FUTURE OF EMERGENCY CARE
REGIONALIZING EMERGENCY CARE
Ben Wheatley, Rapporteur
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
THE NATIONAL ACADEMIES PRESS
500 Fifth Street, N.W.
Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This study was supported by Contract No. HHSP233200800008T, Task Order #21 between the National Academy of Sciences and the Emergency Care Coordination Center, part of the Office of the Assistant Secretary for Preparedness and Response in the Department of Health and Human Services; other contributors include the American College of Emergency Physicians and the Society of Academic Emergency Medicine. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the workshop participants and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Suggested citation: IOM (Institute of Medicine). 2010. Regionalizing Emergency Care: Workshop Summary. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE ON REGIONALIZING EMERGENCY CARE WORKSHOP1
ARTHUR KELLERMANN (Chair), Professor and Associate Dean for Health Policy,
Emory University School of Medicine
ROBERT BASS, Executive Director,
Maryland Institute for Emergency Medical Services Systems
DREW DAWSON, Director,
Office of Emergency Medical Services,
National Highway Traffic Safety Administration,
Department of Transportation
A. BRENT EASTMAN, Chief Medical Officer and Chair of Trauma Services,
MICHAEL HANDRIGAN, Acting Director,
Emergency Care Coordination Center,
Office of the Assistant Secretary for Preparedness and Response,
Department of Health and Human Services
JON KROHMER, Principal Deputy Assistant Secretary and Chief Medical Officer,
Department of Homeland Security
JEFFREY S. UPPERMAN, Director of Trauma,
Children’s Hospital Los Angeles
BEN WHEATLEY, Program Officer
ASHLEY McWILLIAMS, Senior Program Assistant
ROGER HERDMAN, Board Director
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:
BRENT ASPLIN, Chair, Department of Emergency Medicine, Mayo Clinic College of Medicine
MARY JAGIM, Client Engagement Manager, Intelligent Insites
RICARDO MARTINEZ, Executive President of Medical Affairs, The Schumacher Group
JOSEPH WAECKERLE, Chief Medical Officer, Office of Homeland Security, State of Missouri
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by MEGAN McHUGH, Health Research and Educational Trust. Appointed by the Institute of Medicine, she was responsible for making certain that
List of Figures and Boxes
Care delivery in the military’s joint theater trauma system,
A more inclusive regionalization model,
Core elements of emergency medical services systems,
Regionalized response to catastrophic events in Texas: lessons learned,