The Irish Association for Emergency Medicine has long advocated for significant improvements to be made to the way that major trauma care is delivered in Ireland. Measurement using robust audit is fundamental to this and must include the conditions being managed; the processes involved and the outcomes for patients. There is clear international evidence of benefit when trauma services are better organised. Indeed, since 2012, when re-organisation of trauma networks occurred in England, a remarkable increase of 63% has been seen in the odds of survival for patients suffering major trauma. Trauma audit is welcomed by IAEM as an integral component and a necessary first step in trauma system reform in Ireland.
This National Report gives important insights into the changing nature of major trauma in Ireland. Older patients sustaining low falls are now the largest proportion of major trauma patients, which has important implications in terms of preventative strategies and how care is delivered. Deficits in timely access to senior clinical decision makers, expert care and trauma teams are also noted. The report confirms that 40% of severe head injuries are not treated at neurosurgical centres in Ireland, despite clear evidence of much better outcomes for such patients when they are treated in a neurosurgical centre. In England this figure is 15%.
Resourcing the role of clinical audit in our hospitals is key to reassuring patients that the care they receive is monitored closely and can be benchmarked nationally and internationally. Hospitals receiving major trauma must be supported and rewarded for returning clinical audit data as patients are ultimately the beneficiaries of this quality assurance measure. A link to the report can be found here.