Trauma System Agenda for the Future
 

Index

What is Trauma

What is Trauma Systems

The Vision

Executive Summary

Introduction

Comprehensive Trauma Care System: Fundamental Components of Trauma Care

Comprehensive Trauma Care System: Key Infrastructure Elements

Conclusion

Glossary

References

Appendices

Injury Prevention

Current Status

Injury prevention will be a central focus of trauma systems of the future because it offers the greatest potential for reducing the burden - financial and otherwise - of trauma care, as well as morbidity and mortality. At the present time, t he public health infrastructure for injury prevention varies greatly among states and regions. Funding for injury prevention is often non-existent or limited, which prevents long-term implementation and program evaluation.

Injury prevention is variably represented in trauma systems; the focus has traditionally been on secondary and tertiary prevention (efforts to reduce the impact of an injury once it has occurred and optimize its outcome). Although primary injury prevention programs have been implemented by pre-hospital and acute care providers, few have been systematically evaluated.

Community-based injury prevention programs have been demonstrated to avert injury-related morbidity and mortality and to reduce health care costs, although there is a huge gap between what is known to be effective and what is done at the local level. Prevention programs are often created on demand (i.e., requested or based on a single incident) rather than based on a systematic analysis of actual injury data. Prevention efforts often are not targeted or evaluated in relation to community needs. In many cases, injury prevention programs on similar topics are conducted by various organizations in the same community without the benefit of coordination.

The Vision

•  Each State will have a core injury prevention program that provides assistance to local areas, with information and materials coordinated via a central repository or clearinghouse. Specific injury prevention programs will be based on a quantitative community health assessment. The health assessments will be coordinated with other comprehensive public health community assessments. All programs will be evaluated for their effectiveness on a local level.

•  Trauma registry data will help with problem identification and program evaluation and will be fully coordinated with the EMS and public health systems.

•  A comprehensive study of the epidemiology of injuries and trauma will be conducted and predictive models regarding injury occurrence will be developed. The information gained through these efforts will reduce the occurrence of injury, expedite the patient's return to productivity, and minimize the impact of injury.

•  Injury prevention legislation will be enacted, where compelling evidence exists.

•  Injury prevention efforts will be conducted on a collaborative basis, with input from and the involvement of multiple stakeholders and constituency groups. Trauma care systems will establish system-wide injury control coalitions or coordinate with existing initiatives to provide consistent and coordinated community-wide injury prevention programs. I njury prevention programs developed by these coalitions will be evidence-based, using local injury data where available (or linking existing data sources) to identify prevention priorities within the community, with an emphasis on decreasing risk factors. Program evaluation and outcome data will be used to modify or create injury prevention programs, with special effort given to developing rural and frontier models .

•  Injury prevention will be recognized as a legitimate public and governmental service, similar to other safety programs such as fire prevention. Proper funding will be secured for injury prevention, with a greater portion of public health dollars allocated for injury prevention.

•  Injury prevention efforts will be seen as a legitimate health care service that is directly reimbursable to providers.

•  Injury prevention programs, and their availability to the general public, will be required by lead agencies who designate all levels of trauma centers and by the public health systems.

•  Injury prevention will be integrated into existing health delivery systems, such as pediatric and rural health clinics, and prevention materials will be readily available at places where families usually receive care. Age-appropriate injury prevention information will be added to all periodic health examinations and risk assessment systems. Specialty care providers will also identify injury management issues that specifically relate to their practice area.