Archive for the ‘Trauma Systems’ Category

Trauma News Interview with Stewart and Winchell Captures Gist of Stakeholder Meeting on Zero Preventable Deaths

Tuesday, May 16th, 2017

Suggesting that the messaging surrounding the development of a national trauma system should shift from the traditional public health realm to the realm of national security, Dr. Ronald Stewart and Dr. Robert Winchell elaborated on the outcomes of the April meeting of stakeholders in the NASEM report on a National Trauma Care System published last year.

The broad consensus at the meeting, held in Bethesda, MD, was that “there needs to be a strong central directive, but the details need to be worked out locally,” said Winchell. Following establishment at a federal level, he said, “The actual nuts and bolts of the system would be developed by a broad coalition of the providers of the trauma community.”

Dr. Stewart also noted that trauma deaths occurring before the victim arrives at a hospital need to be explored if the goal of Zero Preventable Deaths after Injury is to be realized. “People recognize that if we’re going to get to zero preventable deaths, we have to know what those deaths are and when they occur. That would impact, for example, where you might put EMS resources or what you might do to improve access.”

Another gap in understanding is long-term outcomes for those suffering trauma. “We need to try to work towards data linkage to get more information on those prehospital deaths and also on long-term outcomes after somebody leaves the hospital or leaves a rehabilitation center,” explained Stewart.

“While you might argue that the NASEM report argues for some major revolutionary changes in how things are done, the practical implementation will in many ways be more evolutionary,” suggested Winchell. ”This effort is not necessarily creating entirely new systems, but leveraging existing initiatives and existing programs in a way that serves the end goal better.”

Attendees agreed that the call to action should be modified to ZPDD: Zero Preventable Deaths and Disability.

Read the article.

Needs Based Assessment of Trauma Systems Tool Unveiled in ACS Bulletin

Tuesday, September 6th, 2016

Controversy surrounding the number and location of designated trauma centers in the U.S. has led to much discussion and the emergency of two camps: one in favor of restraining the proliferation of centers and one in favor of allowing individual institutions to decide for themselves whether to pursue designation.

Following the convening of a consensus conference that reviewed the principles for trauma center designation and arrived at a set of practical methods and metrics for use in a needs based assessment, the American College of Surgeons Committee on Trauma this month released the ACS Needs Based Assessment of Trauma Systems (NBATS) tool. The tool is designed “to evaluate the need within a particular geographic area, termed a trauma service area (TSA)…[and] the number of centers needed within the TSA,” say the authors of an article about the tool in the ACS Bulletin (V101 No 9).

Incorporating critical data elements used in other system benchmarking efforts, the ACS NBATS assigns points based on population, transport time, community support and the number of severely injured patients discharged. While there is no clear evidence supporting the use of any of the specific measures proposed, “all the recommendations reflect the expert opinion of the convened group, as derived through a deliberative process,” according the Bulletin article.

The ACS COT is now circulating the tool to stakeholder groups for testing and validation. To participate in the process of review and refinement, contact Maria Alvi, Manager of Trauma Systems and Quality Programs at malvi@facs.org.