Hospital-Based Emergency Care: At the Breaking Point (2007)

Gail L. Warden, M.H.A., F.A.C.H.E., Main Committee Chair, is president emeritus of Henry Ford Health System in Detroit, Michigan, one of the nation’s leading vertically integrated health care systems. He is an elected member of the Institute of Medicine (IOM) of the National Academy of Sciences and served on its Board of Health Care Services and Committee on Quality Health Care in America, as well as serving its two terms on its Governing Council. He chairs the Board of the National Quality Forum, the Healthcare Research and Development Institute, and the newly created National Center for Healthcare Leadership. Mr. Warden cochairs the National Advisory Committee on Pursuing Perfection: Raising the Bar for Health Care Performance. He is a member of The Robert Wood Johnson Foundation Board of Trustees, the Institute for Healthcare Improvement Board, and the RAND Health Board of Advisors. He is director emeritus and past chair of the Board of the National Committee on Quality Assurance. In 1997 President Clinton appointed him to the Federal Advisory Commission on Consumer Protection and Quality in the Health Care Industry. In 1995 Mr. Warden served as chair of the American Hospital Association Board of Trustees. He served as a member of the Pew Health Professions Commission and the National Commission on Civic Renewal, and is past chair of the Health Research and Education Trust Board of Directors. Mr. Warden served as president and chief executive officer of Henry Ford Health System from April 1988 until June 2003. Previously, he served as president and chief executive officer of Group Health Cooperative of Puget Sound in Seattle from 1981 to 1988. Prior to that he was executive vice president of the American Hospital Association from 1976 to 1981, and from 1965

to 1976 he served as executive vice president and chief operating officer of Rush-Presbyterian-St. Luke’s Medical Center in Chicago. Mr. Warden is a graduate of Dartmouth College and holds an M.H.A. from the University of Michigan. He has an honorary doctorate in public administration from Central Michigan University and is a member of the faculty of the University of Michigan School of Public Health.

Benjamin K. Chu, M.D., M.P.H., Hospital-Based Emergency Care Subcommittee Chair, was appointed president, Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals, Southern California Region, in February 2005. Before joining Kaiser Permanente, Dr. Chu was president of the New York City Health and Hospitals Corporation, with primary responsibility for management and policy implementation. Prior to that, he was senior associate dean at Columbia University College of Physicians and Surgeons. He has also served as associate dean and vice president for clinical affairs at the New York University Medical Center, managing and developing the clinical academic hospital network. Dr. Chu is a primary care internist by training, with extensive experience as a clinician, administrator, and policy advocate for the public hospital sector. He was senior vice president for medical and professional affairs at the New York City Health and Hospitals Corporation from 1990 to 1994. During that period, he also served as acting commissioner of health for the New York City Department of Health and acting executive director for Kings County Hospital Center. Dr. Chu has extensive experience in crafting public policy. He served as legislative assistant for health for Senator Bill Bradley as a 1989–1990 Robert Wood Johnson Health Policy Fellow. Earlier in his career, he served as acting director of the Kings County Hospital Adult Emergency Department. His areas of interests include health care access and insurance, graduate medical education policy, primary care, and public health issues. He has served on numerous advisory and not-for-profit boards focused on health care policy issues. Dr. Chu received a masters in public health from the Mailman School at Columbia University and his doctorate of medicine at New York University School of Medicine.

Stuart H. Altman, Ph.D., is Sol C. Chaikin Professor of National Health Policy at the Heller Graduate School for Social Policy and Management. He served as dean of the Heller School from 1977 to a 1993. In August 2005 he again assumed the deanship of the Heller School. Dr. Altman has had extensive experience with the federal government, serving as deputy assistant secretary for planning and evaluation/health in the U.S. Department of Health, Education, and Welfare, 1971–1976; chair of the congressionally mandated Prospective Payment Assessment Commission, 1983–1996; and a member of the Bipartisan Commission on the Future of Medicare, 1999–2001. In

addition, from 1973 to 1974 he served as deputy director for health of the President’s Cost-of-Living Council and was responsible for developing the council’s program on health care cost containment. Dr. Altman has testified before various congressional committees on the problems of rising health care costs, Medicare reform, and the need to create a national health insurance program for the United States. He chaired the IOM’s Committee on the Changing Market, Managed Care, and the Future Viability of Safety Net Providers. His research activities include several studies concerning the factors responsible for the recent increases in the use of emergency departments. He holds a Ph.D. in economics from the University of California, Los Angeles, and has taught at Brown University and the University of California, Berkeley.

