Annually in Ireland, approximately 5,800 patients are hospitalised following major trauma, which can result in life threatening or life-changing injuries. ‘Trauma Networks’ are being implemented, which will have one Major Trauma Centre (for severe injuries) at their hub, with Trauma Units, Local Emergency Hospitals and Local Injury Units forming the spokes (managing less severely injured patients). Patients should be brought seamlessly to the best hospital that can manage their injuries. The National Ambulance Service (NAS) captures data prior to hospitalisation on an electronic Patient Care Record (ePCR). The Major Trauma Audit (MTA) captures in-hospital care. We aim to combine the ePCR and the MTA to inform policy including injury prevention, service configuration, optimal patient management and identify requirements for pre-hospital clinical competencies. This will be achieved in three Work Packages (WPs):
WP1: Proof-of-concept
A proof-of-concept study, achieved by adopting a Trusted Third Party Agreement mechanism, will highlight the value in combining the physiology, mechanism of injury and prehospital intervention details (ePCR) with the in-hospital physiology, interventions and advanced imaging (MTA) datasets, ultimately generating a clinical prediction tool. WP2: Stakeholder input for ongoing dataset combination and utilisation
Stakeholder engagement techniques will explore best-practice mechanisms and a toolkit for ongoing, GDPR-compliant combination of ePCR and MTA datasets, including geospatial data (potentially identifiable) and exploration of methods to include patient reported outcome measures (functional and quality of life outcomes), incorporating requirements from the Data Protection Commissioner, National Office of Clinical Audit, patients, clinicians, NAS, Health Service Executive and other stakeholders.
WP3: Geospatial implications of major trauma services
Once ongoing data combination is approved, we will determine geospatial implications of the trauma network for prehospital care configuration and the patient journey. Results will inform prehospital services configuration, including prehospital clinical competencies and logistics requirements for road/air resourcing, to ensure safe and equitable patient management.