DAR File No. 40426
This rule was published in the June 1, 2016, issue (Vol. 2016, No. 11) of the Utah State Bulletin.
Health, Family Health and Preparedness, Emergency Medical Services
Trauma and EMS System Facility Designations
Notice of Proposed Rule
DAR File No.: 40426
Filed: 05/13/2016 08:49:14 AM
Purpose of the rule or reason for the change:
The amendments align trauma data rules with national level updates and provide clarity on data element requirements.
Summary of the rule or change:
The changes: 1) replace references from ICD-9 to ICD-10; 2) update inclusion criteria to include a hospital stay of longer than 12 hours (as measured from the time of Emergency Department arrival to patient discharge); 3) remove the list of required data elements which is replaced by Subsection R426-9-7(1)(c); 4) no longer require referring hospital information except hospital transfer and hospital name; and 5) replace full Utah Trauma Data Dictionary with addendum that includes only additional elements not included in the National Traffic Data Standard.
State statutory or constitutional authorization for this rule:
- Title 26, Chapter 8a
Anticipated cost or savings to:
the state budget:
There is no anticipated fiscal impact to the state budget because amendments update and clarify standards.
There is no anticipated fiscal impact to local government budgets because amendments update and clarify standards.
There is no impact on small businesses. Reporting is currently required, and amendments update and clarify reportable data elements.
persons other than small businesses, businesses, or local governmental entities:
There are no anticipated fiscal impacts. Reporting is currently required, and amendments update and clarify reportable data elements.
Compliance costs for affected persons:
Affected persons will not have any additional compliance costs. The amendments update and clarify existing requirements.
Comments by the department head on the fiscal impact the rule may have on businesses:
There is no fiscal impact upon business because the proposed changes clarify but do not change any currently required reporting requirements.
Joseph Miner, MD, Executive Director
The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:Health
Family Health and Preparedness, Emergency Medical Services
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106
Direct questions regarding this rule to:
- Guy Dansie at the above address, by phone at 801-273-6671, by FAX at 801-273-4165, or by Internet E-mail at email@example.com
Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:
This rule may become effective on:
Joseph Miner, Executive Director
R426. Health, Family Health and Preparedness, Emergency Medical Services.
R426-9. Trauma and EMS System Facility Designations.
R426-9-100. Authority and Purpose for Trauma System Standards.
(1) Authority - This rule is established under Title 26, Chapter 8a, 252, Statewide Trauma System, which authorizes the Department to:
(a) establish and actively supervise a statewide trauma system;
(b) establish, by rule, trauma center designation requirements and model state guidelines for triage, treatment, transport, and transfer of trauma patients to the most appropriate health care facility; and
(c) designate trauma care facilities consistent with the trauma center designation requirements and verification process established by the Department and applicable statutes.
(2) This rule provides standards for the categorization of all hospitals and the voluntary designation of Trauma Centers to assist physicians in selecting the most appropriate physician and facility based upon the nature of the patient's critical care problem and the capabilities of the facility.
(3) It is intended that the categorization process be dynamic and updated periodically to reflect changes in national standards, medical facility capabilities, and treatment processes. Also, as suggested by the Utah Medical Association, the standards are in no way to be construed as mandating the transfer of any patient contrary to the wishes of his attending physician, rather the standards serve as an expression of the type of facilities and care available in the respective hospitals for the use of physicians requesting transfer of patients requiring skills and facilities not available in their own hospitals.
R426-9-700. Data Requirements for an Inclusive Trauma System.
(1) All hospitals shall collect, and
monthly submit to the Department, Trauma Registry information
necessary to maintain an inclusive trauma system. Designated trauma
centers shall provide such data in a[
. The Department shall provide
funds to hospitals, excluding designated trauma centers, for the
data collection process.
[ The inclusion criteria for a trauma patient are as
ICD9 Diagnostic Codes between 800 and 959.9 (trauma);
(b) At least one of the following patient conditions:
(i) Injury resulted in death; (ii) Admitted to the ] hospital
[ for 24 hours or longer; (iii) Patient] transferred in or out of reporting
hospital via EMS transport
[ and (iv) Patient transported via air ambulance, independent
of hospital admission or hospital transfer status. (c) Exclusion criteria are ICD9 Diagnostic
Codes: (i) 930-939.9 (foreign bodies) (ii) 905-909.9 (late effects of injury) (iii) 910-924.9 (superficial injuries, including
blisters, contusions, abrasions, and insect bites) (2) The information shall be in a National Trauma Data
Standard standardized electronic format and include the following
