Leadership

Current Status

The fragmentation of trauma leadership is a major impediment to the development of a national trauma system. There is currently little focal point at the state or national level to foster the growth of regional trauma systems or support injury research. (A Federal program for trauma system development was in place until 1995, when budgetary considerations led to the program's demise. The program was reinstated, with limited funding, in FY01 & FY02) Currently, trauma system development funding and support emanates from several Federal agencies, and a variety of professional organizations are involved in trauma care. But there is no single voice representing the broad trauma constituency.

The paucity of dollars invested in trauma system development and research in relation to the magnitude of the impact of trauma on society underscore the need for a lead council to advise the federal government on future trauma system development and to promote support for system development.

As at the Federal level, states and regions commonly lack an agency that has the authority, responsibility, and resources to lead the development, operations, and evaluation of a trauma system in their area. There is a critical need for such lead agencies, either public or private, that are recognized and accepted by the full range of community health and safety organizations as the parties responsible for trauma system development and implementation.

The Vision

•  A National Trauma System Leadership Council will be developed to advocate for system development, serve as the locus for policy development and support, and coordinate the work of Federal agencies and professional organizations with injury-related programs. The Council would represent a partnership among private organizations and governmental agencies (national, state, and local) and would include representatives of all major stakeholder groups, including public and private payers and purchasers, and with both rural and urban membership. The Leadership Council will help formulate national trauma system standards and optimal resources guidelines for trauma prevention, and ensure implementation of the recommendations set forth in this Trauma System Agenda for the Future.

•  All states will establish a Lead Agency to coordinate and administer trauma system development. About 75% of existing state lead agencies are located in the State EMS office. 25 It is essential that, wherever the lead agency is situated, effective links should exist between that agency and the state public health, public safety and health care systems.

•  A best practices study will be conducted to identify the optimal components and configuration for local and state lead agencies.

•  The efficacy of trauma system elements and their integration within the trauma system and between EMS and health care systems will be continually examined.

•  State legislators and governors will be informed of the need for an identified and adequately funded lead agency for trauma systems in their region . Enabling legislation at the state level will ensure that public policy supports and sustains leadership on state and local levels.