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Articles

Trauma Systems: The Impetus for Change - LTC2008

George Findlay, NCEPOD

Karim Brohi, London, UK, February 06, 2010

Dr George Findlay from the National Confidential Enquiry into Patient Outcomes & Death (NCEPOD) describes the background to UK trauma care and the need for regional trauma systems.

The Evidence for Trauma Systems - LTC2008

Karim Brohi

Karim Brohi, London, UK, February 06, 2010

Professor Karim Brohi reviews the evidence for regional trauma systems.

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Performance Improvement Programmes - LTC2008

Nigel Tai

Karim Brohi, London, UK, February 06, 2010

Col. Nigel Tai describes the performance improvement and dovernance structure that underpins a regional trauma system

Trauma Systems: Evidence Based Standards of Care - LTC2008

Tom Konig

Karim Brohi, London, UK, February 06, 2010

Col. Nigel Tai describes the performance improvement and dovernance structure that underpins a regional trauma system

Trauma Systems: Data Collection & Management - LTC2008

Tim Coats

Karim Brohi, London, UK, February 06, 2010

Col. Nigel Tai describes the performance improvement and dovernance structure that underpins a regional trauma system

Trauma Systems: Delivering Multispecialty Care - LTC2008

Michael Walsh

Karim Brohi, London, UK, February 06, 2010

Michael Walsh, Director of Trauma at the Royal London Hospital discusses how service reorganisation can lead to the effective delivery of multidpecialty trauma care.

Trauma Systems: Minimising the Impact on Elective Services

Ajit Abraham

Karim Brohi, London, UK, February 06, 2010

Ajit Abraham, Consultant Hepatobiliary surgeon at the Royal London Hospital, describes how an effective trauma service can run alongside a strong elective programme.

Trauma Systems: Prehospital Care Roles & Responsibilities - LTC2008

Fionna Moore

Karim Brohi, London, UK, February 07, 2010

Fionna Moore, Medical Director of the London Ambulance Service and now Director of the London Trauma System, describes the role of prehospital care within a regional trauma system.

Trauma Systems: Acute Hospital Roles & Responsibilities - LTC2008

Ben Teasdale

Karim Brohi, London, UK, February 07, 2010

Ben Teasdale, Consultant in Emergency Medicine at the Homerton Hospital, describes the role of the Acute Hospital or Trauma Unit within a regional trauma system

Trauma Systems: Rehabilitation - The Unmet Need - LTC2008

Clarence Liu

Karim Brohi, London, UK, February 07, 2010

Clarence Liu, Consultant in neurorehabilitation on the importance of robust integrated rehabilitation services to a regional trauma system

Trauma Systems: Emergency Preparedness - LTC2008

Gareth Davies

Karim Brohi, London, UK, February 07, 2010

Dr Gareth Davies, Lead Clinician for London's Helicopter Emergency Medical Service on emergency preparedness planning and implementation in regional trauma systems

Trauma Systems Symposium -  LTC2008

London Trauma Conference 2008

Karim Brohi, London, UK, February 07, 2010

Online video presentations from the Trauma Systems Symposium held at the London Trauma Conference in 2008.

Case Presentations

There are currently no case presentations for this keyword

Research Blog Entries

The Survival Measurement and Reporting Trial for Trauma (SMARTT): Background and Study Design.

Karim, London, UK, January 30, 2010

PubMed ID: 20068485
J Trauma. 2010 Jan 9. [Epub ahead of print]
Authors: Glance LG, Osler TM, Dick AW, Mukamel DB, Meredith W.

Abstract:

BACKGROUND:: This report describes a project funded by the Agency for Healthcare Research and Quality to evaluate the impact of providing hospitals with nonpublic report cards on trauma outcomes. The Survival Measurement and Reporting Trial for Trauma explores the feasibility of using the National Trauma Data Bank as a platform for measuring and improving trauma outcomes. METHODS:: We identified a cohort of 125 hospitals in the National Trauma Data Bank with annual hospital volumes of 250 or more trauma cases meeting specific minimum criteria for data quality. The performance of hospitals in this cohort was evaluated using hierarchical logistic regression model. The effect of each hospital on trauma mortality was captured by a shrinkage coefficient, which is exponentiated to yield an adjusted odds ratio. This adjusted odds ratio represents the likelihood that a trauma patient treated at a specific hospital is more or less likely to die compared with a patient treated at an "average" hospital. RESULTS:: The initial hospital cohort includes 125 hospitals and 157,045 patients admitted in 2006. Most hospitals are either level I (36%) or level II (34%) trauma centers. Patients admitted to the worst-performing hospitals were at least 50% more likely to die than patients admitted to the average hospital, after adjusting for injury severity. CONCLUSION: The initial findings of this trial suggest that there is significant variability in trauma mortality across centers caring for injured patients after adjusting for differences in patient casemix. This variation in risk-adjusted mortality presents an opportunity for improvement. The Survival Measurement and Reporting Trial for Trauma study is designed to test the hypothesis that nonpublic report cards can lead to improved population mortality for injured patients. The results of this study may have substantial implications in the future design and implementation of a national effort to report and improve trauma outcomes in the United States.