Brent R. Asplin, M.D., M.P.H., F.A.C.E.P., is department head of emergency medicine at Regions Hospital and HealthPartners Research Foundation in St. Paul, Minnesota, and is an associate professor and vice chair of the Department of Emergency Medicine at the University of Minnesota. After receiving his degree from Mayo Medical School, he completed the University of Pittsburgh’s Affiliated Residency in Emergency Medicine. To develop his interests in research and health care policy, Dr. Asplin completed The Robert Wood Johnson Clinical Scholars Program at the University of Michigan, where he obtained an M.P.H. in health management and policy. He is currently studying methods for enhancing the reliability and efficiency of health care operations, particularly strategies for improving patient flow in hospital settings.

Thomas F. Babor, Ph.D., M.P.H., spent several years in postdoctoral research training in social psychiatry at Harvard Medical School, and subsequently served as head of social science research at McLean Hospital’s Alcohol and Drug Abuse Research Center in Belmont, Massachusetts. In 1982 he moved to the University of Connecticut School of Medicine, where he has served as scientific director at the Alcohol Research Center and interim chair of the Psychiatry Department. Dr. Babor’s primary interests are psychiatric epidemiology and alcohol and drug abuse. In 1998 he became chair of the Department of Community Medicine and Health Care at the University of Connecticut School of Medicine, where he directs an active research program. Dr. Babor is regional editor of the international journal Addiction. He previously served on two IOM committees—Prevention and Treatment of Alcohol-Related Problems: An Update on Research Opportunities, and Treatment of Alcohol Problems.

Robert R. Bass, M.D., F.A.C.E.P., received his undergraduate and medical degrees from the University of North Carolina at Chapel Hill in 1972 and

1975, respectively. Prior to completing his undergraduate education, he was employed as a police officer in Chapel Hill, North Carolina, and served as a volunteer member of the South Orange Rescue Squad. Dr. Bass completed an internship and residency in the Navy and is currently board certified in both emergency medicine and family medicine. He has served as a medical director for emergency medical services (EMS) systems in Charleston, South Carolina; Houston, Texas; Norfolk, Virginia; and Washington, D.C. Since 1994, Dr. Bass has been executive director of the Maryland Institute for EMS Systems, the state agency responsible for the oversight of Maryland’s EMS and trauma system. He is clinical associate professor of surgery (emergency medicine) at the University of Maryland at Baltimore and is associate professor in the Emergency Health Services Program at the University of Maryland, Baltimore County. Dr. Bass is the immediate past president of the National Association of State EMS Officials and a founding member and the immediate past president of the National Association of EMS Physicians. Additionally, he serves on the board of directors of the American Trauma Society and the University of Maryland Medical System, and is past chair of the EMS Committee of the American College of Emergency Physicians.

A. Brent Eastman, M.D., joined Scripps Memorial Hospital La Jolla in 1984 as director of trauma services and was appointed chief medical officer in 1998. He continues to serve in the role of director of trauma. Dr. Eastman received his medical degree from the University of California, San Francisco, where he also did his general surgical residency and served as chief surgical resident. He spent a year abroad in surgical training in England at Norfolk and Norwich Hospitals. Dr. Eastman served as chair of the Committee on Trauma for the American College of Surgeons from 1990 to 1994. This organization sets the standards for trauma care in the United States and abroad. The position led to his involvement nationally and internationally in the development of trauma systems in the United States, Canada, England, Ireland, Australia, Brazil, Argentina, Mexico, and South Africa. Dr. Eastman has authored or coauthored more than 25 publications and chapters relating principally to trauma. He has held numerous appointments and chairmanships over the last two decades, including chair, Trauma Systems Committee, for the U.S. Department of Health and Human Services; member of the board of directors, American Association for the Surgery of Trauma; and chair, Grant Review Committee, Center for Injury Prevention and Control at the U.S. Centers for Disease Control and Prevention.

