Southern Nevada Trauma System MountainView Hospital Jeremy Bradshaw, CEO
Comparing Regional Trauma Centers per 1 Million Population 3 2.1 2.1 2 1.7 1.7 1.7 1.6 1.5 1.4 1.4 1.4 2 0.9 1 0.8 1 0 St. Louis Sacramento Pittsburg San Diego Baltimore Las Vegas 2017 2025 Source: www.FACS.org; US Census Bureau/Fact Finder; American Business Journal Poor access to a trauma center is linked to higher death rates in the US (Source: American College of Surgeons) The American College of Surgeons recommends 1-2 trauma centers per 1 million people Adding a Level III trauma center would move the Southern Nevada Trauma System from 0.9 to 1.36 trauma centers per 1 million people, closer to the US average 2 Nevada ranks last among U.S. states in preparedness for health disasters (Source: National Health Security Preparedness Index)
Population Northwest Region Growing Faster than Las Vegas Valley Growth Average Annual Growth Rate Projected Annual Growth Rate The Las Vegas Valley population 2000-2016 2018-2023 increased an average of 3.6% per year 2000-2016, compared to 4.9% average 5.5% 2.0% 4.9% annual growth in the NW region. (TNAT 1.8% 5.0% 1.8% 1A-B – Source: US Census Bureau, City-Data) 4.5% 1.6% 1.5% 4.0% The Las Vegas Valley population is 3.6% expected to increase an average of 3.5% 1.4% 1.5% per year through 2023, compared 3.0% 1.2% to 1.8% average annual growth in the 2.5% NW region. (TNAT 1C-D – Source: US 2.0% 1.0% Census Bureau, City-Data; Intellimed) Las Vegas Valley Northwest Region Las Vegas Valley Northwest Region Source: US Census Bureau, City-Data Source: US Census Bureau, City-Data; Intellimed 3
Growth of Senior Population Growing Faster than General Population Senior Average Annual Growth Rate 2000-2016 Population 9.0% 7.7% 8.0% 6.7% The senior population (65+ years) in 7.0% Las Vegas is growing faster than the 6.0% 4.9% general population ( 6.7% annual 5.0% growth compared to 3.6% ). 3.6% 4.0% 3.0% The senior population in the Northwest 2.0% region is growing faster than the 1.0% general population in the Northwest 0.0% region ( 7.7% annual growth compared Las Vegas Valley - NW Region - Las Vegas Valley - NW Region - to 4.9% ). All Ages All Ages Ages 65+ Ages 65+ Source: US Census Bureau, City-Data Source: US Census Bureau, City-Data; Intellimed 4
TFTC Growth TFTC Incidents are Increasing in the Las Vegas Valley TFTC incidents in the Las Vegas Valley TFTC Incidents in Las Vegas 2010-2018 increased 141% from 2010-2018 (TNAT 14,000 1E – Source: SNHD TFTC Transports, RTAB Jan 2019) 11,498 12,000 11,060 TFTC incidents for Step III and Step IV 10,000 patients in the Las Vegas Valley increased 101% from 2015-2017 (TNAT 8,000 1F – Source: SNHD TFTC) 6,770 6,109 5,975 5,848 5,462 6,000 5,222 Incidents of patients meeting trauma 4,771 criteria for Step III and Step IV at 4,000 MountainView Hospital increased 33% from 2017-2018 (TNAT 1G – Source: 2,000 MountainView Trauma Registry) 0 2010 2011 2012 2013 2014 2015 2016 2017 2018 Source: SNHD TFTC 5
Transport Times Transport Times are Increasing in the Las Vegas Valley The Las Vegas Valley demonstrated Transport Response Times 2014-2018 average transport times of 17.8 19 18.3 minutes from 2013-2018 (TNAT 2A) 17.9 15% Transport times for Step III and Step IV 16.8 17 16.5 increase averaged 16 minutes in 2017 (TNAT 2B) 15.9 2014-2018 Transport times for the Northwest 15 Region are above average ( 18.3 minutes in 2018 ) and increasing (TNAT 12.8 2C) 12.7 13 11.8 11.7 11.3 11 2014 2015 2016 2017 2018 NW Metro Goal Source: SNHD TFTC 6
Minimal System Impact MountainView Level III trauma designation will have limited impact on current trauma providers UMC admitted 2,931 trauma patients in 2017 ACS minimum admissions for a Level I is 1,200 Even with a Level III trauma center in the NW region with volume of 500 annual trauma admissions, UMC trauma volumes will double the ACS minimum 7
Trauma Northwest Region is Underserved for Trauma Patients by 2 Trauma Centers Region 5,253 1,680 trauma patients originated Metro from the Northwest region in Northwest 939 2017, more than any non-urban Northeast area, including the Southeast Southeast Southwest 959 75% more trauma patients 1 Trauma 1,680 originated from the Northwest Center 1,342 No Trauma Centers region than from the Southeast region (St. Rose – Siena) Source: NV Annual Trauma Report 8
Benefits to the Northwest Region Appropriately Low-acuity Quicker transport resource UMC patients treated tim es and Sunrise for locally high-acuity cases Im proved EMS crews return Enhanced outcom es for to service faster disaster response patients in the NW region 9
Trauma Activation Key Considerations 03 04 01 02 Costs Criteria Patient Responsibility Amount Will mirror existing Costs include: Pre-hospital Insurance companies Level III trauma physician call panel, notification must cannot deny center in the medical occur prior to coverage, regardless market directorships, transport or transfer of hospital contracting staffing, education, status. Account equipment, adjustments are infrastructure, etc. allowed 10
Why MountainView Aliante Northwest North Las Vegas MountainView Hospital MountainView • Immediate access to I-95 Hospital Current Trauma • 8.5 miles to nearest trauma Center center Summerlin UMC Sunrise • Located in already underserved region of the valley Sunrise Hospital • Northwest population growth expected to outpace Las Vegas growth • ACS consultative site visit Southwest completed. Level III Trauma Henderson 7 Center requirements met Southern Dignity - Sienna Highlands 11
Why MountainView 12
MountainView 1. Trauma Staffing • Trauma Medical Director • Trauma Program Manager Trauma • Trauma/General surgeons • ED physicians and nurses Capabilities • Anesthesia call panel w/ backup • Orthopedic call panel w/ backup • Neurosurgery call panel w/ backup 2. GME Program • Emergency medicine • General surgery • Anesthesia 3. Trauma Quality Program • Participate in national trauma registry • Analysis and process improvement • Participates in TQIP MountainView Hospital meets all ACS Trauma Requirements 4. Trauma Education • TNCC and TCAR completed for nursing staff 5. Injury Prevention/Community Outreach 13
ACS Site Visit ACS Consultative Site Visit – MountainView Strengths Feedback 1. Strong leadership – Medical Director and Program Manager 2. Support from hospital administration Jan 9-10, 2019 3. Five (5) supporting neurosurgeons 13 key strengths identified 4. Seven (7) on-call orthopedic surgeons 5. Residency programs in surgery and emergency medicine ACS Consultative Team: 6. SBIRT completed on 90% of trauma patients -Dr. Michael McGonigal 7. TNCC nursing education in the ED -Dr. Andre Campbell 8. TCAR nursing education in the PACU -Ms. Jorie Klein, RN 9. Well-developed and consistent PI program 10.Robust FAST exam system 11.Strong rehabilitation 12.Participation in regional trauma system meetings and prevention 13.Strong partnership with other trauma centers 14
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