scholarly journals Development of a model to quantify the accessibility of a Canadian trauma system

CJEM ◽  
2017 ◽  
Vol 19 (04) ◽  
pp. 285-292 ◽  
Author(s):  
Gavin Tansley ◽  
Nadine Schuurman ◽  
Mete Erdogan ◽  
Matthew Bowes ◽  
Robert Green ◽  
...  
Keyword(s):  
Trauma Care ◽  
Motor Vehicle ◽  
Trauma System ◽  
Population Level ◽  
Population Based ◽  
Service Planning ◽  
Poor Access ◽  
Level I ◽  
Highly Correlated ◽  
Prehospital Time

ABSTRACT Objectives Trauma systems have been widely implemented across Canada, but access to trauma care remains a challenge for much of the population. This study aims to develop and validate a model to quantify the accessibility of definitive care within one provincial trauma system and identify populations with poor access to trauma care. Methods A geographic information system (GIS) was used to generate models of pre-scene and post-scene intervals, respectively. Models were validated using a population-based trauma registry containing data on prehospital time intervals and injury locations for Nova Scotia (NS). Validated models were then applied to describe the population-level accessibility of trauma care for the NS population as well as a cohort of patients injured in motor vehicle collisions (MVCs). Results Predicted post-scene intervals were found to be highly correlated with documented post-scene intervals (β 1.05, p<0.001). Using the model, it was found that 88.1% and 42.7% of the population had access to Level III and Level I trauma care within 60 minutes of prehospital time from their residence, respectively. Access for victims of MVCs was lower, with 84.3% and 29.7% of the cohort having access to Level III and Level I trauma care within 60 minutes of the location of injury, respectively. Conclusion GIS models can be used to identify populations with poor access to care and inform service planning in Canada. Although only 43% of the provincial population has access to Level I care within 60 minutes, the majority of the population of NS has access to Level III trauma care.

Population-Based Study of Hospital Trauma Care in a Rural State without a Formal Trauma System

2001 ◽  
Vol 50 (3) ◽  
pp. 409-414 ◽  
Author(s):  
Frederick B. Rogers ◽  
Turner M. Osler ◽  
Steven R. Shackford ◽  
Fran Martin ◽  
Mark Healey ◽  
...  
Keyword(s):  
Trauma Care ◽  
Trauma System ◽  
Population Based ◽  
Population Based Study ◽  
Rural State

scholarly journals Models of care for traumatically injured patients at trauma centres in British Columbia: variability and sustainability

CJEM ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 200-206 ◽  
Author(s):  
Benjamin Tuyp ◽  
Kasra Hassani ◽  
Lisa Constable ◽  
Joseph Haegert
Keyword(s):  
Trauma Care ◽  
Trauma System ◽  
Models Of Care ◽  
Short Stay ◽  
Trauma Centres ◽  
Trauma Unit ◽  
Trauma Service ◽  
Level Ii ◽  
Level I ◽  
Injured Patients

AbstractBackgroundSuccessful trauma systems employ a network of variably-resourced hospitals, staffed by experienced providers, to deliver optimal care for injured patients. The “model of care”—the manner by which inpatients are admitted and overseen, is an important determinant of patient outcomes.ObjectivesTo describe the models of inpatient trauma care at British Columbia’s (BC’s) ten adult trauma centres, their sustainability, and their compatibility with accreditation guidelines.MethodsQuestionnaires were distributed to the trauma medical directors at BC’s ten Level I-III adult trauma centres. Follow-up semi-structured interviews clarified responses.ResultsThree different models of inpatient trauma care exist within BC. The “admitting trauma service” was a multidisciplinary team providing exclusive care for injured patients. The “on-call consultant” assisted with Emergency Department (ED) resuscitation before transferring patients to a non-trauma admitting service. The single “short-stay trauma unit” employed on-call consultants who also oversaw a 48-hour short-stay ward.Both level I trauma centres utilized the admitting trauma service model (2/2). All Level II sites employed an on-call consultant model (3/3), deviating from Level II trauma centre accreditation standards. Level III sites employed all three models in similar proportions. None of the on-call consultant sites believed their current care model was sustainable. Inadequate compensation, insufficient resources, and difficulty recruiting physicians were cited barriers to sustainability and accreditation compliance.ConclusionsThree distinct models of care are distributed inconsistently across BC’s Level I-III trauma hospitals. Greater use of admitting trauma service and short-stay trauma unit models may improve the sustainability and accreditation compliance of our trauma system.