George L. Foltin, M.D., F.A.A.P., F.A.C.E.P., began his involvement with the Emergency Medical Services for Children (EMS-C) Program of the Health Resources and Services Administration in 1985. He is board certified in pediatrics, emergency medicine, and pediatric emergency medicine. Dr. Foltin

served on the Medical Oversight Committee for the EMT-Basic National Standard Curriculum project and was a subject expert for the Project to Revise EMT-Intermediate and Paramedic National Standard Curriculum. He is a former board member of the National Association of EMS Physicians and served on the Committee on Pediatric Emergency Medicine of the American Academy of Pediatrics (AAP). Currently Dr. Foltin cochairs the Statewide AAP Committee on Pediatric Emergency Medicine and sits on the Regional Medical Advisory Committee of New York City. He has published extensively in the field of EMS for children, has been principal investigator for several federal grants, and serves as a consultant to the New York City and State departments of health, as well as to federal programs such as those of the Maternal and Child Health Bureau, the Agency for Healthcare Research and Quality, and the National Highway Traffic Safety Administration.

Shirley Gamble, M.B.A., served as senior advisor to The Robert Wood Johnson Foundation’s Urgent Matters initiative, which is working to help hospitals eliminate emergency department crowding and help communities understand the challenges facing the health care safety net. Ms. Gamble has over 20 years of experience in the health care industry, serving as an executive with Incarnate Word Health Services, Texas Health Plans HMO, and Tampa General Hospital. As a partner in Phase 2 Consulting, a health care management and economic consulting firm, Ms. Gamble led performance improvement and strategic planning efforts for major hospital systems, managed care entities, and university faculty practice plans. She currently is chief operating officer for the United Way Capital Area in Austin, Texas. She holds an M.B.A. and B.A. from the University of Texas at Austin.

Darrell J. Gaskin, Ph.D., M.S., is associate professor of health policy and management at The Johns Hopkins Bloomberg School of Public Health and deputy director of the Morgan-Hopkins Center for Health Disparities Solutions. Dr. Gaskin’s research focuses on health care disparities and access to care for vulnerable populations. Dr. Gaskin was awarded the Academy Health 2002 Article-of-the-Year Award for his Health Services Research article entitled “Are Urban Safety-Net Hospitals Losing Low-Risk Medicaid Maternity Patients?” Dr. Gaskin is active in professional organizations. He is a member of Academy Health, the American Economic Association, the National Economics Association (NEA), the International Health Economics Association, the American Society of Health Economists, and the American Public Health Association (APHA). He has served as a member of the board of directors of the NEA. He has been a member of the Governing Council of the APHA and is currently solicited program chair and section councilor for the APHA’s Medical Care Section. He has chaired the disparities program committee for Academy Health. He is a member of the board

of directors for the Maryland Citizen’s Health Initiative. Dr. Gaskin earned his Ph.D. in health economics at The Johns Hopkins University, a master’s degree in economics from the Massachusetts Institute of Technology, and a bachelor’s degree in economics from Brandeis University.

Robert C. Gates, M.P.A., began his career in the County of Los Angeles Chief Administrative Office, where he was principal budget analyst for the public health, hospital, and mental health departments. He left Los Angeles to become chief operating officer for the University of California, Irvine, Medical Center in Orange County. While in Orange County, he was instrumental in creating its paramedic system. Mr. Gates then returned to Los Angeles County and spent 6 years as chief deputy director of the Department of Health Services, guiding the creation of the Los Angeles County Trauma Center system. He was then appointed director of health services for Los Angeles County and served in that capacity for over 11 years. Mr. Gates is currently serving as medical services for indigents project director for the Orange County Health Care Agency.

Marianne Gausche-Hill, M.D., F.A.C.E.P., F.A.A.P., serves as professor of clinical medicine at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). She is director of EMS and EMS fellowship and director of pediatric emergency medicine fellowship at Harbor-UCLA Medical Center. Dr. Gausche-Hill also serves as director of pediatric emergency medicine at the Little Company of Mary Hospital in Torrance, California. Board certified in both emergency medicine and pediatric emergency medicine, she earned her medical degree and completed her residency at UCLA. Dr. Gausche-Hill is the first emergency physician in the United States to have completed a pediatric emergency fellowship and passed the sub-board examination. She has done extensive research on prehospital pediatric care, authoring Pediatric Advanced Life Support: Pearls of Wisdom in 2001 and Pediatric Airway Management for the Prehospital Professional in 2004. Her research tracking the results of the use of the windpipe tube method versus the traditional bag-and-pump method as oxygen treatment for pediatric emergencies was published in the Journal of the American Medical Association and in Annals of Emergency Medicine. In May 1999, her work earned the prestigious Best Clinical Science Presentation award from the Society for Academic Emergency Medicine.

