MSS013: ASSESSING REGIONAL MEDICAL OPERATIONS CENTER (RMOCC) KNOWLEDGE AND LARGE PATIENT INFLUX PREPAREDNESS IN MICHIGAN TRAUMA CENTERS
Emma H Harris, MS1; Jacob M Dougherty, BS1; Laura Gerhardinger, MA2; Andrew Isaacson, MD1; Joey Johnson, MD3; Alfred Baylor, MD1; Daniel Stinner, MD4; Benjamin Mosher, MD5; Jennifer Hagen, MD6; Bryant W Oliphant, MD, MBA, MSc1; 1Wayne State University School of Medicine; 2University of Michigan, Center for Healthcare Outcomes and Policy; 3University of Alabama, Birmingham; 4Vanderbilt University School of Medicine; 5University of Michigan Health, Sparrow Hospital; 6University of Florida
Objectives: The potential of large-scale combat operations (LSCO) with a near peer adversary (NPA) has pushed military and civilian entities to further develop the concept of Regional Medical Operation Coordinating Centers (RMOCC) to load balance patient distribution after evacuation from theatre. While RMOCCs were used during COVID-19, the volume and severity of injuries from a LSCO would surpass any previous surge and require specialized trauma care. Although the American College of Surgeons Committee on Trauma (ACS-COT) has held high-level discussions about RMOCCs, it is unclear whether individual trauma centers are aware of this concept, or are prepared to participate in such an initiative. To address this gap, we surveyed Trauma Medical Directors (TMDs) and Trauma Program Managers (TPMs) in a single state to assess their knowledge, capabilities, and perceived barriers to participating in an RMOCC.
Methods: We used a trauma center directory listserv to distribute an internet-based survey to TMDs and TPMs at all 35 ACS-COT–verified Level I and II centers in one state. The survey assessed respondents’ basic awareness of the RMOCC concept, their center’s baseline capacities (e.g., med-surg beds, ICU beds, ORs), and an approximated capacity in a surge scenario. We also queried their perceived barriers for participating in an RMOCC at their institution. Descriptive statistics were used to analyze multiple choice responses, and themes were extracted from open text responses.
Results: We obtained 20 responses (10 TMD; 10 TPM) from 17 trauma centers (6 Level I; 11 Level II). Half of the respondents had no prior knowledge of RMOCCs, and 60% were unfamiliar with their purpose. In a hypothetical surge scenario, respondents reported they could increase med-surg beds by 116%, ICU beds by 135%, and OR capacity by 126%. Overall, 52% believed their center was prepared to participate in an RMOCC. Themes to describe RMOCCS centered on resource coordination and regional triage, while highlighting significant gaps in awareness. Staffing shortcomings and non-elective patients were the top perceived barriers to implementing an RMOCC.
Conclusion: Awareness of RMOCCs among trauma leaders in Michigan is limited, despite ACS-COT discussions at the national level. However, trauma centers reported substantial surge capacity and over half expressed readiness to engage in regional coordination. These findings underscore the potential structural capacity as well as the urgent need for education and integration of trauma centers leaders into future RMOCC initiatives to ensure preparedness for a LSCO or other mass casualty event.