County accepts EMS base-hospital and trauma catchment reports, directs stakeholder pilot process

The San Diego County Board of Supervisors received two consultant reports on the region's emergency medical services system and directed staff to convene a stakeholder-driven implementation process to pilot recommended changes and report back within 12 months.

County EMS staff and consultants presented findings that the base-station hospital system has burdensome radio-reporting practices, fragmented data collection and inconsistent quality-improvement programs. The trauma catchment-area evaluation concluded most adult trauma catchment boundaries are generally appropriate but flagged strain on particular trauma centers from injured patients crossing from the U.S. ' Mexico border and recommended improved collaboration among trauma hospital leadership, better trauma registry data and latitude/longitude capture of incidents.

Key consultant recommendations included standardizing quality assurance, improving real-time hospital status and situational awareness, clarifying the role of a core group of emergency medical physicians providing direction to paramedics, and limiting radio reports to calls requiring physician medical direction. The reports also recommended technology upgrades such as an app-based tool for trauma notification and a single command-and-control view of hospital capacity to level-load patient distribution.

The board voted unanimously to accept the reports and directed the County Administrative Office, County Fire and the EMS office to lead a stakeholder process that will pilot changes; the LEMSA medical director retains statutory authority to implement many of the medically focused recommendations. Staff said they will return with any items that require board action as pilots are developed.