John D. Halamka, M.D., M.S., is chief information officer of the CareGroup Health System, chief information officer and associate dean for educational technology at Harvard Medical School, chair of the New England Health Electronic Data Interchange Network (NEHEN), acting chief executive offi-

cer of MA-Share, chief information officer of the Harvard Clinical Research Institute, and a practicing emergency physician. As chief information officer at CareGroup, he is responsible for all clinical, financial, administrative, and academic information technology serving 3,000 doctors, 12,000 employees, and 1 million patients. As chief information officer and associate dean for educational technology at Harvard Medical School, he oversees all educational, research, and administrative computing for 18,000 faculty and 3,000 students. As chair of NEHEN, he oversees administrative data exchange in Massachusetts. As chief executive officer of MA-Share, he oversees the clinical data exchange efforts in Massachusetts. As chair of the Healthcare Information Technology Standards Panel, he coordinates the process of harmonization of electronic standards among all stakeholders nationwide.

Mary M. Jagim, R.N., B.S.N., C.E.N., F.A.E.N., is an experienced emergency/trauma nurse with extensive leadership background in program development and implementation, emergency department management and nursing workforce issues, emergency preparedness, government affairs, and community-based injury prevention. She is currently internal consultant for emergency preparedness and pandemic planning for MeritCare Health System in Fargo, North Dakota. Well versed in current issues affecting emergency/trauma nursing and emergency care, Ms. Jagim has served on the Emergency Nurses Association board of directors, for which she was national president in 2001. She currently serves as chair of the Emergency Nurses Association Foundation, is a member of the faculty for Key Concepts in Emergency Department Management, and is a fellow in the Academy of Emergency Nursing. She also served on the Centers for Disease Control and Prevention’s (CDC) National Strategies for Advancing Child Pedestrian Safety Panel to Prevent Pedestrian Injuries and currently is cochair for Advocates for Highway and Auto Safety. Ms. Jagim received her B.S.N. from the University of North Dakota in 1984.

Arthur L. Kellermann, M.D., M.P.H., is professor and chair of the Department of Emergency Medicine at the Emory University School of Medicine and director of the Center for Injury Control at the Rollins School of Public Health at Emory University. His primary research focus is injury prevention and control. He has also conducted landmark research on prehospital cardiac care, use of diagnostic technology in emergency departments, and health care for the poor. His papers have been published in many of the nation’s leading medical journals. He is a recipient of the Hal Jayne Academic Excellence Award from the Society for Academic Emergency Medicine, the Excellence in Science Award from the Injury Control and Emergency Health Services Section of the American Public Health Association, and the

Scholar/Teacher Award from Emory University. A member of the IOM, Dr. Kellermann served as cochair of the IOM’s Committee on the Consequences of Uninsurance from 2001 to 2004.

William N. Kelley, M.D., currently serves as professor of medicine, biochemistry, and biophysics at the University of Pennsylvania School of Medicine. Previously, he served as chief executive officer of the University of Pennsylvania Medical Center and Health System and dean of the School of Medicine from 1989 to February 2000. At the University of Pennsylvania, Dr. Kelley led the development of one of the first academic fully integrated delivery systems in the nation. He also built and implemented the largest health and disease management program in the country, with over 500 physicians and staff and 60 separate clinical sites engaged in implementing the program. Dr. Kelley holds a patent in a frequently used gene transfer technique that has allowed for numerous advances in the application of gene therapy. He received his M.D. from Emory University School of Medicine and completed his residency in internal medicine at Parkland Memorial Hospital in Dallas. After a fellowship with the National Institutes of Health and a teaching fellowship at Harvard Medical School, he began his academic career as assistant professor of medicine at Duke University School of Medicine, moving on to head Duke’s Division of Rheumatic and Genetic Diseases before becoming chair of internal medicine at the University of Michigan Medical School.

