wa-law.org > bill > 2025-26 > HB 2232 > Original Bill
The legislature intends to:
Implement the recommendations of the emergency cardiac and stroke system assessment directed by chapter 58, Laws of 2022 to support efforts to improve emergency cardiac and stroke care in Washington and reduce death and disability resulting from cardiac and stroke events. This includes developing an inclusive system of optimal cardiac and stroke care throughout the continuum of care delivery. Coordinated health care delivery systems require ongoing levels of oversight, evidence-based inputs, coordination, and evaluation of performance. Accordingly, the legislature intends that the department has the responsibility for oversight and coordination of the statewide cardiac and stroke system of care; and
Establish a single statewide data repository for time-sensitive emergencies, including stroke events, cardiac events such as heart attack and sudden cardiac arrest, and trauma events, such as traumatic brain injury. The data repository shall be established by maintaining the existing reporting requirements under the trauma registry and adding new data sets related to stroke events and cardiac events. The result will provide a data repository that is able to analyze data on the incidence, severity, and causes of cardiac, stroke, and trauma events. In addition, the data repository will have the capacity to interact with the statewide electronic emergency medical services data system to provide complete information about the status of the time-sensitive emergency response system in Washington.
1.Until January 1, 2031, when the time-sensitive emergencies data repository is established under subsection (2) of this section, the department shall maintain a statewide data registry to collect and analyze data on the incidence, severity, and causes of trauma, including traumatic brain injury. The department shall collect additional data on traumatic brain injury should additional data requirements be enacted by the legislature. The registry shall be used to improve the availability and delivery of prehospital and hospital trauma care services. Specific data elements of the registry shall be defined by rule by the department. To the extent possible, the department shall coordinate data collection from hospitals for the trauma registry with the health care data system authorized in chapter 70.170 RCW. Every hospital, facility, or health care provider authorized to provide level I, II, III, IV, or V trauma care services, level I, II, or III pediatric trauma care services, level I, level I-pediatric, II, or III trauma-related rehabilitative services, and prehospital trauma-related services in the state shall furnish data to the registry. All other hospitals and prehospital providers shall furnish trauma data as required by the department by rule.
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By January 1, 2031, the department shall establish the statewide time-sensitive emergencies data repository to collect and analyze data on the incidence, severity, and causes of time-sensitive emergencies.
The time-sensitive emergencies data repository shall consist of data elements identified by the department in rule as relevant to assessing the timeliness of the care delivered to patients experiencing time-sensitive emergencies and evaluating performance on nationally recognized measures, the delivery of care, and patient outcomes, including:
A data set related to trauma events, including traumatic brain injury;
A data set related to cardiac events, such as heart attack and sudden cardiac arrest; and
A data set related to stroke events.
Beginning January 1, 2031, on a quarterly basis and in a format approved by the department:
Every hospital, facility, or health care provider authorized to provide level I, II, III, IV, or V trauma care services, level I, II, or III pediatric trauma care services, level I, level I-pediatric, II, or III trauma-related rehabilitative services, and prehospital trauma-related services must submit to the data repository those data required under (b)(i) of this subsection (2);
Every hospital authorized by the department to provide specialized emergency cardiac care must submit to the data repository those data required under (b)(ii) of this subsection (2); and
Every hospital authorized by the department to provide specialized emergency stroke care shall submit to the data repository those data required under (b)(iii) of this subsection (2).
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The department shall establish a data validation process for the statewide time-sensitive emergencies data repository and implement a plan for continuous data quality improvement.
The department may minimize the creation of new reporting requirements by using existing data sources and coordinating with state and national organizations involved in time-sensitive emergency services quality improvement. The department may enter into any necessary data-sharing agreements for this purpose.
The department shall provide technical assistance to ambulance and aid services, hospitals, including critical access hospitals, and emergency care regional partners.
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Beginning July 1, 2033, and annually thereafter, the department shall provide a summary report of the data collected pursuant to this subsection (2) and an analysis of the statewide progress toward improving quality of care and patient outcomes. The department shall report all data in aggregate form and post the data on the department's website.
The 2033 report must include an analysis of data collected and recommendations regarding whether on-site verification of hospitals' adherence to cardiac and stroke systems of care is needed to improve citizens' access to safe, timely, evidence-based care for stroke, acute coronary syndrome, and cardiac arrest.
The department must establish a statewide electronic emergency medical services data system and adopt rules requiring licensed ambulance and aid services to report and furnish patient encounter data to the electronic emergency medical services data system. The data system must be used to improve the availability and delivery of prehospital emergency medical services. The department must establish in rule the specific data elements of the data system and secure transport methods for data. The data collected must include data on suspected drug overdoses for the purposes of including, but not limited to, identifying individuals to engage substance use disorder peer professionals, patient navigators, outreach workers, and other professionals as appropriate to prevent further overdoses and to induct into treatment and provide other needed supports as may be available.
In each emergency medical services and trauma care planning and service region, a regional emergency medical services and trauma care systems quality assurance program shall be established by those facilities authorized to provide levels I, II, and III trauma care services. The systems quality assurance program shall evaluate trauma care delivery, patient care outcomes, and compliance with the requirements of this chapter. The systems quality assurance program shall also evaluate emergency cardiac and stroke care delivery. The emergency medical services medical program director and all other health care providers and facilities who provide trauma and emergency cardiac and stroke care services within the region shall be invited to participate in the regional emergency medical services and trauma care quality assurance program.
