scholarly journals The Process of Regional Trauma System Development in Shenzhen, China: An 8-Year Journey

2021 ◽  
Author(s):  
Guixi Zhang ◽  
Gilberto Ka Kit Leung ◽  
Chung Mao Lo ◽  
Richard Kwong-Yin Lo ◽  
John Wong ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Trauma Care ◽  
Trauma Center ◽  
System Development ◽  
Trauma System ◽  
Mainland China ◽  
Geospatial Analysis ◽  
Trauma Resuscitation ◽  
American College Of Surgeons ◽  
Improvement Programs

Abstract Background: International experiences have shown that trauma system development significantly reduces preventable deaths and disabilities. During the 8-year study, the aim was to find solutions for trauma system development in Shenzhen, China, so as to reduce trauma mortality and morbidity. Methods: Introducing the ATLS® program to mainland China was started in 2013. A geospatial analysis of traumatic incidents was conducted in 2014. A regional trauma center was illustrated as an example to be used as a reference. The trauma audit meeting was introduced as an approach to continuous trauma quality improvement. The Shenzhen Trauma Surgery Committee was established to finalize the plan for designation of trauma care hospitals. The American College of Surgeons Trauma System Development Guidelines were translated into Chinese. Results: ATLS® provider course was held in Shenzhen and totally 205 doctors received training. A regional trauma center where adopted ATLS® principles as the standard for trauma resuscitation and early trauma care, with results showing significant improvements in trauma team organization, trauma resuscitation, definitive trauma care and a significant reduction in mortality among major trauma patients. The trauma audit meeting was introduced to 8 hospitals. A new trauma system plan for Shenzhen was set up and a consensus was reached on trauma center designation. The American College of Surgeons' “Resources for Optimal Care of the Injured Patient” was translated into Chinese and published in November 2020. Conclusion: The critical steps in establishing the framework for the Shenzhen trauma system included: geospatial analysis of traumatic incidents, trauma care training for providers, trauma center development, regional trauma center designation and development of trauma quality improvement programs. This practical approach can be replicated in other countries seeking to establish a trauma system. We are now working toward extension of this approach to other regions of mainland China.

Analysis of Hospital Ability to Provide Trauma Services: A Comparison between Teaching and Community Hospitals

1991 ◽  
Vol 6 (4) ◽  
pp. 455-458 ◽  
Author(s):  
Keith W. Neely ◽  
Robert L. Norton ◽  
Ed Bartkus ◽  
John A. Schiver
Keyword(s):  
Trauma Care ◽  
Trauma Center ◽  
Trauma System ◽  
Teaching Hospitals ◽  
Trauma Centers ◽  
Ct Scanner ◽  
Community Hospitals ◽  
Availability Analysis ◽  
Level Ii ◽  
American College Of Surgeons

AbstractHypothesis:Teaching hospitals (TH) can maintain the American College of Surgeons Committee on Trauma (ACSCOT) criteria for Level II trauma care more consistently than can community hospitals (CH).Methods:A retrospective analysis of 2,091 trauma system patients was done to determine if TH in an urban area are better able to meet the criteria for Level II trauma care than are CH. During the study period, a voluntary trauma plan existed among five hospitals; two TH and three CH. A hospital could accept patients that met trauma system entry criteria as long as, at that moment, it could provide the resources specified by ACSCOT. Hospitals were required to report their current resources accurately. A centralized communications center maintained a computerized, inter-hospital link which continuously monitored the availability of all participating hospitals. Trauma system protocols required paramedics to transport system patients to the closest available trauma hospital that had all the required resources available. Nine of the required ACSCOT Level II trauma center criteria were monitored for each institution emergency department (ED); trauma surgeon (TS); operating room (OR); angiogaphy (ANG); anesthesiologist (ANE); intensive care unit (ICU); on-call surgeon (OCS); neurosurgeon (NS); and CT scanner (CT) available at the time of each trauma system entry.Results:With the exception of OR, TH generally maintained the required staff and services more successfully than did CH. Further, less day to night variation in the available resources occurred at the TH. Specifically, ANE, ICU, TS, NS and CT were available more often both day and night, at TH than CH. However, OR was less available at TH than CH during both day and night (p<.01).Conclusions:In this community, TH provided a greater availability of trauma services than did CH. This study supports the designation of TH as trauma centers. A similar availability analysis can be performed in other communities to help guide trauma center designation.

