Background
Organisation | Definition |
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World Health Organization http://www.who.int/emergencycare/gaci/gaci_flyer_web.pdf?ua=1%5d | A preplanned approach to the provision of the spectrum of trauma services, including but not limited to injury prevention and control initiatives, timely transport from scene of injury to trauma care facility, availability of trauma care providers and services when needed, and rehabilitation |
US Department of Health and Human Services | Preplanned, comprehensive, and coordinated statewide and local injury response networks that include all facilities with the capability of care for the injured. |
US National Highway Traffic Safety Administration | Organized, coordinated effort in a defined geographic area that delivers the full range of care to all injured patients and is integrated with the local public health system |
Australian Institute of Health and Welfare | Integrated and systematic structure designed to facilitate and coordinate a multidisciplinary system response to provide optimal care to injured patients from onset of injury through rehabilitation and return of ideal functioning |
Trauma Association of Canada | A preplanned, organized, and coordinated injury control effort in a defined geographic area |
UK Trauma network | A model of care designed to care for patients with multiple serious injuries that could result in death or serious disability, including head injuries, life-threatening wounds and multiple fractures |
European commission | In a model system, key trauma system elements (Leadership, Professional resources, Education and advocacy, Information, Finances, Research, Technology, Disaster preparedness and response) are integrated and coordinated to provide cost-efficient and appropriate services |
State of Israel trauma model | A chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care |
Core components | Subcomponents |
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Oversight | Trauma system plan Trauma system advisory committee Trauma services medical director Lead agency Disaster planning |
Prehospital care | Pre-hospital major trauma definition EMS transport system Triage and transport protocols Emergency services medical director EMS treatment protocols Communication between EMS and hospitals |
Definitive care | Facility designation through an accreditation agency Inclusive design Sitting of facilities (coverage) Interfacility transfer agreements/protocols Communication between transferring hospitals |
Rehabilitation | Integrated rehabilitation services |
Human resources | Workforce resources Educational preparation |
Evaluation | Data collection–trauma registries Injury surveillance Benchmarking Integration of evaluation throughout the care continuum Research Interdisciplinary review committee |
Methods
Eligibility criteria
Study designs
Participants
Interventions
Comparators
Outcome measures
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Primary endpoints:
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Mortality (e.g. population-based, in-hospital, 30 days, 12 months, preventable)
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Functional capacity (e.g. Functional Independence Measure, Glasgow Outcome Scale, return to work, level of dependency)
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Quality of life (e.g. Short Form-36, WHOQOL, EQ-5D)
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Burden of disease (e.g. years of life lost, Quality-Adjusted Life Years, Disability-Adjusted Life Years)
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Secondary endpoints:
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Adverse events (complications, patient safety events)
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Healthcare utilization (e.g. hospital, intensive care unit, ventilator, and rehabilitation length of stay; hospital readmission; emergency department visits; general practitioner visits; paramedical services)
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Costs (e.g. acute care, rehabilitation, loss in productivity)
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