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Health Services Research




Trauma System Development in Canada: Overcoming the Challenges of Geography through an Evaluation of Structure and Process
A.B. Nathens, A.R. Gagliardi, R.W. Pong, G. Rubenfeld, N.C. Schuurman, J.E. Sherman, O. Mian, J.C. Hogenbirk, M.B. Gibbon, M.G. Delmege, et al.

Severely injured patients have a lower mortality risk if cared for in trauma centres. Thus, survival is dependent on an integrated regional system of care so that these patients are identified, supported and rapidly transported to a trauma centre. But trauma centres are mostly located in urban regions, limiting prompt access to the 20% of Canadians living in rural areas. Owing to the distribution of trauma patients and centres, 50% of trauma patients receive preliminary care at non-designated centres before transfer to a trauma centre.

As trauma system configuration and preliminary care might have significant impact on ensuring the "right patient gets to the right place at the right time," the project proposed the following overarching objectives:

1.
To assess the relationship between trauma system structure and process.

2.
To optimize the preliminary care of the patient with major injury.

Findings from this 5-year research program influenced policies and practice to improve access to and quality of trauma care.

CRaNHR will focus on two components in the research program: (1) Explore knowledge, training and beliefs of EMS providers in triaging and supporting trauma patients and (2) Explore knowledge, training and beliefs of physician providers in triaging and providing preliminary care to trauma patients in the emergency department setting.

(funded by the Canadian Institutes of Health Research)


(Names in bold denote CRaNHR investigators and research staff.)