The department shall:
Establish and implement a plan for achieving continuous quality improvement in the care provided under the time-sensitive emergencies data repository. The department shall develop and implement the statewide plan using the time-sensitive emergencies data repository, the statewide electronic emergency medical services data system, and other data sources available to the department;
Establish a system performance oversight process using data from the statewide time-sensitive emergencies data repository;
Analyze data concerning time-sensitive emergency response and treatment and identify areas in need of improvement;
Provide quarterly reports on system performance and quality of care measures to the emergency cardiac and stroke technical advisory committee and the hospital technical advisory committee of the emergency medical services and trauma care steering committee;
Provide recommendations to the emergency medical services and trauma care steering committee for the improvement of time-sensitive emergency services in the state;
Provide aggregate time-sensitive emergencies care feedback to participating ambulance and aid services, trauma regions, and hospitals to improve performance on care and system coordination;
Use data from the statewide time-sensitive emergencies data repository to further the development of cardiac, stroke, and trauma system standards and education; and
Identify and disseminate interventions to improve time-sensitive emergency care in prehospital and hospital settings and in local and regional systems of care.
The department may respond to requests for data and other information from the trauma registry established in subsection (1) of this section, the statewide time-sensitive emergencies data repository established in subsection (2) of this section, and the statewide electronic emergency medical services data system established in subsection (3) of this section for special studies, public health activities, and analysis consistent with requirements for confidentiality of patient and quality assurance records. The department may require requestors to pay any or all of the reasonable costs associated with such requests that might be approved.
Data elements related to the identification of individual patient's, provider's, and facility's care outcomes shall be confidential, shall be exempt from chapter 42.56 RCW, and shall not be subject to discovery by subpoena or admissible as evidence.
Patient care quality assurance proceedings, records, and reports developed pursuant to this section are confidential, exempt from chapter 42.56 RCW, and are not subject to discovery by subpoena or admissible as evidence in any civil action, except, after in camera review, pursuant to a court order which provides for the protection of sensitive information of interested parties including the department: (a) In actions arising out of the department's designation of a hospital or health care facility pursuant to RCW 70.168.070; (b) in actions arising out of the department's revocation or suspension of designation status of a hospital or health care facility under RCW 70.168.070; (c) in actions arising out of the department's licensing or verification of an ambulance or aid service pursuant to RCW 18.73.030 or 70.168.080; (d) in actions arising out of the certification of a medical program director pursuant to RCW 18.71.212; or (e) in actions arising out of the restriction or revocation of the clinical or staff privileges of a health care provider as defined in RCW 7.70.020 (1) and (2), subject to any further restrictions on disclosure in RCW 4.24.250 that may apply. Information that identifies individual patients shall not be publicly disclosed without the patient's consent.
The department may contract with a single entity to develop and administer the statewide time-sensitive emergencies data repository established under subsection (2) of this section. The department shall conduct a competitive procurement to select an entity to develop and administer the time-sensitive emergencies data repository.
Within funds appropriated for this specific purpose, the department shall assist critical access hospitals and rural hospitals with their platforms to meet the department's data collection requirement and support prehospital services, particularly in rural areas, in acquiring improved equipment and additional personnel training for the treatment of patients experiencing a cardiac, stroke, or trauma event.
Within funds appropriated for this specific purpose, the department shall conduct public education of the signs and symptoms of heart attack and stroke and the lifesaving benefits of calling 911 and seeking immediate treatment.
For purposes of this section, "time-sensitive emergency" means a medical condition for which rapid assessment, intervention, and coordinated transport to an appropriate facility are critical to improving patient outcomes and reducing the risk of death or permanent disability. Time-sensitive emergencies include stroke events, cardiac events, such as heart attack and sudden cardiac arrest, and trauma events, including traumatic brain injury.
By January 1, 2011, the department shall endeavor to enhance and support an emergency cardiac and stroke care system through:
Encouraging hospitals to voluntarily self-identify cardiac and stroke capabilities, indicating which level of cardiac and stroke service the facility provides. Hospital levels must be defined by the previous work of the emergency cardiac and stroke technical advisory committee and must follow the guiding principles and recommendations of the emergency cardiac and stroke work group report;
Giving a hospital "deemed status" and designating it as a primary stroke center if it has received a certification of distinction for primary stroke centers issued by the nonprofit organization known as the joint commission. When available, a hospital shall demonstrate its cardiac or stroke level through external, national certifying organizations, including, but not limited to, primary stroke center certification by the joint commission; and
Within the current authority of the department, adopting cardiac and stroke prehospital patient care protocols, patient care procedures, and triage tools, consistent with the guiding principles and recommendations of the emergency cardiac and stroke work group report.
A hospital that voluntarily participates in the system:
Shall participate in internal, as well as regional, quality improvement activities;
Shall participate in a national, state, or local data collection system that measures cardiac and stroke system performance from patient onset of symptoms to treatment or intervention, and includes, at a minimum, the nationally recognized consensus measures for stroke. Beginning January 1, 2031, hospitals that participate in the system shall submit data to the time-sensitive emergencies data repository; and
May advertise participation in the system, but may not claim a verified certification level unless verified by an external, nationally recognized, evidence-based certifying body as provided in subsection (1)(b) of this section.