16 Del. Admin. Code § 4305-3.0
The following words and terms, when used in these regulations, should have the following meaning:
"ACS" means the American College of Surgeons.
"Attending" means a physician with practice privileges delineated by the hospital's facility's medical staff.
"Board certified" means a physician certified by an appropriate specialty board recognized by the American Board of Medical Specialties or the American Osteopathic Association.
"Bypass" means a request by a facility to an Emergency Medical Service that patients be directed to another facility's Emergency Department due to a shortage or unavailability of beds, equipment, personnel, or other essential resource.
"Classification of injuries" include the following:
"Minor injuries" means those patients with an Injury Severity Score less than 9.
"Moderate injuries" means those patients with an Injury Severity Score between 9 and 15.
"Major (severe) injuries" means those patients with an Injury Severity Score greater than 15.
"Community trauma center" or "Level III" means an acute care facility that provides assessment, resuscitation, stabilization, and triage of all trauma patients, arranging for 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.
"Continuing Medical Education credit" or "CME credit" means educational hours for physicians approved by the Accreditation Council of Continuing Medical Education or an agency recognized by this council.
"Credentialing process" means a facility's procedure for granting practice privileges to healthcare providers.
"Definitive care" means a level of medical intervention capable of providing comprehensive services for a patient's injuries and associated conditions.
"Demonstrated commitment" means provision of evidence (visible and written) that demonstrates clearly an institution-wide commitment to trauma care.
"Designation" means a process through which a facility is confirmed by the Division to have the appropriate resources to manage patients with injuries of particular degrees of severity, and is granted the authorization to function as a Delaware trauma center.
"Division" means the Delaware Division of Public Health.
"Division Director" means the Director of the Delaware Division of Public Health.
"Emergency Medical Services" or "EMS" means the arrangement of personnel, facilities, equipment, transportation, and communication to provide for the effective and coordinated delivery of medical care in emergency situations resulting from accidents, illnesses, or natural disasters.
"Facility Trauma Quality Management Program" means the review program within each trauma center which monitors such aspects of the trauma program as adherence to policies and patient outcome with the goal of assuring that optimal care is continuously provided.
"In-house" means physically present in the facility.
"Injury control" means methodologies designed for the purpose of preventing and eliminating injuries.
"Injury Severity Score " means a retrospective summary score derived by applying a prescribed scoring system and mathematical formula to a listing of a trauma patient's injuries. Use of this scoring system allows objective comparisons of trauma patients based on their injuries.
"Interfacility transfer" means the transfer of a patient from 1 facility to another facility.
"Level III" see definition for "community trauma center".
"Level IV" see definition for "participating facility".
"Participating facility" or "Level IV" means 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 facilities contribute data to the Delaware Trauma System Registry and Quality Improvement Program.
"Pediatric trauma centers" means children's facilities which meet the standards for a particular classification of trauma center within Delaware's Pediatric Trauma Standards and the corresponding classification in Delaware's Adult Trauma Standards.
"Performance improvement" or "PI" means a process of measuring the outcome of a particular component, process, procedure, or treatment within the trauma care continuum, then modifying the process or procedure to improve patient care. PI is often interchanged with the term "quality improvement" or "QI".
"Performance Improvement and Patient Safety" or "PIPS" means processes for identifying adverse events and implementing subsequent corrective action plans.
"Prevention" means efforts to decrease the numbers and severity of traumatic injuries.
"Protocols" means written standards for clinical practice in a variety of situations within the Trauma System.
"Quality improvement" or "QI" see definition for "performance improvement".
"Regional Level I Trauma Center" means 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 II Trauma Center" means a regional trauma center with the capability to provide initial care for all trauma patients. Most patients would continue to be cared for in this center; there may be some complex cases requiring transfer for the depth of services of a Regional Level I or specialty center.
"Response time" means the time interval between notification and arrival of the general surgeon or surgical specialist at the patient's bedside.
"Specialty center" means a facility and staff that meet minimum standards established under the program and are designated by the board for program use in the comprehensive diagnostic and treatment services for a specific medical condition. This may include pediatric centers, burn centers, and others.
"Transfer agreement" means a formal written agreement between hospitals which provides for the acceptance of patients in transfer.
"Trauma" means any bodily injury. Injury is the result of an act that damages, harms, or hurts; unintentional or intentional damage to the body resulting from acute exposure to mechanical, thermal, electrical, or chemical energy or from the absence of such essentials as heat or oxygen.
"Trauma center" means a specialized facility distinguished by the immediate availability of specialized surgeons, physician specialists, anesthesiologists, nurses, and resuscitation and life support equipment on a 24-hour basis to care for severely injured patients or those at risk for severe injury.
"Trauma facility" means an acute care facility which has received and maintains current State designation as a trauma center.
"Trauma Medical Director" or "TMD" means the physician responsible for and has the authority to develop and enforce policies and procedures relevant to the care of the injured patient and to oversee the structure and process of the trauma PIPS program. Each trauma center is required by the ACS to have a TMD.
"Trauma Program Manager" or "TPM" means the individual with the daily responsibility for process and performance improvement activities as they relate to nursing and ancillary personnel involved in the care of trauma patients. The TPM's role includes partnering with the TMD in the development of policies and oversight of the program. Each trauma center is required by ACS to have a TPM.
"Trauma registry" means a database to provide information for analysis and evaluation of the quality of patient care, including epidemiological and demographic characteristics of trauma patients. The 'Expanded' data set provides a basis for the facility's Trauma Quality Program; the 'Minimal' data set collects largely demographic information.
"Trauma System Medical Advisor" means an advisor on both specific and general trauma clinical and patient care issues which are brought to the Trauma System Committee or its subcommittees.
"Trauma System Quality Management Program" means the program which reviews aspects of the Trauma System such as interfacility transfers and triage decisions with the goal of assuring that the various components of the Trauma System are functioning optimally.
"Triage" means the sorting of patients in terms of priority need for care, so that appropriate treatment, transportation, and destination decisions can be made according to predetermined protocols.
"Verification" means a process in which the trauma care capability and performance of a facility are evaluated by experienced on-site reviewers.
16 Del. Admin. Code § 4305-3.0