DHS 118.03(17)(17) “Hospital” means entities approved under subch. II of ch. 50, Stats., and ch. DHS 124, including critical access hospitals, that routinely provide trauma care, excluding hospitals whose principal purpose is to treat persons with a mental illness. DHS 118.03(18)(18) “Indicator review” means the RTAC’s assessment of trauma system performance based on desired trauma system measurements and used by the RTAC in the performance improvement process. DHS 118.03(19)(19) “Lead agency” means an organization or agency that serves as the focal point for program development on the local, regional and state level. In this chapter, the department serves as the lead agency. DHS 118.03(20)(20) “Level I” means a class of trauma care facility that is characterized by the hospital’s capability of providing leadership and total care for every aspect of traumatic injury from prevention through rehabilitation, including research. DHS 118.03(21)(21) “Level II” means a class of trauma care facility that is characterized by the hospital’s ability to provide initial definitive trauma care regardless of the severity of injury, but may not be able to provide the same comprehensive care as a level I trauma center. DHS 118.03(22)(22) “Level III” means a class of trauma care facility that is characterized by the hospital’s ability to: DHS 118.03(22)(b)(b) Provide emergency surgery and arrange, when necessary, transfer to a level I or II trauma facility for definitive surgical and intensive trauma care. DHS 118.03(23)(23) “Level IV” means a class of trauma care facility that is characterized by the hospital’s ability to stabilize and provide advanced trauma life support prior to patient transfer. 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.