Improving Trauma Care to Reduce Preventable Deaths

Federal agencies host listening session to discuss ways to implement recommendations of groundbreaking report on trauma

The Federal Interagency Committee on EMS (FICEMS) and the Council on Emergency Medical Care (CEMC) recently hosted a listening session on EMS issues to improve trauma care. Spurred by the National Academies of Sciences, Engineering and Medicine (NASEM) report, A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury, trauma experts from across the care spectrum shared ideas on steps that could be taken to implement the report’s recommendations and decrease the number of people killed by traumatic injuries in the United States.

Jon Krohmer, MD, Director of the National Highway Traffic Safety Administration (NHTSA) Office of EMS, moderated the discussion. “This is only the start of the conversation,” he said. In fact, the federal agencies represented on the Federal Interagency Committee on EMS and the Council of Emergency Medical Care plan on soliciting public comment through an official Request for Information in 2018.

The NASEM report made several recommendations relevant to EMS systems, including:

  • “The Secretary of Health and Human Services and the Secretary of Defense, together with their governmental, private, and academic partners, should work jointly to ensure that military and civilian trauma systems collect and share common data spanning the entire continuum of care. Within that integrated data network, measures related to prevention, mortality, disability, mental health, patient experience, and other intermediate and final clinical and cost outcomes should be made readily accessible and useful to all relevant providers and agencies.”

  • “To support the development, continuous refinement, and dissemination of best practices, the designated leaders of the recommended national trauma care system should establish processes for real-time access to patient-level data from across the continuum of care and just-in-time access to high-quality knowledge for trauma care teams and those who support them”

  • “All military and civilian trauma systems should participate in a structured trauma quality improvement process.”

  • “Congress, in consultation with the U.S. Department of Health and Human Services, should identify, evaluate, and implement mechanisms that ensure the inclusion of prehospital care (e.g., emergency medical services) as a seamless component of health care delivery rather than merely a transport mechanism.”

During the meeting, which was held in Washington, DC, on December 6, many attendees discussed the importance of increasing data collection and integration in order to truly understand the problem and measure the effectiveness of improvement efforts. For example, several experts stressed the importance of linking prehospital and hospital data to medical examiner data in order to even determine which deaths were “preventable” and further analyze the care provided.

“One of the successes of the military [efforts to reduce battlefield deaths] was the data capture,” said James Robinson, Assistant Chief of Denver EMS and a member of the committee that wrote the National Academy report. “How do we make that easy [in EMS]?”

Other topics discussed included how to measure success, how to improve access to EMS and definitive trauma care in rural and underserved areas, creating a culture that emphasizes patient-centered, evidence-based care, and finding ways for military and civilian providers to collaborate and maintain proficiency.

An executive summary of the meting will be available soon on EMS.gov.

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