Kenneth W. Kizer, M.D., M.P.H., expanded his role as chairman of the board for Medsphere Systems Corporation to become its chief executive officer in December 2005. He joined Medsphere after serving as president and chief executive officer of the National Quality Forum (NQF), a private, nonprofit, voluntary consensus standards-setting organization established in Washington, D.C., in 1999, pursuant to a presidential commission. Prior to that, he served for 5 years as under secretary for health in the U.S. Department of Veterans Affairs. In this capacity, he was the highest-ranking physician in the federal government and chief executive officer of the veterans health care system, the largest integrated health care system in the United States. Dr. Kizer also served as director of the California Department of Health Services and was California’s top health official for over 6 years. Prior to that, he was chief of public health for California and director of California’s Emergency Medical Services Authority. He practiced emergency medicine and toxicology in both private and academic settings for over 15 years. Dr. Kizer is an honors graduate of Stanford University and UCLA. He is board certified in six medical specialties and/or subspecialties and has authored more than 350 original articles, book chapters, and other publications in the medical literature. He is a fellow of numerous

professional societies and a member of the Alpha Omega Alpha National Honor Medical Society, the Delta Omega National Honorary Public Health Society, and the IOM.

Peter M. Layde, M.D., M.Sc., is professor and interim director of the Health Policy Institute at the Medical College of Wisconsin. He has been an epidemiologist for over 25 years and an active injury control researcher for over 20 years. He has published extensively on agricultural injuries and methods for injury epidemiology, including early work on the use of case-control studies for homicide and on the epidemiological representativeness of trauma center–based studies. He has been an ad hoc reviewer for the Injury Grant Review Committee for over 10 years and served as a member of that committee from 1997 to 2000. Dr. Layde serves as codirector of the Injury Research Center at the Medical College of Wisconsin and as director of its Research Development and Support Core. He is also principal investigator for the Risk Factors for Medical Injury research project.

Eugene Litvak, Ph.D., is cofounder and director of the Program for the Management of Variability in Health Care Delivery at the Boston University Health Policy Institute. He is also a professor at the Boston University School of Management. He received his doctorate in operations research from the Moscow Institute of Physics and Technology in 1977. In 1990, he joined the faculty of the Harvard Center for Risk Analysis in the Department of Health Policy and Management at the Harvard School of Public Health, where he still teaches as adjunct professor of operations management. Prior to that time he was chief of the Operations Management Group at the Computing Center in Kiev, Ukraine. His research interests include operations management in health care delivery organizations, cost-effective medical decision making, screening for HIV and other infectious diseases, and operations research. He was the leading author of cost-effective protocols for screening for HIV and is the principal investigator from the United States for an international trial of these protocols, which is supported by the U.S. Agency for International Development. Dr. Litvak was also principal investigator for the Emergency Room Diversion Study, supported by a grant from the Massachusetts Department of Public Health. He serves as a consultant on operations improvement to several major hospitals and is on the faculty of the Institute for Health Care Improvement.

John R. Lumpkin, M.D., M.P.H., is senior vice president and director, Health Care Group at The Robert Wood Johnson Foundation. Dr. Lumpkin joined the Illinois Department of Public Health (IDPH) in 1985 as associate director of IDPH’s Office of Health Care Regulations, and later became the first African American to hold the position of director. Dr. Lumpkin served

6 years as chair of the National Committee for Vital and Health Statistics, advising the Secretary of the U.S. Department of Health and Human Services on health information policy. He received his medical degree in 1974 from Northwestern University Medical School. He trained in emergency medicine at the University of Chicago and earned his M.P.H. from the University of Illinois at Chicago, School of Public Health. Dr. Lumpkin is past president of the Association of State and Territorial Health Officials, a former member of the board of trustees of the Foundation for Accountability, former commissioner of the Pew Commission on Environmental Health, former board member of the National Forum for Health Care Quality Measurement and Reporting, past board member of the American College of Emergency Physicians, and past president of the Society of Teachers of Emergency Medicine. He has been the recipient of the Bill B. Smiley Award, Alan Donaldson Award, and African American History Maker Award, and was named Public Health Worker of the Year.

