Program Staff

Trauma Center History
Trauma Care has evolved into a specialty in many local and regional hospitals over recent years. Historically called emergency rooms, trauma centers have established high quality, comprehensive medical services for patients. The public relies on trauma centers to provide quality care from initial injury to final disposition, whether at the local hospital or tertiary care center. Regardless of where the trauma program is located, it provides critical services in a timely manner to patients who often need lifesaving measures. As a Trauma Program Manager (TPM), it is a primary responsibility to ensure patients are receiving the best care possible. This is often accomplished by compilation and analysis of data, policy review, and continuous quality improvement initiatives. The following chapters will provide an overview of many aspects of trauma care and acts as a guide to help the TPM succeed in their role. TPM will be referenced throughout the manual and will be the collective title for the role.

Trauma Center Levels
The verification of trauma levels is important in qualifying what essential services are offered at a hospital. The Iowa Department of Public Health (IDPH) is responsible for the verification, or re-verification, of each Level III and IV hospital on a three-year cycle. Criteria from the American College of Surgeons Committee on Trauma (ACS-COT) is utilized to ensure consistent practice standards and available resources. Basic definitions of each trauma level are outlined below. 

Trauma Center History
Trauma Care has evolved into a specialty in many local and regional hospitals over recent years. Historically called emergency rooms, trauma centers have established high quality, comprehensive medical services for patients. The public relies on trauma centers to provide quality care from the initial injury to final disposition, whether at the local hospital or tertiary care center. Regardless of where your program is located, it provides critical services in a timely manner to patients who often need lifesaving measures. As a Trauma Coordinator (TC), or a Trauma Program Manager (TPM) it is your primary responsibility to ensure patients are receiving the best care possible. This is often accomplished by compilation and analysis of data, policy review, and continuous quality improvement initiatives. The following chapters will provide an overview of many aspects of trauma care and acts as a guide to help you succeed in your new role as a TC or TPM. 

Trauma Center Levels
The designation of trauma levels is important to distinguish what essential services are offered at a hospital. The Minnesota Department of Health (MDH) is responsible for the designation, or re-designation, of your hospital on a three year cycle. Recommendations are given by the American College of Surgeons’ Committee on Trauma to ensure consistent practice standards and available resources. Basic definitions of each trauma level are outlined below. 

Introduction
Welcome to the trauma and emergency healthcare system in Southwest Texas and thank you for your interest in learning more about the trauma program in Southwest Texas. You will find this manual beneficial as you embark upon this role and we encourage you to retain a copy of this text as it may serve as reference material later in your career.

Trauma Care History in Texas
Trauma care has evolved into a specialty of many local and regional hospitals over recent decades. Trauma centers have established high quality, comprehensive medical services to patients. The public relies on trauma centers to provide emergency services in settings ranging from high density urban areas to distant rural critical access facilities. Regardless of where your program is located, it provides critical services in a timely manner to patients who often need lifesaving measures. As a Trauma Program Manager or Coordinator (TPM/C), it is your primary responsibility to ensure patients are receiving the best care possible. This is often accomplished by compilation and analysis of data, policy review, and continuous performance improvement patient safety initiatives. The following chapters will provide an overview of many aspects of trauma care and acts as a guide to help you succeed in your new role as a TPM/C.

Introduction
In 2018 a working group of trauma nurses was set up to guide the development of this professional development framework. The group comprised representation from hospitals across the country, from small to large hospitals, and a range of experience from new to role to experienced (Appendix A).

The group identified four key areas of focus which form the basis of the framework:

1. Current state
2. Core trauma nursing skills and training
3. Advanced trauma nurse career options
4. Future trauma nursing state

This framework does have limitations and in particular we note the need to build the capacity and capability of the Maori trauma nursing workforce, incorporating Te Tiriti o Waitangi to address the burden of trauma for Maori across all aspects of the trauma system, and providing guidance on the level of resourcing in line with caseload. Future revisions of this framework should incorporate these aspects. This is the first time a trauma nurse professional development framework has been developed in New Zealand. We envisage this framework will be amended in time as our understanding of the role evolves and our trauma system matures.

Notwithstanding these limitations, this early work is an important step to building a high-performing trauma nursing workforce in New Zealand.

About major trauma in New Zealand
Major trauma accommodates those patients that incur injuries which have a threat to life. There are approximately 2,000 major trauma events per year and include injuries ranging from serious injury such as pelvic fractures, through to catastrophic injuries such as traumatic brain injury or mangled limbs which require intensive life-long care.

The burden of trauma is distributed unequally across New Zealand, and between population groups. Some regions have a disproportionally high incidence of major trauma and variation in the causes of injury. The burden of major trauma for Maori ais nearly double that for non-Maori, and the high incidence rate for young Maori males is of concern.

The National Trauma Network (the “Network”) was set up in 2012 to drive quality improvement across the trauma system and bring us into line with contemporary trauma systems internationally. Sponsored by ACC the Network has a strong clinical focus as the opportunity to improve outcomes for major trauma patient is largely in pre-hospital and hospital care. Best practice care results in fewer deaths and decreased life-long injury, and a more efficient health service.

There are variable levels of maturity in the trauma systems across the country, and many nurses and doctors are relatively new to role. The intent of this framework is to support a common understanding and consistent implementation of the trauma nurse role.