History
A System for Trauma Care was first proposed in NSW in 1988. The proposal incorporated a three level system of acute hospitals providing care for the injured. The recommendations of this proposal included:
- An administrative structure at hospital level with designated clinical leaders, trauma service directors supported by trauma committees, and clinical review based on data collection.
- Trauma education be provided to the public and training in trauma management be provided to health providers.
- A plan of regionalisation with each highest level centre linked to a geographic area of responsibility within NSW.
The plan foreshadowed a NSW pre hospital bypass protocol by seeking to minimise inter hospital transfers and to enable more patients to be delivered by ambulance to the hospital most appropriate for their eventual needs. The ambulance triage tool, NSW Ambulance pre hospital Protocol 4 Trauma Triage Protocol was commenced in Sydney in March 1992.
In 1993 the National Road Trauma Advisory Council (NRTAC) released the Report of the Working Party on Trauma systems. The report made 25 recommendations that included:
- regional trauma systems based on networks and linkages
- designation of hospitals resourced to provide a level of care
- establishment of State and Territory Trauma Systems Management Committees to implement the NRTAC report and to monitor the established trauma systems
In 1994 NSW Health restructured the NSW Trauma System in line with the NRTAC recommendations. The NSW Trauma Systems Advisory Committee (TSAC) was established. The role of TSAC was to coordinate the system wide organisation of trauma services, review the performance of core components and provide feedback to NSW Health and to NSW Trauma Networks and review trauma related services such as retrieval.
A Trauma Monitoring System was introduced and NSW Major Trauma Services were provided with seeding funds to establish Trauma Registries (a computerised database). Area Health Service based, Trauma Services were established with three levels of trauma hospital identified, level I being the lowest and level III being the highest.
The NSW Institute of Trauma and Injury Management (ITIM) was set up in late January 2002 as a result of recommendations of the Greater Metropolitan Services Implementation Group (GMSIG).
Also in this section:
» Organisational Structure» Entry into the System
» Multi-Disciplinary Approach