W. Daniel Manz, B.S., is director of EMS for the Vermont Department of Health. He has been involved in EMS for more than 25 years and worked as an emergency medical technician (EMT), volunteer squad leader, hospital communications technician, EMS regional coordinator, EMS trainer, and state EMS director. Much of his work has been in rural areas, including Maine and Saudi Arabia. Mr. Manz has been active in the National Association of State EMS Directors, serving as its president for 2 years and representing the association on several national projects, including the Emergency Medical Services Agenda for the Future, the Health Care Financing Administration’s Negotiated Rule Making process, and the recently completed National EMS Scope of Practice Model. Mr. Manz remains active as a volunteer EMT-Intermediate with the local ambulance service in his community. In his spare time he enjoys running, fishing, and sheep farming.

Richard A. Orr, M.D., serves as professor at the University of Pittsburgh School of Medicine, associate director of the Cardiac Intensive Care Unit at the Children’s Hospital of Pittsburgh, and medical director of the Children’s Hospital Transport Team of Pittsburgh, Pennsylvania. Dr. Orr has devoted much of his career to interfacility transportation problems of infants and children in need of tertiary care. He is a member of many professional organizations and societies and has authored numerous articles regarding the safe and effective air and surface transport of the critically ill and injured pediatric patient. Dr. Orr is also a noted lecturer to the air and ground transport community, both nationally and internationally. He is editor of Pediatric Transport Medicine, a unique 700-page book published in 1995. He is the 2001 recipient of the Air Medical Physician Association (AMPA) Distinguished Physician Award and a founding member of AMPA.

Jerry L. Overton, M.A., serves as executive director, Richmond Ambulance Authority, Richmond, Virginia, and has overall responsibility for the Richmond EMS system. His duties extend to planning and administering the high-performance system’s design, negotiating and implementing performance-based contracts, maximizing fee-for-service revenues, developing advanced patient care protocols, and employing innovative equipment and treatment modalities. Mr. Overton was previously executive director of the Kansas City, Missouri, EMS system. In addition, he has provided technical assistance to EMS systems throughout the United States and Europe, Russia, Asia, Australia, and Canada. He designed an implementation plan for an emergency medical transport program in Central Bosnia–Herzegovina. Mr. Overton is a faculty member of the Emergency Medical Department of the Medical College of Virginia, Virginia Commonwealth University, and the National EMS Medical Directors Course, National Association of EMS Physicians. He is past president of the American Ambulance Association and serves on the board of directors of the North American Association of Public Utility Models.

John E. Prescott, M.D., is dean of the West Virginia University (WVU) School of Medicine, and received both his B.S. and M.D. degrees at Georgetown University. He completed his residency training in emergency medicine at Brooke Army Medical Center, San Antonio, and was then assigned to Fort Bragg, North Carolina, where he was actively engaged in providing both operational and hospital emergency care in a variety of challenging situations. In 1990 he joined WVU and soon assumed leadership of the Section of Emergency Medicine. During that same year, he founded and became the first director of WVU’s Center for Rural Emergency Medicine. In 1993 he became the first chair of WVU’s newly established Department of Emergency Medicine. Dr. Prescott is a past recipient of major CDC and private foundation grants. His research and scholarly interests include rural emergency care, injury control and prevention, medical response to disasters and terrorism, and academic and administrative medicine. In 1999 Dr. Prescott became WVU’s associate dean for the clinical enterprise and president/chief executive officer of University Health Associates, WVU’s physician practice plan. In 2003 he was named senior associate dean; he was appointed dean of the WVU School of Medicine in 2004. He has been a fellow of the American College of Emergency Physicians since 1987 and is the recipient of WVU’s Presidential Heroism Award.

Nels D. Sanddal, M.S., REMT-B, is president of the Critical Illness and Trauma Foundation (CIT) in Bozeman, Montana, and is currently on detachment as director of the Rural Emergency Medical Services and Trauma Technical Assistance Center. Mr. Sanddal has been involved in EMS since

the 1970s and has held many state, regional, and national positions in organizations furthering EMS causes, including president of the Intermountain Regional EMS for Children Coordinating Council and core faculty for the Development of Trauma Systems Training Programs for the U.S. Department of Transportation. He is a nationally registered EMT-Basic, volunteers with a local fire department, and has been involved with CIT since its inception in 1986. He holds an M.S. in psychology and is currently pursuing a Ph.D. in health services.

