Report 2013-116 Recommendation 3 Responses

Report 2013-116: Los Angeles County: Lacking a Comprehensive Assessment of Its Trauma System, It Cannot Demonstrate That It Has Used Measure B Funds to Address the Most Pressing Trauma Needs (Release Date: February 2014)

Recommendation #3 To: Los Angeles County

To determine whether its trauma system is appropriately designed and serving the needs of residents in underserved areas and the needs of the most at-risk populations, the board should use Measure B funds to engage the College of Surgeons by July 2014 to perform a comprehensive assessment of the trauma system and then make the results available to the public. To the extent the assessment identifies weaknesses in the trauma system, the board should develop strategies to address those weaknesses where feasible. Specifically, the board should ask the College of Surgeons to do the following: assess the adequacy of helicopter services it provides in underserved areas.

Annual Follow-Up Agency Response From September 2015

Los Angeles County highly values objective, rigorous external input from knowledgeable experts with respect to continuous improvement of its trauma system. Such input is regularly obtained from the LA County Trauma Hospital Advisory Committee, the State EMS Authority, and the LA County EMS Commission. LA County acknowledges the suggestion to engage the American College of Surgeons (ACS) in an analysis of the trauma system. However, LA County is already taking a multitude of steps and will be working with the American College of Surgeons, as described in its response, to improve the trauma system for all County residents and visitors.

For example, LA County has been notified that the State EMS Authority, the preeminent subject matter expert in California trauma and emergency services planning, has scheduled a review of the State trauma system in March 2016. It should be noted that the EMS Authority has already contracted with the American College of Surgeons for this review. LA County plans to fully participate in this review. The results of the review and any recommendations or comments relevant to LA County will be thoroughly evaluated internally and through its committee process.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement


1-Year Agency Response

LA County highly values objective, rigorous external input from knowledgeable experts with respect to continuous improvement of its trauma system. Such input is regularly obtained from the Trauma Hospital Advisory Committee, the State EMS Authority, and the EMS Commission. Although the suggestion to engage the American College of Surgeons (ACS) in an analysis of the trauma system is reasonable, LA County is already taking the obvious steps needed to improve the trauma system for all County residents.

  • Response Date: February 2015

California State Auditor's Assessment of 1-Year Status: Will Not Implement

We stand by our recommendation that the board should use the College of Surgeons to assess the adequacy of helicopter services it provides in underserved areas. As we reported, Los Angeles' current monitoring efforts do not enable it to examine whether its trauma system serves residents, such as those in underserved areas and at-risk population groups, equitably. Additionally, we reported that EMS's efforts to review helicopter data were undocumented and not specific to underserved areas. Thus, EMS cannot demonstrate that underserved areas fare as well as other areas of the county in terms of transport times. We believe engaging the College of Surgeons to perform such an assessment would allow Los Angeles to ensure its trauma system is serving the needs of residents in underserved areas.


6-Month Agency Response

LA County highly values objective, rigorous external input from knowledgeable experts with respect to continuous improvement of its trauma system. Such input is regularly obtained from the Trauma Hospital Advisory Committee, the State EMS Authority, and the EMS Commission. Although the suggestion to engage the American College of Surgeons (ACS) in an analysis of the trauma system is reasonable, LA County is already taking the obvious steps needed to improve the trauma system for all County residents. Several of these steps are described in the response to other recommendations.

  • Estimated Completion Date:
  • Response Date: August 2014

California State Auditor's Assessment of 6-Month Status: Will Not Implement

We stand by our recommendation that the board should use the College of Surgeons to assess the adequacy of helicopter services it provides in underserved areas. As we reported, Los Angeles' current monitoring efforts do not enable it to examine whether its trauma system serves residents, such as those in underserved areas and at-risk population groups, equitably. Additionally, we reported that EMS's efforts to review helicopter data were undocumented and not specific to underserved areas. Thus, EMS cannot demonstrate that underserved areas fare as well as other areas of the county in terms of transport times. We believe engaging the College of Surgeons to perfrom such an assessment would allow Los Angeles to ensure its trauma system is serving the needs of residents in underserved areas.


60-Day Agency Response

The benefits of having ACS review the helicopter services are unclear.

  • Estimated Completion Date: TBD
  • Response Date: April 2014

California State Auditor's Assessment of 60-Day Status: No Action Taken


All Recommendations in 2013-116

Agency responses received are posted verbatim.


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