Suggesting that the messaging surrounding the development of a national trauma system should shift from the traditional public health realm to the realm of national security, Dr. Ronald Stewart and Dr. Robert Winchell elaborated on the outcomes of the April meeting of stakeholders in the NASEM report on a National Trauma Care System published last year.
The broad consensus at the meeting, held in Bethesda, MD, was that “there needs to be a strong central directive, but the details need to be worked out locally,” said Winchell. Following establishment at a federal level, he said, “The actual nuts and bolts of the system would be developed by a broad coalition of the providers of the trauma community.”
Dr. Stewart also noted that trauma deaths occurring before the victim arrives at a hospital need to be explored if the goal of Zero Preventable Deaths after Injury is to be realized. “People recognize that if we’re going to get to zero preventable deaths, we have to know what those deaths are and when they occur. That would impact, for example, where you might put EMS resources or what you might do to improve access.”
Another gap in understanding is long-term outcomes for those suffering trauma. “We need to try to work towards data linkage to get more information on those prehospital deaths and also on long-term outcomes after somebody leaves the hospital or leaves a rehabilitation center,” explained Stewart.
“While you might argue that the NASEM report argues for some major revolutionary changes in how things are done, the practical implementation will in many ways be more evolutionary,” suggested Winchell. ”This effort is not necessarily creating entirely new systems, but leveraging existing initiatives and existing programs in a way that serves the end goal better.”
Attendees agreed that the call to action should be modified to ZPDD: Zero Preventable Deaths and Disability.