The GOAL-Trauma Study Blog
The Implementation and Impact of Trauma Systems
Trauma systems have been a cornerstone of modern emergency care for the past century. As far back as 1922, the American College of Surgeons recognised the need for a systematic approach to trauma care. Since then, these systems have evolved and spread internationally, demonstrating significant improvements in patient mortality rates.
Over the past 2 decades, trauma systems have been gradually implemented in various high-income countries. The drivers for development often stem from growing evidence on the suboptimal patient outcomes provided in trauma and an increased advocacy by clinicians. For instance, in the UK, a 1988 study revealed that nearly a third of trauma facilities were potentially preventable – this led to significant changes, culminating in the implementation of the regional trauma system in London in 2010.
Ensuring trauma systems are designed to meet local and national needs is key if they are to be successful in their implementation
Multiple studies and meta-analyses have demonstrated overall improvements in mortality rates following trauma system implementation, and the most significant benefits are observed in severely injured patients. Notably, these improvements often increase with system “maturity”, continuing for 10 years or more after initial implementation.
Regionalised trauma centres have been shown to be cost-effective compared to many commonly funded medical interventions. However, the impact on broader health economic or quality of life measures is less well-documented. Ensuring trauma systems are designed to meet local and national needs is key if they are to be successful in their implementation
