CIRCULACIÓ I ESTACIONAMENT DE VEHICLES DE MOTOR

The main elements of our fieldwork took place between May and September 2009.

method purpose

Review of key policy documents, standards of care, and academic literature.

To develop our understanding of the development of major trauma care; identify standards of care; and to identify data sources for triangulation with data collected from TARN and on our visits. Census of hospitals with an emergency department

that do not submit data to TARN and a survey of hospital trusts that do.

To establish why hospitals do not submit data to TARN, and what benefits arise for those that do. We also requested information on consultant presence in emergency departments. Semi-structured interviews with key stakeholders,

including the Department of Health, NCEPOD, TARN, and the Royal College of Surgeons.

Qualitative analysis of themes to identify issues with major trauma care and to triangulate with quantitative data.

Visits to 10 ambulance trusts and nine hospital trusts. To gain an understanding of the local arrangements and challenges for

the regionalisation of services for major trauma. Telephone interviews and visits with strategic

health authorities.

To gain an understanding of the existing delivery of major trauma care within SHA areas, and any plans for reorganisation.

Analysis of data from TARN. To develop a national picture of the quality of major trauma care (including performance against relevant standards), and to identify the extent of any variation in the care provided.

Discussions with patient representative groups, such as Headway.

To gain an understanding of the patient experience following major trauma.

Economic analysis/modelling of costs. To estimate the cost of treating major trauma, and the value of lost economic output associated with death and the injuries sustained.

36

endnotes Major trauma care in England

Endnotes

Trauma and Audit Research Network (2009). Modelling Trauma Workload: A Project 1

for the Department of Health.

The National Confidential Enquiry into Patient Outcome and Death (2007). Trauma: 2

Who cares?

MC Christensen et al (2008). Outcomes and costs of blunt trauma in England and 3

Wales. Critical Care 12(1): R23.

MC Christensen et al (2008). Outcomes and costs of penetrating trauma injury 4

in England and Wales. Injury, International Journal of the Care of the Injured 39: 1013-1025.

Department for Transport (2009). The Accidents Sub-Objective: TAG Unit 3.4.1. 5

RA Davenport et al (2010). A major trauma centre is a specialty hospital not a 6

hospital of specialties. British Journal of Surgery 97: 109–117.

ID Anderson et al (1989). Retrospective Study of 1000 Deaths from Injury in 7

England and Wales. British Medical Journal 296: 1305-1308.

National Audit Office (1992). NHS Accident & Emergency Departments in England. 8

DW Yates et al (1992). Preliminary analysis of the care of injured patients in 33 9

British hospitals: First report of the UK Major Trauma Outcome Study. British Medical Journal 305: 737-740.

J Nicholl, J Turner (1997). Effectiveness of a regional trauma system in reducing 10

mortality from major trauma: before and after study. British Medical Journal 315: 1349-1354.

FE Lecky et al (2002). Lack of change in trauma care in England and Wales since 11

1994. Emergency Medicine Journal 19: 520-523.

Department of Health (2008). High Quality Care for All – NHS Next Stage Review 12

Final Report.

The Information Centre for Health and Social Care (2009). Ambulance Services 13

England 2008-09.

Medical Care Research Unit (2006). The costs and benefits of changing ambulance 14

service response time performance standards.

The Association of Air Ambulances (2008). A Framework For A High Performing Air 15

Major trauma care in England endnotes

37

Joint Royal Colleges Ambulance Liaison Committee (2006). UK Ambulance Service 16

Clinical Practice Guidelines.

I Greaves, K Porter, J Garner (2009). Trauma Care Manual (Second Edition). 17

JS Sampalis et al (1997). Direct transport to tertiary trauma centers versus transfer 18

from lower level facilities: impact on mortality and morbidity among patients with major trauma. Journal of Trauma 43(2): 288-295.

B Celso et al (2006). A systematic review and metaanalysis comparing outcome of 19

severely injured patients treated in trauma centers following the establishment of trauma systems. Journal of Trauma 60: 371-378.

NC Mann et al (1999). Systematic review of published evidence regarding trauma 20

system effectiveness. Journal of Trauma 47: S25-S33.

The Royal College of Surgeons of England and the British Orthopaedic Association 21

(2000). Better Care for the Severely Injured.

Trauma and Audit Research Network (2009). Modelling Trauma Workload: A Project 22

for the Department of Health.

National Institute for Health and Clinical Excellence (2007). Head Injury: Triage, 23

assessment, investigation and early management of head injury in infants, children and adults.

British Orthopaedic Association press release. NHS “black hole” for patients with 24

major trauma injuries. September 2008.

HC Patel et al (2005). Trends in head injury outcome from 1989 to 2003 and the 25

effect of neurosurgical care: an observational study. Lancet 366: 1538-44. Intensive Care National Audit & Research Centre (ICNARC) presentation at 26

Ambulance Service Network conference on 13 October 2009.

A Tennant (2005). Admission to hospital following head injury in England: Incidence 27

and socio-economic associations. BioMed Central Public Health 5(21).

National Institute for Health and Clinical Excellence (March 2009). Rehabilitation 28

after critical illness.

LJ Bradley et al (2006). Inappropriate acute neurosurgical bed occupancy and 29

short falls in rehabilitation: implications for the National Service Framework. British Journal of Neurosurgery 20(1): 36-39.

State Government Victoria (2009). Victorian State Trauma Registry 2007-08: 30

Summary report.

AB Nathens et al (2001). Relationship Between Trauma Center Volume and 31

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In document Activitat de la Sindicatura de Greuges de Barcelona: Informe 2012 (página 67-86)