Establishing a national trauma system

A prerequisite for high-quality trauma care in hospital emergency departments is the existence of a strategy for the planning, organization and provision of a national trauma system. The strategy for the organization of a national trauma care system needs to be formulated by health policymakers with input from medical professionals to provide research-based guidelines, standards and general advice about the treatment of trauma victims. Trauma centres in several European Countries have protocols for the pre-hospital and hospital phase. National guidelines need to be formulated in consultation with national, scientific medical societies on trauma centres and their organization.

Each trauma system must be defined by local needs and assessments of capacity and developed with due regard for local culture, legislation, infrastructure, health-system capacity, economic considerations and administrative resources [36]. International essential trauma care guidelines have recently been established by the World Health Organization.

There is considerable potential worldwide and in Europe to upgrade arrangements for trauma care and improve training in trauma care at the primary health care level, in district hospitals and in tertiary care hospitals [48][7][11]. The US vision of a national trauma system is set out below [41].

The US Vision of a Trauma System for the Future

Trauma systems, when fully implemented throughout the U.S., will enhance community health through an organized system of injury prevention, acute care and rehabilitation that is fully integrated with the public health system in a community. Trauma systems will possess the distinct ability to identify risk factors and related interventions to prevent injuries in a community, and will maximize the integrated delivery of optimal resources for patients who ultimately need acute trauma care. Trauma systems will address the daily demands of trauma care and form the basis for disaster preparedness. The resources required for each component of a trauma system will be clearly identified, deployed and studied to ensure that all injured patients gain access to the appropriate level of care in a timely, coordinated and cost-effective manner.

Comprehensive Trauma Care System: Key Infrastructure Elements

The infrastructure of a trauma care system includes eight key elements:

Leadership
Professional resources
Education and advocacy
Information
Finances
Research
Technology
Disaster preparedness and response

In a model system, these elements are integrated and coordinated to provide cost-efficient and appropriate services across the continuum of care