauma care as a result of system-wide review,"

Section 7. Amend §9706. Title 16. Delaware Code, by adding thereto a new subsection (g) to read as follows:

"(g) The Director of Public Health shall, except for those activities and responsibilities for basic life support, which is under the jurisdiction of the State Fire Prevention Commission:

a. Use the Trauma System Committee recommendations as the basis for establishing a plan for the implementation and maintenance of Delaware's Inclusive Statewide Trauma Care System. The State Trauma System Plan shall address each component or trauma care as outlined in national references such as Model Trauma Care .System Plan, HRSA-BHRD, September 1990 and subsequent revisions. These include but are not limited to:

1) prehospital care - standardized and statewide policies, procedure and protocols to be used by all emergency medical service providers and licensed personnel for the identification, treatment and Transport of trauma patients.

2) prevention - efforts to decrease the numbers and severity of injuries. resulting in decreased demand for care.

3) hospital care - standards and criteria for hospital personnel, equipment and designation that identify the necessary resources that hospitals must have in order to he recognized within Delaware's Inclusive Statewide Trauma Care System as a specified category trauma facility. These standards and criteria shall be consistent with those identified in tuitional trauma system references. such as the American College of Surgeons' Resources for Optimal Care of the Injured Patient: 1993 and subsequent revisions. All expenses associated with utilizing a nationally recognized accreditation team to verify a hospital's compliance with hospital designation criteria will be the responsibility of the hospital being surveyed.

2) rehabilitative care - standards for the follow-up care for persons with disabilities resulting from injuries.

4) trauma continuing education - The on-going trauma related education for trauma care system personnel/providers to maintain knowledge and skills.

2) manna care system evaluation - monitor policies and procedures regarding the effectiveness/impact of trauma care systems.

b. The Director of Public Health shall have the authority to promulgate rules for the management of all components of Delaware's Inclusive Statewide Trauma Cure System, and shall seek input and review from the Trauma System Committee.

c. Maintain a program of trauma care system evaluation, including a trauma data collection and registry system and a mechanism for evaluating and monitoring system performance throughout the continuum of trauma care."

Section 8. Amend Chapter 97, Title 16, Delaware Code, by adding thereto a new §9707 to read as follows:

"§9707. Confidentiality of Quality Review Program and Participants

1) Confidentiality of Quality Review Program and Participants

As used in this section 'records' means the recordings of interviews and all oral or written reports, statements, minutes, memoranda, charts, statistics, data and other documentation generated by the Trauma System Committee or its subcommittees for the stated purposes of trauma system medical review or quality care review and audit.

All quality management proceedings shall be confidential. Records of the Trauma System Committee, its quality care review committee and members, attendees and visitors at meetings held for stated purposes of trauma system medical review or quality care review and audit shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding. Raw data shall not be available for public inspection nor is it a public record within the meaning of the Delaware Freedom or Information Act.

2) Immunity

No person shall be subject to, and shall be immune from, any claim. suit. liability, damages or any other recourse, civil or criminal, arising from any act or proceeding. decision or determination undertaken or performed, or recommendation made while discharging any duty or authority under this chapter, so long as such person acted in good faith without malice. and within the scope of his or her duty or authority under this chapter or any other provisions of the Delaware law. federal law or regulations or duly adopted rules and regulations providing for the administration of this chapter. good faith being presumed until proven otherwise. with malice required to be shown by the complainant."

Section 9. Amend §9703(c). Title 16, Delaware Code by striking subsection (12) in its entirety and substitute a new subsection (12) to read as follows:

"(12) The Trauma Systems Committee Chairman".

Approved July 8, 1996