The injury lawyers of Crossen Kooi Law discuss Indiana’s attempts
to address trauma issues and injuries issues in the State of Indiana and
how the State has moved to address these concerns.
On November 6, 2009, Governor Mitch Daniels signed Executive Order 09-08
for creation of the Indiana State Trauma Care Committee.
HERE for a link to the full text of the order.
As discussed in the Order’s preamble, there are several factors which
lead to this committee’s development. They include, but are not
limited to, the following:
• Injury is the leading cause of death for citizens from 1 year to
34 years of age in the State of Indiana and in the United States. More
than 95,000 Indiana citizens are hospitalized and over 5,000 citizens
die from injuries each year.
• Indiana injuries defined as trauma require rapid evaluation and
transport to specific hospitals with trauma care capabilities, staffed
and equipped to provide the comprehensive care needed. All hospital emergency
departments are not trauma centers.
• A trauma system is an organized, coordinated effort in a geographic
area that delivers the full range of care to all injured patients. Until
March 2006, Indiana was one of a very few states with no laws or regulations
providing legal authority for state oversight of trauma care, a necessary
element of a trauma system. Indiana Public Law 155 – 2006 now provides
authority for the Indiana State Department of Health to be the lead state
agency for an Indiana trauma care system.
• States with trauma systems have a review process to designate hospitals
according to the level of care that can be provided to injured patients
– ranging from emergency department evaluation and stabilization
in smaller hospitals to the most comprehensive levels of care provided
in hospitals verified by the American College of Surgeons Committee on
• Indiana now has 8 hospitals that are Level I or Level II trauma
centers as verified through a strenuous review process by the American
College of Surgeons Committee on Trauma. These facilities include:
Indianapolis –Wishard, Methodist, Riley Hospitals (Level I)
Fort Wayne – Parkview and Lutheran Hospitals (Level II)
South Bend – Memorial Hospital (Level II)
Evansville – St. Mary’s and Deaconess Hospitals (Level II)
• Indiana trauma system development is being addressed by an Indiana
State Department of Health (ISDH) Trauma System Advisory Task Force, organized
in May 2004. The Task Force has broad representation from numerous organizations
and individuals interested in developing a statewide trauma care system.
Organizations and individuals that make up the task force include:
- Indiana State Health Department
- Indiana Rural Health Association
- Indiana Farm Bureau Insurance
- Indiana Emergency Nurses’ Association
- Indiana American College of Emergency Physicians
- Indiana American College of Surgeons – Committee on Trauma
- Indiana Hospital Association
- Indiana Department of Homeland Security, Fire and Emergency Medical Services
- Indiana Trauma Network
- Trauma surgeons, emergency physicians, registered nurses, paramedics,
state legislators, hospital administrators, rehabilitation specialists,
Issues being considered by the Task Force include:
- leadership of a statewide trauma system
- policies, legislation and financing needed for such a system
- system design, based on data and needs assessments
- education of policy-makers, health professionals and the public
- information management and quality of care indicators
- collaboration and resources to support a statewide system
- development and maintenance of a state trauma registry
- standards and procedures for trauma care level designation of hospitals.
Task Force Efforts:
- The goal of a statewide trauma system is the prevention of injuries
and the coordination of care of injured patients to accomplish decreased
death and disabilities due to trauma.
- It is desirable for all Indiana hospitals to eventually be part of a
statewide trauma system, based on the level of care each hospital is able
- System participation by hospitals would be voluntary.
- Collaboration between emergency medical services, hospitals, rehabilitation
facilities and public health is needed.
- A statewide trauma registry is necessary because it provides a proven
mechanism to examine trauma patient care data on a confidential basis.
- Widespread education is needed to inform numerous constituencies (legislators,
hospitals, the public) about a statewide trauma system.