The American College of Surgeons (ACS) hosted a Northern California Surgical Health Care Quality Forum January 14 at the Mission Bay Conference Center at the University of California-San Francisco (UCSF). During this 15th stop on the College’s national Inspiring Quality (IQ) Tour, health care leaders from the Bay Area shared lessons learned in trauma and critical care delivery following the July 2013 Asiana Airlines crash landing at the San Francisco International Airport.
Cohosting the program were John Maa, MD, FACS, President of the Northern California Chapter of the ACS and chair, University of California office of the president tobacco-related disease research program scientific advisory committee; and Shelley A. Marks, MD, FACS, general surgeon and department head, Palo Alto Clinic, and President-Elect of the Northern California Chapter. California Assemblywoman Fiona Ma (D), former Speaker Pro Tempore, California State Assembly, delivered the keynote address.
“That a major airliner crashed with a less than 1 percent fatality rate is a tribute to safety advances in aviation and the strength and importance of our emergency medical system, particularly in its capacity to absorb a massive surge in patient volume and complexity,” said Dr. Maa. “The successful medical outcome after the Asiana accident demonstrates to our nation what hospitals can accomplish working collaboratively in a region.”
“The infrastructure that allowed San Francisco to respond so effectively to the major mass-casualty event is really based upon principles put forth in the ACS book, Resources for Optimal Care of the Injured Patient, and includes an organized response to injury for things like pre-hospital medical education, setting up pre-hospital systems, 911 communications systems, triage, and transport protocol,” added David B. Hoyt, MD, FACS, ACS Executive Director. “It’s amazing when you look at a map of the area and realize that casualties were distributed to 12 different hospitals in a little over an hour. That would not have been possible 30 years ago.”
Forum hosts urged consideration of the following actions:
- Preparedness and coordination across the continuum from the site of the accident to acute in-hospital care to expedite patient access to lifesaving treatments through search and rescue, rapid transport and helipads, translators, and coordination of operating room resources.
- As authorized under the Public Health Service Act of the Affordable Care Act, Congress should appropriate $224 million to fully fund trauma and emergency medical services programs. These funds would provide adequate support of existing programs and a financial investment in future research in emergency care coordination, trauma systems, and regionalization to sustain emergency departments nationwide.
- The leadership and expertise of the ACS Committee on Trauma (COT) should be leveraged to help surgeons apply meaningful new efforts to improve local, national, and international trauma care.
The keynote speaker, Ms. Ma, suggested ways to strengthen California’s emergency response. “Looking forward, I believe greater regional cooperation and communication is needed between all stakeholders involved in response, including emergency medical services, the Coast Guard, the American Red Cross, and hospitals,” she said, adding, “Translation services at the scene of the accident could help alleviate future incidents where medical providers face challenging language barriers.”
“Preparations and verification of a trauma center through the American College of Surgeons assure the public that we have the resources we need to take care of injured patients,” said M. Margaret Knudson, MD, FACS, professor and interim chief of surgery, San Francisco General Hospital and Trauma Center, UCSF division of general surgery. She said that the ACS COT developed a disaster preparedness course designed by a Navy surgeon responding to the Beirut, Lebanon, bombings that provided surgeons with a background to mass-casualty events. Civilian trauma surgeons thereby learned how to treat casualties in Iraq and Afghanistan, she said. “These are some of the most severe injuries you will ever see in your career, and in Iraq there is a mass-casualty event almost every day, so you get an idea of what you need to do and respond as a surgeon,” Dr. Knudson said.
Additional forum participants included Michael C. Huang, MD, assistant clinical professor, neurological surgery, UCSF; Thomas G. Weiser, MD, MPH, general surgeon and assistant professor of surgery, Stanford University Medical Center; and Randolph W.Y. Wong, MD, FACS, general and thoracic surgeon, Mills-Peninsula Health Services, Sutter Health, Burlingame.
For more information, visit the IQ website.