Ministry of Health

http://newzealand.govt.nz/

    
 ©Copyright
 Published: 28/11/2011

Planning a Statewide Trauma System
Trish McDougall

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Outline

Strengths and Weaknesses
of
Planning
a
Statewide Trauma System

Trish McDougall
Executive Manager
NSW Institute of Trauma and Injury Management

HISTORY
 2000
NSW Health Council
 2001
GMSIG Report released
 2001
Greater Metropolitan
Transitional Task (GMTT) Force established
 2001
Virtual Trauma Institute Committee convened
 2002
NSW Institute
of Trauma and Injury Management
(NSW ITIM)
“ OPERATIONAL”

Sydney Area Health Services

Trauma Centre Development
 Trauma Data > Minister for Health
 ISS>15 ( 2001)
 Mechanism of Injury
 Age
 Sex
 Outcome
 This collated very minimum data set had a maximum impact on future funding

Trauma Centres Development
 2002 Trauma Centre Site visits conducted
Outcome
 Staffing Variances- Range 0.5FTE -11FTE
 Funding Issues
 Roles and Responsibilities not defined

Funding
 Minimum Staffing to maintain a Trauma Service Identified and Documented
 Trauma Director
 Trauma Nurse Coordinator
 Trauma Data Manager
 Area Trauma Nurse Coordinator
 Funding Proposal submitted to GMTT to support Trauma Service Infrastructure June 2002
 Recurrent funding made available in 2002-2003 Health Budget to fund
 NSW ITIM
 Trauma service infrastructure
 $3.500,000

Trauma Funding
Accountability
 Detailed Roles and Responsibilities FOR Trauma Services defined and documented by NSW ITIM
 Trauma Service Information package given to Area Health Services including CEO’S Directors of Nursing and Administration Managers
 Reporting requirements to NSW ITIM regarding enhancement funding communicated to Area Health Services
 Site visits by NSW ITIM CEO and Executive Manager

Trauma System Development
 2002-2005
 27 new or upgraded trauma positions in place
 State-wide Trauma Education in progress
 State Trauma Committees Operational
 2002,2003,2004 NSW ITIM Trauma Minimum Data Set Reports Published

NSW ITIM Minimum Data Set
 25 data points
 Consensus
 Payment for data at six monthly intervals
 Report publication annually
 All hospitals identified in the report with a summary data report
 Rural system data identified

Population

State Trauma Committees
 Pre hospital Trauma System Committee
 Trauma Services Committee
 Allied Health and Rehabilitation Committee
 Education and Research Committee
 State Death Review Committee
 Clinical Practice Guideline Committee
Multidisciplinary Membership - Rural /Metropolitan

Strengths
 Champion for Trauma IDENTIFIED
 Establishment of the Institute of Trauma
 Direct Access to the Minister
 Annual Trauma Minimum Data Sets available from each Trauma Centre for collated report and individual reports
 Recurrent targeted funding
 Accountability by AHS to NSW ITIM

Strengths
Networking between Trauma Centres and ITIM

Weaknesses
 Funding not directed to Rural Hospitals
 Trauma Surgical Training issues not addressed
 Some Area Health Services not prepared to inject any funding into existing services
 Sharing of resources between hospitals still difficult to achieve
 Trauma education for medical staff in particular in metropolitan and rural areas not mandatory

Summary
 Documented improved outcomes
 The notification process and feedback to Clinicians in rural and metropolitan centres is well established
 Access to trauma education programs for Medical, Nursing, Allied Health and Ambulance has improved (particularly in remote areas)