scholarly journals An inventory of Canadian trauma systems: opportunities for improving access to trauma care

CJEM ◽  
2014 ◽  
Vol 16 (03) ◽  
pp. 207-213 ◽  
Author(s):  
Christopher C.D. Evans ◽  
J.M. Tallon ◽  
Jennifer Bridge ◽  
Avery B. Nathens
Keyword(s):  
Trauma Care ◽  
System Development ◽  
Trauma System ◽  
Mail Survey ◽  
Trauma Systems ◽  
Trauma Centres ◽  
Improved Outcomes ◽  
System Components ◽  
Trauma Surgeons ◽  
Future Work

ABSTRACT Objective: Despite evidence that patients suffering major traumatic injuries have improved outcomes when cared for within an organized system, the extent of trauma system development in Canada is limited. We sought to compile a detailed inventory of trauma systems in Canada as a first step toward identifying opportunities for improving access to trauma care. Methods: We distributed a nationwide online and mail survey to stakeholders intended to evaluate the extent of implementation of specific trauma system components. Targeted stakeholders included emergency physicians, trauma surgeons, trauma program medical directors and program managers, prehospital providers, and decision makers at the regional and provincial levels. A “snowball” approach was used to expand the sample base of the survey. Descriptive statistics were generated to quantify the nature and extent of trauma system development by region. Results: The overall response rate was 38.7%, and all levels of stakeholders and all provinces/territories were represented. All provinces were found to have designated trauma centres; however, only 60% were found to have been accredited within the past 10 years. Components present in 50% or fewer provinces included an inclusive trauma system model, interfacility transfer agreements, and a mechanism to track bed availability within the system. Conclusion: There is significant variability in the extent of trauma system development in Canada. Although all provinces have designated trauma centres, opportunities exist in many systems to implement additional components to improve the inclusiveness of care. In future work, we intend to quantify the strength of the relationship between different trauma system components and access to definitive trauma care.

Trauma System Development and Future Directions

1993 ◽  
Vol 8 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Judith B. Braslow ◽  
Joan A. Snyder
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Trauma Care ◽  
System Development ◽  
Trauma System ◽  
The United States ◽  
Advisory Council ◽  
Medical Services ◽  
Emergency Medical ◽  
Care Systems

AbstractTraumatic injury, both unintentional and intentional, is a serious public health problem. Trauma care systems play a significant role in reducing mortality, morbidity, and disability due to injuries. However, barriers to the provision of prompt and appropriate emergency medical services still exist in many areas of the United States. Title XII of the Public Health Service Act provides for programs in support of trauma care planning and system development by states and localities. This legislation includes provisions for: 1) grants to state agencies to modify the trauma care component of the state Emergency Medical Services (EMS) plan; 2) grants to improve the quality and availability of trauma care in rural areas; 3) development of a Model Trauma Care System Plan for states to use as a guide in trauma system development; and 4) the establishment of a National Advisory Council on Trauma Care Systems.

Trauma Center Quality Improvement Programs in the United States, Canada, and Australasia

2012 ◽  
Vol 256 (1) ◽  
pp. 163-169 ◽  
Author(s):  
Henry T. Stelfox ◽  
Sharon E. Straus ◽  
Avery Nathens ◽  
Russell L. Gruen ◽  
Syed M. Hameed ◽  
...  
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Trauma Center ◽  
The United States ◽  
Improvement Programs ◽  
Quality Improvement Programs

scholarly journals Trauma care and referral patterns in Rwanda: implications for trauma system development

2016 ◽  
Vol 59 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Georges Ntakiyiruta ◽  
Evan G. Wong ◽  
Mathieu C. Rousseau ◽  
Landouald Ruhungande ◽  
Adam L. Kushner ◽  
...  
Keyword(s):  
Trauma Care ◽  
System Development ◽  
Trauma System ◽  
Referral Patterns

scholarly journals Designing and Conducting Initial Application of a Performance Assessment Model for in-Hospital Trauma Care