scholarly journals Influence of a province-wide trauma system on motor vehicle collision process of trauma care and mortality: a 10-year follow-up evaluation

2012 ◽  
Vol 55 (1) ◽  
pp. 8-14 ◽  
Author(s):  
John Tallon ◽  
Deshayne Fell ◽  
Saleema Karim ◽  
Stacy Ackroyd-Stolarz ◽  
David Petrie
Keyword(s):  
Trauma Care ◽  
Motor Vehicle ◽  
Trauma System ◽  
Motor Vehicle Collision ◽  
Collision Process ◽  
Vehicle Collision

scholarly journals Self-harm presentation across healthcare settings by sex in young people

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Amanda Marchant ◽  
Samantha Turner ◽  
Lloyd Balbuena ◽  
Evyn Peters ◽  
Dave Williams ◽  
...  
Keyword(s):  
Primary Care ◽  
Linked Data ◽  
Hospital Admissions ◽  
Population Level ◽  
Population Based ◽  
Service Planning ◽  
Individual Level ◽  
Healthcare Data ◽  
Healthcare Settings ◽  
Self Harm

BackgroundAccurate data on self-harm is crucial to suicide prevention efforts. It has been previously found that around twice as many people who self-harm seek help in primary care than in secondary care. Little is known about how contacts for self-harm differ across settings at a population level. This study utilised individual-level linked data across GP, Emergency Departments (ED), outpatients and hospital admissions examining contacts across settings and time by sex for self-harm in 10-24 year olds. MethodsA whole-population based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented. ResultsA total of 937,697 individuals aged 10-24 years contributed 5,369,794 person years of data from the 01.01.2003-30.09.2015. There were differences in self-harm contacts by demographic variables particularly with regards to sex and admissions to hospital following ED attendance. ConclusionThis is the first study to compare self-harm in people aged 10-24 years across primary care, EDs, and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention. Understanding patterns of presentation will inform service planning and configuration for follow-up care and could inform tailored support, for example for males in ED. Linked data provides important evidence to support the development of interventions across healthcare settings.

Influence of a New Province-Wide Trauma System on Motor Vehicle Trauma Care and Mortality

2006 ◽  
Vol 60 (3) ◽  
pp. 548-552 ◽  
Author(s):  
John M. Tallon ◽  
Deshayne B. Fell ◽  
Stacy Ackroyd-Stolarz ◽  
David Petrie
Keyword(s):  
Trauma Care ◽  
Motor Vehicle ◽  
Trauma System

scholarly journals Reading Between the Lines: A Pursuit of Estimating the Population Prevalence of Mental Illness Using Multiple Data Sources

2021 ◽  
pp. 070674372110162
Author(s):  
Jordan Edwards ◽  
Katholiki Georgiades
Keyword(s):  
Mental Illness ◽  
Mental Health Policy ◽  
Public Mental Health ◽  
Population Level ◽  
Population Based ◽  
Service Planning ◽  
Data Sources ◽  
Multiple Data Sources ◽  
Multiple Data ◽  
Combining Data

Population-based prevalence estimates of mental illness are foundational to health service planning, strategic resource allocation, and the development and evaluation of public mental health policy. Generating valid, reliable, and context-specific population-level estimates is of utmost importance and can be achieved by combining various data sources. This pursuit benefits from the right combination of theory, applied statistics, and the conceptualization of available data sources as a collective rather than in isolation. We believe there is a need to read between the lines as theory, methodology, and context (i.e., strengths and limitations) are what determines the meaningfulness of a combined prevalence estimate. Currently lacking is a gold standard approach to combining estimates from multiple data sources. Here, we compare and contrast various approaches to combining data and introduce an idea that leverages the strengths of pre-existing individually linked population-based survey and health administrative data sources currently available in Canada.

scholarly journals MP47: Factors associated with preventable trauma death: a narrative review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S59-S60
Author(s):  
G. Genois ◽  
I. Vlahovic ◽  
L. Moore ◽  
B. Beck ◽  
P. Blanchard ◽  
...  
Keyword(s):  
Adverse Events ◽  
Trauma Care ◽  
Motor Vehicle ◽  
Trauma System ◽  
Narrative Review ◽  
Expert Assessment ◽  
Cochrane Central Register ◽  
Preventable Death ◽  
Trauma Death ◽  
Panel Review

