Provided that your application process wasn't competitive, you would receive a provisional designation (two years) for the designation level for which you applied. The department will send to you a list of requirements you'll need to meet.
Once you address the requirements and your facility is in compliance with WAC, your contract will be amended and a full designation awarded.
A competitive application process, or simply “competition,” occurs when the number of facilities applying for a designation level within a single region outnumbers the total number of available slots as determined by the regional council.
Competitive designation processes require far more scrutiny than a standard designation process — as some facilities won't be designated.
A provisional designation is given to facilities that, through the application and/or site review process, don't meet WAC 246-976 standards. The provisional designation is shorter in duration than a standard designation award (one to two years instead of three) and requires the completion of department-determined requirements to regain full designation.
Provisional designation doesn't affect the facilities designation level or the amount of trauma grant funds received.
All applicable personnel need to have met the education requirements sometime within the three-year designation cycle for which you're contracted, not for the designation cycle for which you're now applying.
Yes. Currency in ATLS meets the WAC requirements for PERs.
Yes. You'll need three data reports, which the department will send to you shortly after you receive your application. These reports are the trauma profile, mechanism and transfer reports. The profile and mechanism report are necessary to complete Section 1: Trauma Service Profile. The transfer report is needed to answer response item 1 in Section 7: Patient Transfer and Diversion.
No. The difference is small, so just use the number provided in the report specific to the total number of patients meeting the Washington Trauma Registry (WTR) criteria. The queries used in the current report for total pediatric and adult patients are based on age only. They don't include the inclusion criteria variable, so the total number of patients meeting the WTR criteria is slightly less than the totals of each age group when added individually. This is something that will be addressed in the next revision cycle of these reports.
Yes. It's much easier and just as acceptable to include letters of commendation or concern in a Word document. Please be sure to reference as to which patient the letter is for. You may put this document at the end of the section and reference it with the title “Item 1 Response.”
We encourage you to create a summarized Word or Excel table showing who (position title; individual names not required) attended with an “x” or check. You don't have to send scanned copies of original sign-in sheets.
Ninety percent of all trauma personnel must meet the education and training requirements at any given time. The intent of the 90-percent rule is to allow time for new hires to receive the appropriate trauma training. If your facility is temporarily out of compliance with this rule, you must submit a written plan of compliance with an expected completion date in your application for re-designation.
Respond to these issues openly in the application. The department encourages you to provide a response to these issues in the form of an action plan. This action plan should be a Word document that includes what item(s) for which you're not in compliance, a detailed process of how you plan on coming into compliance and a timeline for completion. Put this action plan at the end of the section and be sure to reference what item(s) it's in response to.
If not addressed in the application,we'll ask for an action plan in the final report anyways, so it's much better to show us that you have acknowledged the issue and are working to resolve it.
Yes, but only case-by-case. It's important for the department to receive applications on time in order for us to make strict final report deadlines.
The designation announcement date is the same for all facilities in your designation group and is found on the Trauma Service and Trauma Rehab Service Designation Schedule (PDF) document. On that date, you'll receive official correspondence from us with the designation decision for your facility.
The Department of Health has 60 days from the designation decision announcement date to finish final reports for Level IV and V facilities. For Level I-III facilities, the department has 120 days from the date of the site review to get final reports out. Your report will arrive via email sometime within the applicable timeframe depending on your designation level.
Yes, the purpose of trauma team activation is to use patient information from the field to identify trauma patients who would benefit from evaluation and treatment by a general surgeon upon their arrival in the emergency department, regardless of whether the patient would be admitted or transferred. Trauma services are required to develop and follow their patient criteria that trigger mandatory activation of the general surgeon.
Washington Administrative Code (WAC) rules are clear about the required response times for general surgeons. If the on-call general surgeon is unavailable because he/she is managing trauma patient care or performing elective surgery at another facility, then the facility calling the trauma team activation would need to go on divert, and that facility would not be meeting trauma standards of care. Surgeon response times should be continuously monitored through the QI process.
Although this is not a direct violation of WAC it's strongly discouraged. If a surgeon performs elective surgery while on trauma call a written surgeon back-up protocol is necessary. The availability of the on-call surgeon or instances of surgeon unavailability must be monitored closely through the Trauma QI process. If the unavailability of the surgeon seriously hinders your obligations as a Level I, II, or III trauma center, measures must be taken to alleviate the problem.
Medical records are selected based on a criteria which is given to trauma service (Levels I-III only) about three months prior to their scheduled site visit.