Base Station Hospital & Trauma Catchment Review

The purpose of this project is to conduct a comprehensive review and evaluation of:

1. Base Station Hospital System (BSHS)
2. Trauma Center Catchment Area Designations (TCCAD)

Public and stakeholder input is critical to ensure a comprehensive evaluation. Opportunities to learn and provide feedback on the project will be available through this site and other activities.

We look forward to hearing from you!

Background

County EMS monitors and evaluates the local emergency medical system on an ongoing basis by conducting surveillance and reporting key system performance indicators and metrics. In collaboration with its partners through advisory groups such as the Emergency Medical Care Committee and the Health Services Capacity Task Force, the County EMS then revises policies and protocols as indicated by the data. Although there are systems in place to ensure data-driven adjustments can be made to the local EMS system when needed, there has not been a comprehensive evaluation of the base station hospital system model and trauma center catchment area designations in several decades. With the changing dynamics of the San Diego region in recent years and anticipated changes to San Diego demographics over the next decade, a comprehensive evaluation of these critical system components will be beneficial to ensure the local EMS system will continue to be one of the finest in the nation.

In developing the comprehensive evaluations, many factors will be considered including:

• Industry research
• Best practices
• Public and stakeholder input

How can you participate in the process:

• Stay informed by reviewing the information on this site
• Share the information with others
• Participate in the engagement tools on this site
• Contribute to conversations at meetings and listening sessions
• Speak up! Don't hesitate to ask question

What is a Base Station Hospital?

In San Diego County, Base Station Hospitals are designated by the County EMS Office to provide on-line medical direction to EMS professionals responding to 9-1-1 calls in the field. This medical direction, provided by the base station hospital physician through specially-trained Mobile Intensive Care Nurses (MICNs), focuses on patient treatment on the scene and assists in determining appropriate patient destinations.

The base hospital also provides EMS continuing education, quality assurance review, and monitors compliance with associated prehospital protocols and policies.

The base station hospital coordinates patient distribution in a large-scale disaster or other incidents, as described in the County of San Diego Emergency Operations Plan Annex D – Multi-Casualty Operations.

In San Diego County, there are currently seven base hospitals in the EMS system:

• Tri-City Medical Center,
• Palomar Medical Center,
• Scripps Memorial Hospital La Jolla,
• Scripps Mercy Hospital San Diego,
• Sharp Memorial Hospital,
• UCSD Medical Center Hillcrest, and
• Sharp Grossmont Hospital.

Additionally, in San Diego County, there are 14 hospitals with emergency departments that are not Base Station Hospitals.

With the exceptions of Sharp Grossmont and Tri-City, the designated Base Station Hospitals are also designated as Trauma Centers

What is a Trauma Catchment Area?
Trauma catchments refer to geographic areas with defined boundaries assigned to a designated trauma center - a trauma system designation "map." These Trauma Catchments are designated to determine where paramedics will transport a patient with significant traumatic injuries for specialized trauma care.

Factors that determine the trauma catchment area include but is not limited to the following:

• population
• projected population trends,
• drive time,
• response time, and
• other factors as defined in County EMS Policy T-705, Trauma Catchment Service Area.

Trauma Catchment Designations are an important element to high-quality, 24/7 available, trauma care. The County EMS Office, on behalf of the Board of Supervisors, designates specific hospitals with the staff and resources necessary to treat emergency medical patients identified by the Base Station Hospital as meeting San Diego County trauma patient criteria per County EMS Policy T-460, Identification of the Trauma Center Patient.

In San Diego County, there are six trauma centers in the EMS system:

• Palomar Medical Center,
• Scripps Memorial Hospital La Jolla,
• Scripps Mercy Hospital San Diego,
• Sharp Memorial Hospital,
• UCSD Medical Center Hillcrest, and
• Rady Children’s Hospital.

In the organized EMS delivery system, paramedics and EMTs transport patients meeting trauma criteria to the appropriate, designated trauma center based on the Trauma Catchment Area designation.