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Implementation of recommended trauma system criteria in south-eastern Norway: a cross-sectional hospital survey

DOI: 10.1186/1757-7241-20-5

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Abstract:

Recommendations for a national trauma system in Norway were published in 2007. We wanted to assess the level of implementation of these recommendations.A survey of all acute care hospitals that receive severely injured patients in the south-eastern health region of Norway was conducted. A structured questionnaire based on the 2007 national recommendations was used in a telephone interview of hospital trauma personnel between January 17 and 21, 2011. Seventeen trauma system criteria were identified from the recommendations.Nineteen hospitals were included in the study and these received more than 2000 trauma patients annually via their trauma teams. Out of the 17 criteria that had been identified, the hospitals fulfilled a median of 12 criteria. Neither the size of the hospitals nor the distance between the hospitals and the regional trauma centre affected the level of trauma resources available. The hospitals scored lowest on the criteria for transfer of patients to higher level of care and on the training requirements for members of the trauma teams.Our study identifies a major shortcoming in the efforts of regionalizing trauma in our region. The findings indicate that training of personnel and protocols for inter-hospital transfer are the major deficiencies from the national trauma system recommendations. Resources for training of personnel partaking in trauma teams and development of inter-hospital transfer agreements should receive immediate attention.Formalized trauma systems were described more than three decades ago [1]. Supported by an increasing amount of empirical evidence, the benefit of trauma systems have been widely accepted among trauma care providers [2-5]. In spite of this, relatively few regions internationally have fully implemented the trauma system concepts. Factors that make trauma system implementation challenging, like financial costs, lack of political will, and resistance against centralizing health care services, have been identified [6-9]

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