NTDS data elements: (a) Demographic Data: D_01 Patient's Home Zip Code D_02 Patient's Home Country D_03 Patient's Home State D_04 Patient's Home County D_05 Patient's Home City D_06 Alternate Home Residence D_07 Date of Birth D_08 Age D_09 Age Unit D_10 Race D_11 Ethnicity D_12 Sex (b) Injury Information: I_01 Injury Incident Date I_02 Injury Incident Time I_03 Work-Related I_04 Patient's Occupational Industry I_05 Patient's Occupation I_06 ICD-9 Primary External Cause Code I_07 ICD-10 Primary External Cause Code I_08 ICD-9 Place Of Occurrence External Cause
Code I_09 ICD-10 Place Of Occurrence External Cause
Code I_10 ICD-9 Additional External Cause Code I_11 ICD-10 Additional External Cause Code I_12 Incident Location Zip Code I_13 Incident Country I_14 Incident State I_15 Incident County I_16 Incident City I_17 Protective Devices I_18 Child Specific Restraint I_19 Airbag Deployment I_20 Report Of Physical Abuse I_21 Investigation Of Physical Abuse I_22 Caregiver At Discharge (c) Pre-Hospital Information P_01 EMS Dispatch Date P_02 EMS Dispatch Time P_03 EMS Unit Arrival Date At Scene Or Transferring
Facility P_04 EMS Unit Arrival Time At Scene Or Transferring
Facility P_05 EMS Unit Departure Date From Scene Or Transferring
Facility P_06 EMS Unit Departure Time From Scene Or Transferring
Facility P_07 Transport Mode P_08 Other Transport Mode P_09 Initial Field Systolic Blood Pressure P_10 Initial Field Pulse Rate P_11 Initial Field Respiratory Rate P_12 Initial Field Oxygen Saturation P_13 Initial Field GCS -Eye P_14 Initial Field GCS -Verbal P_15 Initial Field GCS -Motor P_16 Initial Field GCS -Total P_17 Inter-Facility Transfer P_18 Trauma Center Criteria P_19 Vehicular, Pedestrian, Other Risk Injury (d) Emergency Department Information ED_01 ED/Hospital Arrival Date ED_02 ED/Hospital Arrival Time ED_03 Initial ED/Hospital Systolic Blood
Pressure ED_04 Initial ED/Hospital Pulse Rate ED_05 Initial ED/Hospital Temperature ED_06 Initial ED/Hospital Respiratory Rate ED_07 Initial ED/Hospital Respiratory Assistance ED_08 Initial ED/Hospital Oxygen Saturation ED_09 Initial ED/Hospital Supplemental Oxygen ED_10 Initial ED/Hospital GCS -Eye ED_11 Initial ED/Hospital GCS -Verbal ED_12 Initial ED/Hospital GCS -Motor ED_13 Initial ED/Hospital GCS -Total ED_14 Initial ED/Hospital GCS Assessment
Qualifiers ED_15 Initial ED/Hospital Height ED_16 Initial ED/Hospital Weight ED_17 Alcohol Use Indicator ED_18 Drug Use Indicator ED_19 ED Discharge Disposition ED_20 Signs Of Life ED_21 ED Discharge Date ED_22 ED Discharge Time (e) Hospital Procedure Information HP_01 ICD-9 Hospital Procedures HP_02 ICD-10 Hospital Procedures HP_03 Hospital Procedure Start Date HP_04 Hospital Procedure Start Time (f) Diagnosis Information DG_01 Co-Morbid Conditions DG_02 ICD-9 Injury Diagnoses DG_03 ICD-10 Injury Diagnoses (g) Injury Severity Information IS_01 AIS Predot Code IS_02 AIS Severity IS_03 ISS Body Region IS_04 AIS Version IS_05 Locally Calculated ISS (h) Outcome Information O_01 Total ICU Length Of Stay O_02 Total Ventilator Days O_03 Hospital Discharge Date O_04 Hospital Discharge Time O_05 Hospital Discharge Disposition (i) Financial Information F_01 Primary Method Of Payment (x) Quality Assurance Information Q_01 Hospital Complications (3) Additional data elements, not included in the NTDS,
to be submitted include: (a) Demographic Information A.1 Tracking Number A.2 Hospital Number A.10 Medical Record Number A.11 Social Security Number (b) Injury Information B.3 Injury Cause Code B.4 Trauma Type B.19 Injury Details (c) Pre-hospital Information D.3 EMS Agency D.4 EMS Origin D.8 EMS Respond Date D.7 EMS Respond Time D.14 EMS Destination Arrival Date D.13 EMS Destination Arrival Time D.15 EMS Destination D.16 EMS Trip Form Received D.24 Initial Field GCS Assessment Qualifiers (d) Referring Hospital Information C.1 Hospital Transfer C.2 Transport Mode into Referring Hospital C.3 Referring Hospital C.4 Referring Hospital Arrival Date C.5 Referring Hospital Arrival Time C.6 Referring Hospital Discharge Date C.7 Referring Hospital Discharge Time C.8 Referring Hospital Admission Type C.9 Referring Hospital Pulse C.10 Referring Hospital Respiratory Rate C.11 Referring Hospital Systolic Blood Pressure C.12 Referring Hospital GCS -Eye C.13 Referring Hospital GCS -Verbal C.14 Referring Hospital GCS -Motor C.15 Referring Hospital GCS Assessment
Qualifiers C.16 Referring Hospital GCS Total C.17 Referring Hospital Procedures (e) Emergency Department Information E.1 ED Admit Type E.2 ED Admit Service E.6 ED Admission Date E.5 ED Admission Time E.14 ED Transferring EMS Agency E.15 ED Discharge Destination Hospital (f) Inpatient Information E.10 Inpatient Admission Date E.9 Inpatient Admission Time E.12 Hospital Discharge Date E.11 Hospital Discharge Time E.16 Transfer Reason E.18 Hospital Discharge Destination Hospital E.19 DC Transferring EMS Agency (vii) Outcome Information E.20 Outcome]
KEY: emergency medical services, trauma, reporting, trauma center designation
Date of Enactment or Last Substantive Amendment: [
August 21, 2015]
Authorizing, and Implemented or Interpreted Law: 26-8a-252
More information about a Notice of Proposed Rule is available online.
The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull-pdf/2016/b20160601.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.
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For questions regarding the content or application of this rule, please contact Guy Dansie at the above address, by phone at 801-273-6671, by FAX at 801-273-4165, or by Internet E-mail at firstname.lastname@example.org. For questions about the rulemaking process, please contact the Division of Administrative Rules.