DHS 118.03(24)(24) “Loop-closure” means the process whereby an RTAC has identified a quality improvement problem, completed an evaluation, developed an action plan and notified appropriate health care providers of the results. DHS 118.03(25)(25) “Medical director” means the physician who is designated in an operational plan to be responsible for all of the following off-line medical direction activities: DHS 118.03(25)(a)(a) Controlling, directing and supervising all phases of the emergency medical services program operated under the plan and the emergency medical services practitioners performing under the plan. DHS 118.03(25)(b)(b) Establishing standard operating protocols for emergency medical services practitioners performing under the plan. DHS 118.03(25)(c)(c) Coordinating and supervising evaluation activities carried out under the plan. DHS 118.03(25)(d)(d) Designating on-line medical control physicians, if the physicians are to be used in implementing the emergency medical services program. DHS 118.03(26)(26) “Needs assessment” means a written report prepared by an RTAC identifying and documenting trauma care and injury prevention resources and deficiencies within a defined area of the trauma system and which serves as the basis for developing a regional trauma plan. DHS 118.03(27)(27) “Nurse anesthetist” means a professional nurse licensed under ch. 441, Stats., who has obtained, through additional education and successful completion of a national examination, a certification as an anesthesia nursing specialist. DHS 118.03(28)(28) “Off-line medical direction” means medical direction that does not involve voice communication provided to emergency medical services practitioners and emergency medical responders providing direct patient care. DHS 118.03(29)(29) “On-line medical direction” means medical direction of the activities of an emergency medical services practitioner that involves voice communication provided to the emergency medical services practitioners by the medical director or by a physician designated by the medical director. DHS 118.03(30)(30) “On-line medical control physician” means a physician who is designated by the medical director to provide voice communicated medical direction to emergency medical services practitioner and emergency medical responder personnel and to assume responsibility for the care provided by emergency medical technician and first responder personnel in response to that direction. DHS 118.03(31)(31) “Out-of-hospital” means care provided to sick or injured persons before or during transportation to a medical facility, including any necessary stabilization of the sick or injured person. DHS 118.03(32)(32) “Pediatric trauma center” means a freestanding or separate administrative unit in a hospital that is dedicated to addressing the trauma needs of a pediatric patient population and meets the resource requirements outlined by the ACS for verification as a pediatric trauma center. DHS 118.03(33)(33) “Performance improvement” means a method of evaluating and improving processes of trauma patient care that emphasizes a multidisciplinary approach to problem solving. DHS 118.03(34)(34) “Physician” means a person licensed under ch. 448, Stats., to practice medicine and surgery. DHS 118.03(34m)(34m) “PIPS” means performance improvement and patient safety. DHS 118.03(35)(35) “Protocol” means a written statement approved by the department and signed and dated by the medical director that lists and describes the steps any out-of-hospital care provider is to follow in assessing and treating a patient. DHS 118.03(36)(36) “Regional trauma advisory council” or “RTAC” means an organized group of healthcare entities and other concerned individuals who have an interest in organizing and improving trauma care within a specified geographic region approved by the department. DHS 118.03(37)(37) “Regional trauma plan” means a written report prepared by an RTAC that meets all of the following criteria: DHS 118.03(37)(a)(a) Identifies the region’s current trauma care development strengths and weaknesses. DHS 118.03(37)(b)(b) Describes specific goals for future growth and activities in the region. DHS 118.03(38)(38) “Resource hospital” means a hospital in Wisconsin or a bordering state that makes a written commitment to assist the level III coordinating facility of an RTAC to meet the needs required for the development, implementation, maintenance and evaluation of the regional trauma system. DHS 118.03(39)(39) “Rural” means outside a metropolitan statistical area specified under 42 CFR 412.62 (ii) (A) or in a city, village or town with a population of less than 14,000. DHS 118.03(40)(40) “Statewide trauma advisory council” or “STAC” means the entity established by the department to advise the department on a variety of issues pertaining to the establishment and operation of the statewide trauma care system. DHS 118.03(41)(41) “Trauma care system” means a comprehensive and organized approach to facilitating and coordinating a multidisciplinary system response to traumatically injured patients and includes the continuum of care from initial injury detection through definitive care, rehabilitation and injury control.