2021 ◽  
Author(s):  
Yalda Mousazadeh ◽  
Homayoun Sadeghi-Bazargani ◽  
Ali Janati ◽  
Mahboub Pouraghaei ◽  
Farzad Rahmani ◽  
...  
Keyword(s):  
Performance Assessment ◽  
Trauma Care ◽  
Trauma Center ◽  
Model Development ◽  
Assessment Model ◽  
Structured Interviews ◽  
Model Application ◽  
Initial Application ◽  
Improvement Programs ◽  
A Performance

Abstract Background: Trauma is a major cause of death worldwide, especially in developing countries. The increasing cost of health care and the differences in the quality of provided services indicates the need to assess trauma care. This study aimed to develop and use a performance assessment model for in-hospital trauma care with a focus on traffic injures.Methods: This multi-method study was conducted in three main phases of indicators determination, model development, and model application. Trauma care performance indicators were extracted through literature review and were confirmed using a two-round Delphi survey and experts’ perspective. Two focus group discussions and 16 semi-structured interviews were held to design the initial model. In the next step, components and final form of the model were confirmed following pre-determined factors including importance and necessity, simplicity, clarity, and relevance. Finally, the model was tested by applying it in a trauma center. Results: A total of 50 trauma care indicators were approved after reviewing the literature and obtaining the experts' views. The final model consisted of six components of assessment level, teams, methods, scheduling, frequency, and data source. The model application revealed problems of a selected trauma center in terms of information recording, patient deposition, some clinical services, waiting time for depositing, recording of medical errors and complications, patient follow-up, and patient satisfaction.Conclusion: Performance assessment with an appropriate model can identify deficiencies and failures of provided services in trauma centers. Understanding the current situation is one of the main requirements for designing any quality improvement programs.

Status of trauma quality improvement programs in the Americas: a survey of trauma care providers

2017 ◽  
Vol 220 ◽  
pp. 213-222 ◽  
Author(s):  
Hilary L. Zetlen ◽  
Lacey N. LaGrone ◽  
Jorge Esteban Foianini ◽  
Eduardo Huaman Egoavil ◽  
Jorge Sproviero ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Trauma Care ◽  
Care Providers ◽  
Improvement Programs ◽  
Quality Improvement Programs

scholarly journals Collecting data on organizational structures of trauma centers: the CAFE web service

2020 ◽  
Vol 5 (1) ◽  
pp. e000473
Author(s):  
Mathias Brochhausen ◽  
Jane W Ball ◽  
Nels D Sanddal ◽  
Jimm Dodd ◽  
Naomi Braun ◽  
...  
Keyword(s):  
Trauma Care ◽  
Trauma Center ◽  
Organizational Structures ◽  
Trauma Centers ◽  
Trauma Systems ◽  
Improvement Program ◽  
Web Based ◽  
Organizational Attributes ◽  
American College Of Surgeons ◽  
Verification Process

BackgroundDuring the past several decades, the American College of Surgeons has led efforts to standardize trauma care through their trauma center verification process and Trauma Quality Improvement Program. Despite these endeavors, great variability remains among trauma centers functioning at the same level. Little research has been conducted on the correlation between trauma center organizational structure and patient outcomes. We are attempting to close this knowledge gap with the Comparative Assessment Framework for Environments of Trauma Care (CAFE) project.MethodsOur first action was to establish a shared terminology that we then used to build the Ontology of Organizational Structures of Trauma centers and Trauma systems (OOSTT). OOSTT underpins the web-based CAFE questionnaire that collects detailed information on the particular organizational attributes of trauma centers and trauma systems. This tool allows users to compare their organizations to an aggregate of other organizations of the same type, while collecting their data.ResultsIn collaboration with the American College of Surgeons Committee on Trauma, we tested the system by entering data from three trauma centers and four trauma systems. We also tested retrieval of answers to competency questions.DiscussionThe data we gather will be made available to public health and implementation science researchers using visualizations. In the next phase of our project, we plan to link the gathered data about trauma center attributes to clinical outcomes.

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