Mich. Admin. Code R. 330.253 - Definitions; P to V

Rule 3.

(1) As used in this part:

(a) "Protocol" means a patient care standard, standing order, policy, or procedure for providing EMS that is established by an MCA and approved by the department under section 20919 of the code, MCL 333.20919.

(b) "Provisional" means a one-time, temporary-time-limited status conferred on a facility by the department that most closely matches the current level of care based on the published criteria for certification for which it is applying.

(c) "PSRO" or ""professional standards review organization" means a committee established by a life support agency or MCA for the purpose of improving the quality of medical care, as provided in section 1 of 1967 PA, 270, MCL 331.531.

(d) "Quality improvement program" means actions taken by a life support agency, MCA, stroke center, or jointly between a life support agency, MCA, or stroke center with a goal of continuous improvement of medical care in accordance with the code. Actions must take place under a PRSO, as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(e) "RPSRO" or "regional PRSO" means a committee established by the regional stroke system for the purpose of improving the quality of stroke care within a recognized stroke region as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(f) "Regional stroke plan" means a written plan prepared by a regional stroke advisory council, and approved by the regional stroke system, that is based on minimum criteria established by the department.

(g) "RSAC" or "regional stroke advisory council" means a committee established by a regional stroke system whose function is to provide leadership and direction in matters related to stroke system development in their region, and to monitor the performance of the stroke agencies and healthcare facilities within the region, including, but not limited to, the review of stroke deaths and preventable complications, and it is comprised of the following:

(i) MCA personnel.

(ii) EMS personnel.

(iii) Life support agency representatives.

(iv) Healthcare facility representatives.

(v) Physicians.

(vi) Nurses.

(vii) Consumers.

(h) "Regional stroke system" means an organized group comprised of the local MCA within a region, that integrates into existing regional trauma network or regional systems of care authority and is responsible for appointing a regional stroke advisory council and creating a regional stroke plan.

(i) "Regional systems of care authority" means an organization recognized by the department, comprised of approved MCAs within a region, also approved as the Regional Trauma Network, which provides clinical oversight for the regional trauma system, regional stroke system and regional STEMI system within the region.

(j) "Statewide stroke care advisory subcommittee" means a stroke care advisory subcommittee that acts as the department's subject matter experts for the clinical and operational components of stroke care. As the system matures and signals readiness to capitalize on efficiencies, the system will merge into the statewide stroke care advisory subcommittee and the statewide STEMI care advisory subcommittee into the statewide cardiovascular care advisory subcommittee.

(k) "Statewide stroke registry" means a system for collecting data that the department manages, analyzes, and disseminates results.

(l) "Statewide stroke system of care" means a comprehensive and integrated arrangement of emergency services personnel, stroke centers, equipment, services, communications, MCAs, and organizations necessary to provide stroke care to all patients within a particular geographic region.

(m) "STEMI" means an ST-segment elevation myocardial infarction defined by symptoms of myocardial infarction associated with an ST-segment elevation on an ECG.

(n) "Stroke" means a cerebrovascular disease that causes a sudden interference in the blood supply to the brain causing neuronal injury with neurological symptoms. This occurs when a blood vessel in the brain is blocked by a clot or a vessel rupture.

(o) "Stroke bypass" means to forego EMS transport of a patient to the nearest healthcare facility for facility whose resources are more appropriate to the stroke patient, pursuant to direction given to pre-hospital EMS by online medical direction or predetermined triage criteria, as established by department-approved protocols.

(p) "Stroke care" means diagnostic evaluation, triage, acute intervention, emergency transport and other acute care services for stroke patients who potentially require emergent medical or surgical intervention or treatment, and may include education, risk reduction, and subacute stroke management.

(q) "Stroke center" means a healthcare facility designated by the department as having met the criteria set forth by a department-approved, CMS-recognized professional certifying organization as being any of the following:

(i) Level I or comprehensive stroke center.

(ii) Level II or thrombectomy capable stroke center.

(iii) Level III or primary stroke center.

(iv) Level IV or acute stroke ready center.

(r) "Stroke diversion" means the re-routing of a stroke patient from a stroke care facility that has 1 or more of its essential resources currently functioning at maximum capacity, or is otherwise unavailable, to an alternate stroke care facility to serve the best interests of the stroke patient.

(s) "Stroke response" means an individual who has been identified as a potential stroke patient and requires the utilization of the stroke care system.

(t) "Triage" means classifying patients according to the severity of their medical conditions.

(u) "Verification" means an evaluation process conducted by a national professional certifying organization to verify resources and improve stroke care.

(2) A term defined in the code has the same meaning when used in these rules.

Notes

Mich. Admin. Code R. 330.253

2023 MR 21, Eff. 11/6/2023