Introduction: Trauma care is highly complex and prone to medical errors. Accordingly, several studies have identified adverse events and conditions leading to potentially preventable or preventable deaths. Depending on the availability of specialized trauma care and the trauma system organization, between 10 and 30% of trauma-related deaths worldwide could be preventable if optimal care was promptly delivered. This narrative review aims to identify the main determinants and areas for improvements associated with potentially preventable trauma mortality. Methods: A literature review was performed using Medline, Embase and Cochrane Central Register of Controlled Trials from 1990 to a maximum of 6 months before submission for publication. Experimental or observational studies that have assessed determinants and areas for improvements that are associated with trauma death preventability were considered for inclusion. Two researchers independently selected eligible studies and extracted the relevant data. The main areas for improvements were classified using the Joint Commission on Accreditation of Healthcare Organizations patient event taxonomy. No statistical analyses were performed given the data heterogeneity. Results: From the 3647 individual titles obtained by the search strategy, a total of 37 studies were included. Each study included between 72 and 35311 trauma patients who had sustained mostly blunt trauma, frequently following a fall or a motor vehicle accident. Preventability assessment was performed for 17 to 2081 patients using either a single expert assessment (n = 2, 5,4%) or an expert panel review (n = 35, 94.6%). The definition of preventability and the taxonomy used varied greatly between the studies. The rate of potentially preventable or preventable death ranged from 2.4% to 76.5%. The most frequently reported areas for improvement were treatment delay, diagnosis accuracy to avoid missed or incorrect diagnosis and adverse events associated with the initial procedures performed. The risk of bias of the included studies was high for 32 studies because of the retrospective design and the panel review preventability assessment. Conclusion: Deaths occurring after a trauma remain often preventable. Included studies have used unstandardized definitions of a preventable death and various methodologies to perform the preventability assessment. The proportion of preventable or potentially preventable death reported in each study ranged from 2.4% to 76.5%. Delayed treatment, missed or incorrect initial diagnosis and adverse events following a procedure were commonly associated with preventable trauma deaths and could be targeted to develop quality improvement and monitoring projects.

Delayed Mesenteric Hematoma of the Sigmoid Colon Following Blunt Abdominal Trauma

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Motor Vehicle ◽  
Pelvic Fractures ◽  
Motor Vehicle Crash ◽  
Organ Injury ◽  
Contrast Extravasation ◽  
Body Fracture ◽  
Mesenteric Hematoma ◽  
Level I ◽  
Hispanic Male ◽  
Trauma Bay

A 25-year-old Hispanic male was transferred to our level I trauma center after being ejected 40 feet from a motor vehicle crash. Once stabilized in the trauma bay, a computed tomography (CT) scan of the abdomen/pelvis with IV contrast revealed two AAST Organ Injury Scale grade III liver lacerations without contrast extravasation, bilateral pulmonary contusions, right posterior non-displaced fourth rib fracture, non-displaced right scapular body fracture, and bilateral anterior and posterior pelvic fractures [Figures 1–2]. A non-operative approach to the hepatic lacerations was chosen and the patient underwent closed reduction and percutaneous pinning of his posterior pelvic fractures as well as anterior external fixation of his bilateral pubic rami fractures.

Saving Lives on the Battlefield: A Joint Trauma System Review of Pre-Hospital Trauma Care in Combined Joint Operating Area - Afghanistan (CJOA-A)

2013 ◽  
Author(s):  
Russ S. Kotwal ◽  
Frank K. Butler ◽  
Erin P. Edgar ◽  
Stacy A. Shackelford ◽  
Donald R. Bennett ◽  
...  
Keyword(s):  
Trauma Care ◽  
Trauma System ◽  
System Review ◽  
Joint Trauma

Studying Populations of Online Communities

2019 ◽  
pp. 173-193
Author(s):  
Benjamin Mako Hill ◽  
Aaron Shaw
Keyword(s):  
Online Communities ◽  
Information Diffusion ◽  
Diffusion Processes ◽  
Empirical Studies ◽  
Population Level ◽  
Study Groups ◽  
Population Based ◽  
Large Majority ◽  
Community Processes ◽  
Published Research

While the large majority of published research on online communities consists of analyses conducted entirely within individual communities, this chapter argues for a population-based approach, in which researchers study groups of similar communities. For example, although there have been thousands of papers published about Wikipedia, a population-based approach might compare all wikis on a particular topic. Using examples from published empirical studies, the chapter describes five key benefits of this approach. First, it argues that population-level research increases the generalizability of findings. Next, it describes four processes and dynamics that are only possible to study using populations: community-level variables, information diffusion processes across communities, ecological dynamics, and multilevel community processes. The chapter concludes with a discussion of a series of limitations and challenges.

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