The quality of trauma care varies greatly in current military and civilian trauma care systems depending on when and where an individual is injured, according to the National Academies of Sciences, Engineering, and Medicine http://nationalacademies.org report discussing how to improve the trauma care system.
The Committee Chair responsible for the report, Donald Berwick, President Emeritus and Senior Fellow, Institute for Healthcare Improvement www.ihi.org said, “Although many lives have been saved, treatments for trauma can differ from location to location which may result in these disparities costing lives.”
He adds, “With the decrease in combat and the need to maintain readiness for trauma care between wars, a window of opportunity now exists to integrate the military and civilian trauma systems and not view them separately, but as one.”
The Committee envisions a national trauma care system grounded in a learning health system applied across all phases of trauma care delivery which would go from prehospital care at the point-of-injury to hospitalization, rehabilitation, and beyond.
This is going to require synergized military and civilian efforts, committed leadership from both sectors, and a strategy that aims to reduce variations in care and outcomes while supporting continuous learning and innovation.
One area of great importance involves collecting and using data to generate new knowledge on best practices in trauma care as needed to drive continuous improvement and to compare the performance of similar organizations.
The report suggests that a Consortium should be formed with HHS, DOD, VA, the private sector, and professional society partners. The Consortium should work together to ensure that military and civilian trauma systems collect and share common data spanning the entire continuum of care.
This integrated data network should provide measures related to prevention, mortality, disability, mental health, and patient experiences. Also, other intermediate and final clinical and cost outcomes should be made readily accessible to all relevant providers and agencies.
The Committee wants to see DOD and the VA link patient data stored in their respective systems to provide a full longitudinal view of trauma care delivery and related outcomes for each patient. The Office of the National Coordinator for HIT www.health.gov should work to improve the integration of prehospital and in hospital trauma care data into electronic health records.
Today, Emergency Medical Services (EMS) provide a disjointed set of systems across the nation with differing standards of care and few universal protocols. The Committee recommends that Congress in consultation with HHS should identify, evaluate, and implement mechanisms to ensure the inclusion of prehospital care as a seamless component of healthcare delivery rather than as a transport mechanism.
Go to http://www.nap.edu to view the report “A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury”. For more information, call 1-800-624-6242.