For some Canadians, a routine commute to work in the morning may end at a designated trauma centre, courtesy of a moment of inattention or a slippery road. For others, it might be a life threatening medical condition.
The services that trauma centres and networks provide to Canadians are many and varied. Providing a coordinated response to mass casualty incidents, treating traumatic injury, assessing a patient’s rehabilitation needs, and providing emotional support and counselling to patients and families are just a few of the critical services they offer. Equally vital is their role in preventing or reducing trauma by analyzing information about injury rates to identify risk factors and offering injury prevention programs. These programs help to address issues such as domestic violence awareness and alcohol and substance abuse.
It is paramount that these essential services are high quality and delivered safely and consistently throughout the country. Accreditation is one way trauma networks can achieve this.
The Trauma Association of Canada (TAC) has been accrediting Canadian trauma centres and systems since the 1990s. In 2012, TAC and Accreditation Canada formed a partnership to move the process to Accreditation Canada to ensure the long-term sustainability of trauma accreditation.
This partnership capitalized on the strengths and expertise of each organization—TAC for trauma services and Accreditation Canada for developing and administering accreditation programs—to forge a new and highly specialized Trauma Distinction program. Trauma Distinction marries TAC’s vision to Improve the lives of all those affected by or at risk of traumatic injury with Accreditation Canada’s vision of Excellence in quality health services for all. It recognizes organizations that demonstrate clinical excellence and an outstanding commitment to leadership in trauma care.
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TAC’s Trauma System Accreditation Guidelines were the foundation of the Trauma Distinction program. Performance measures and evidence-based protocols were developed, and the patient-centred focus was expanded and strengthened to create a robust program of excellence. An important part of the program is an on-site visit every two years conducted by expert evaluators with extensive practical experience in trauma care, to provide oversight and guidance.
Key components of the program include:
- Standards—The Trauma System Standards and the Trauma Centre Standards are rigorous and highly specialized standards based on the latest research and evidence related to excellence in trauma care.
- Protocols—Distinction requires the use of evidence-based protocols to promote a consistent approach to care and increase effectiveness and efficiency.
- Indicators—Indicator data must be submitted on a regular basis and performance thresholds for a core set of performance indicators must be met.
- Excellence and Innovation—The program requires trauma centres to implement a project or initiative that aligns with best practice guidelines, uses the latest knowledge, and integrates evidence to enhance quality of care.
The Trauma System Standards are evaluated at the system level and are focused on how pre-hospital, inter-facility transport and rehabilitation services are integrated within the trauma system to maximize the recovery of trauma patients. The standards promote a coordinated strategy for rehabilitation services, with rehabilitation starting in the trauma centre and continuing once the patient is transferred to a rehabilitation centre or unit or discharged home. They address the planning, design and evaluation of the trauma system, and collaboration with partners.
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Evaluated at the site level, the Trauma Centre Standards cover the essential components that Level I to V trauma centres should have in place to ensure the successful functioning of the trauma system as a whole. They address the assessment and management of trauma patients from the incident scene until the patient is medically stable and able to begin rehabilitation or proceed to an alternate level of care. The standards focus on quality of care, planning and design of the centre, care coordination, and support to patients and families coping with trauma.
The program components were evaluated by an advisory committee and small working groups of trauma experts from across Canada. Broader feedback on the standards and performance indicators was provided by Accreditation Canada client organizations, surveyors, and TAC members via a web-based national consultation. Finally, the program was pilot tested with a representative sample of organizations.
Trauma Distinction will be available to trauma centres across the country beginning in September 2014.