Page 56 - Regional Services Plan 2016/19

2.9 Midland Trauma System (MTS)
Chair: Dr Grant Christey, Clinical Director MTS Programme Manager: Alaina Campbell Project Manager: Suzanne Andrew Lead Chief Executive: Dr Nigel Murray
Context
Trauma continues to have a major impact on Midland communities, resulting in 5980 admissions in 2014 and 23,839 hospital bed days. The cost of this to the hospitals alone is estimated at over $43m – the intangible cost to patients and families is enormous. After 5 years of sustained clinical effort, data collection, and data platform building, MTS is now entering its output phase wherein we can use our clinical network and the information we have gathered to reduce the burden of trauma on the community, both in prevention, and in improving our responses at the point where prevention fails.
Key principles: Patients come first
 ensuring highest quality trauma care
 focused on patient needs
 promoting collaboration between all trauma care providers
Key regional objectives for 2015-17:
 Enhanced data entry and access by DHBs using online tools to identify clinical and system issues
 Midland Trauma Research Centre (MTRC) for enhanced collaboration with community partners
 Web-based, relational data platform ’TQual’ to enable effective ’Triple Aim’ quality improvement activities.
 Stage 2 of MTS Business Case to enable adequate resourcing and progress of regional and hub services.
MTS Targets to 2018
Operational Targets
 All Midland DHBs entering data via web-based registry
 Midland Trauma Research Centre (MTRC) operational by end 2016
 TQual relational data warehouse operational by end 2016
 All Midland DHBs to receive quarterly updates of their trauma data as Qlik Sense files by June 2016
Clinical Targets
 Reduce mortality in severely injured (ISS >12) from 8.4% (2014) to 7.0% (world best practice is 10%).
 Compliance to clinical exsanguination algorithms >90%.
 In-hospital early deaths by exsanguination <3% of severely injured patients.
 >95% data-capture of patients admitted to Midland hospitals as a result of trauma
System Targets
Note: trauma Length of Stay (LOS) calculation is the total bed-days per trauma event across hospitals.
 Reduce overall LOS from 4.9 (2014) to 4.5 days (approximately 1800 bed days p.a.)
 Reduce LOS in severely injured from 24 (2014) to 21 days
 Produce quantitative evidence to inform optimal inter-hospital vehicle, staff and resource utilisation
Population Targets
 Predominant at-risk community groups identified from incidence studies
 Identification of equity and access discrepancies in Midland trauma population completed by December 2016
 Functional linkage developed with regional and local injury prevention agencies
Line of Sight
 Waikato DHB DAP - support regional collaboration (p86)
 Taranaki DHB DAP - Shorter stays in ED – regional collaboration (p103); Trauma patient pathways (p132); Major trauma data collection,
workforce, clinical interface, review of case management role (pp132-134)
 Bay of Plenty DHB DAP - actions to support delivery of regional priorities (p84)
 Lakes DHB DAP - multi trauma patients with SCI - pre hospital destination and referral pathway (p151); major trauma data collection,
workforce, clinical interface, review of case management role (pp152-153)
 Hauora Tairāwhiti DAP - Midland Regional Services Plan – any service changes provided in RSP (p155)
Initiative
Milestone/Date
Responsibility
1. Trauma specialist workforce is optimal, well trained and sustainable
Midland has a quality trauma specialised workforce in a supportive, progressive environment, with the workforce matched to the priority strategic elements, and MTS personnel are supported in career and professional development.
Outputs/Deliverables
 Optimal FTE applied to trauma positions within each Midland DHB, with appropriate resources to support training and education (MRTS Business Case - stage 2 endorsement)
 Implementation of an optimal workforce plan for MTS hub group Recommendations made for clinical and data staff in individual DHBs
 Define and implement professional development pathways for all MTS members in Midland DHB trauma services – training sessions / study days delivered and attended by June 2017
Q1 2016/17 Q2 2016/17 Q4 2016/17
Midland DHBs
56
INITIATIVES OF REGIONAL NETWORKS AND CLINICAL ACTION GROUPS