C. William Schwab, M.D., F.A.C.S., is professor of surgery and chief of the Division of Traumatology and Surgical Critical Care at the University of Pennsylvania. His surgical practice reflects his expertise in trauma systems, including caring for the severely injured patient and incorporating the most advanced techniques into trauma surgery. He is director of the Firearm and Injury Center at Penn and holds several grants supporting work on reducing firearm and nonfirearm injuries and other repercussions. He has served as a trauma systems consultant to CDC, New York State, and several state health departments. He has established trauma centers and hospital-based aeromedical programs in Virginia, New Jersey, and Pennsylvania. He currently directs a network of three regional trauma centers throughout southeastern Pennsylvania. He has been president of the Eastern Association for the Surgery of Trauma and vice chair of the American College of Surgeons Committee on Trauma and currently serves as president of the American Association for the Surgery of Trauma.

Mark D. Smith, M.D., M.B.A., has led the California HealthCare Foundation in developing research and initiatives aimed at improving California’s health care financing and delivery systems since the foundation’s formation in 1996. Prior to joining the foundation, he was executive vice president at the Henry J. Kaiser Family Foundation and served as associate director of the AIDS Service and assistant professor of medicine and health policy and management at The Johns Hopkins University. Dr. Smith is a member of the IOM and is on the board of the National Business Group on Health. Previously, he served on the Performance Measurement Committee of the National Committee for Quality Assurance and the editorial board of the Annals of Internal Medicine. A board-certified internist, Dr. Smith is a member of the clinical faculty at the University of California, San Francisco, and an attending physician at the AIDS clinic at San Francisco General Hospital.

David N. Sundwall, M.D., was nominated by Governor Jon Huntsman Jr. to serve as executive director of the Utah State Department of Health in January 2005 and was subsequently confirmed for this position by the Utah

Senate. In this capacity, he supervises a workforce of almost 1,400 employees and a budget of almost $1.8 billion. Previously, Dr. Sundwall served as president of the American Clinical Laboratory Association (ACLA) from September 1994 until he was appointed senior medical and scientific officer in May 2003. Prior to his position at ACLA, he was vice president and medical director of American Healthcare System (AmHS), at that time the largest coalition of not-for-profit multihospital systems in the country. Dr. Sundwall has extensive experience in federal government and national health policy, including serving as administrator, Health Resources and Services Administration; in the Public Health Service, U.S. Department of Health and Human Services (DHHS); and as assistant surgeon general in the Commissioned Corps of the U.S. Public Health Service (1986–1988). During this period, he had adjunct responsibilities at DHHS, including serving as cochair of the secretary’s Task Force on Medical Liability and Malpractice and as the secretary’s designee to the National Commission to Prevent Infant Mortality. Dr. Sundwall also served as director, Health and Human Resources Staff (Majority), U.S. Senate Labor and Human Resources Committee (1981–1986). He was in private medical practice in Murray, Utah, from 1973 to 1975. He has held academic appointments at the Uniformed Services University of the Health Sciences, Bethesda, Maryland; Georgetown University School of Medicine, Washington, D.C.; and the University of Utah School of Medicine. He is board certified in internal medicine and family practice. He is licensed to practice medicine in the District of Columbia, is a member of the American Medical Association and the American Academy of Family Physicians, and previously served as volunteer medical staff of Health Care for the Homeless Project.

Joseph L. Wright, M.D., M.P.H., is executive director of the Child Health Advocacy Institute at Children’s National Medical Center in Washington, D.C. In that capacity, he provides strategic leadership for the organization’s advocacy mission and community partnership initiatives. He is professor and vice chair in the Department of Pediatrics, as well as professor of emergency medicine and prevention and community health at The George Washington University Schools of Medicine and Public Health. He has been attending faculty in the Division of Emergency Medicine at Children’s Hospital since 1993 and was recently appointed interim executive director for hospital-based specialties at the institution. Dr. Wright is founding director of the Center for Prehospital Pediatrics at Children’s and serves as the State EMS Medical Director for Pediatrics within the Maryland Institute for Emergency Medical Services Systems. His major areas of scholarly interest include EMS for children, injury prevention, and the needs of underserved communities. Dr. Wright received the Shining Star award from the Los Angeles-based Starlight Foundation for outstanding community service;

was inducted into Delta Omega, the nation’s public health honor society; and was elected to membership in Leadership Greater Washington. He has been appointed over the years to several national advisory bodies, including the National Association of Children’s Hospitals and Related Institutions and the American Academy of Pediatrics, where he serves as chair of the Subcommittee on Violence.