Welcome The Trauma Audit & Research Network (TARN) Data Collection session.
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Transcript of Welcome The Trauma Audit & Research Network (TARN) Data Collection session.
Welcome
The Trauma Audit & Research Network (TARN)
Data Collection session
Today
Background
Inclusion criteria
Identifying cases
Quality Assurance: Data Accreditation and Completeness
Data Entry
Injury scoring & calculating the ISS (Injury Severity Score)
Ps14 (Probability of Survival) & Hospital Survival rate (Ws)
TARN
Largest European Trauma registry
Over 500,0000 injured patients with more than 46,000
injured children
Review and monitor processes of care & outcomes
Report to trusts & commissioners
Inform changes in practice: Improve Trauma Care
TARN Team Administrator/PA:Gemma Reed
Coding team:Laura BlakeleyNaomi BrookPaul GembarskiPhil Hammond (Supervisor)Corinne TilleyVictoria Zagrodnik
Training & Audit Manager:Laura White
Financial Accountant:Jean Hodkinson
Projects Manager:Victoria Phillipson
Registry Manager:Tom Jenks
Systems Analysts:Marisol FragosoSophie JonesTom LawrenceMike Young
Medical Statistician:Omar Bouamra
Executive Director:Maralyn Woodford
Operations Director & Deputy to the Executive Director:Antoinette Edwards
TARN
Academic: University’s of Manchester, Sheffield and Leicester
Non Profit making
100% membership in England and Wales
Members in Southern Ireland, Denmark and Switzerland
Clinically led
BOARD and Executive Committees
Research and Audit Committees
TARN Research Committee
Director: Professor Fiona Lecky, Clinical Professor & Honorary Consultant in Emergency Medicine (EM) at ScHARR and Salford Royal NHS Foundation Trust
11 members including: Executive Director, Medical Statistician, Registry Manager, Data Analysts, Clinical Research Advisor, Research Fellows, Pre-hospital research advisor.
Meet Monthly to review: Ongoing Research projects
New Research proposals
Meetings & teleconferences with researchers
Have you got a Research idea?
Complete Request form or email [email protected]
TARN Audit Committee
Director: Dr Dhushy Kumar, Consultant in Critical Care, Pre-hospital Care and Anaesthesia at University Hospital Coventry.
15 members - National representation: Clinicians, TNCs, Data Coordinators, Rehabilitation, TARN Executive Director, TARN Registry & Training Managers
Meet 6 times per year to discuss audit changes Have you got an audit request?
Email [email protected]
The beginning
1988: Report by RCS: The Management of patients with Major Injuries“Serious deficiencies in the management of severely injured patients”
Enhancing pre-hospital care, ensuring appropriate medical intervention Rapid transfer to the best local facility Assessing the use of helicopters Adopting ATLS principles Integrating trauma services within and between hospitals Investing in rehabilitation services
System of Auditing & Research
TARN Established in 1989: Based Salford Royal Hospital
Major Trauma reports 2000: Joint report by RCS and BOA: Better Care for the Severely Injured
“Standards & outcome measures developed, against which institutions can audit the
outcome of treatment”
2007: NECPOD: Trauma: Who cares?“Given the importance of evaluation of processes and outcomes in the trauma patient, all units providing treatment for severely injured patients should contribute to the Trauma Audit & Research Network”
Major Trauma Network development
Public Accounts Committees March 2010Chief Executive of NHS on public record as ......
Committing to development of Major Trauma Networks across England by end of 2011/12
Mandating TARN membership
Most Major Trauma Networks “live” April 2012
17 Major Trauma Network and Major Trauma Centres (MTCs)
Thames Valley
Wessex
Severn
Peninsula
East of England NetworkAddenbrooke’s Hospital
East Midlands NetworkNottingham University Hospital
Yorkshire & HumberLeeds General HospitalSheffield Teaching Hospital NHS Trust Sheffield Children’s Hospital Hull Royal Infirmary
NorthernJames Cook University HospitalRoyal Victoria Infirmary, Newcastle
Sussex Network Royal Sussex County Hospital
Greater Manchester NetworkSalford Royal HospitalWythenshawe HospitalManchester Royal Infirmary Royal Manchester Children’s Hospital
Merseyside & Cheshire NetworkUniversity Hospital of AintreeWalton Centre for NeurologyRoyal Liverpool University Hospital Alder Hey Children’s Hospital
South Cumbria & Lancashire Network Royal Preston Hospital
West Midlands Network
North West Midlands NetworkRoyal Stoke University Hospital
Centre of England NetworkUniversity Hospital of Coventry & Warwickshire Birmingham and the Black Country NetworkQueen Elizabeth Hospital, BirminghamBirmingham Children’s Hospital
Severn Network Southmead HospitalBristol Royal Children’s Hospital
Peninsula Network Derriford Hospital
Thames Valley Network John Radcliffe Hospital
Wessex Network Southampton General Hospital
NE London Network Royal London Hospital
NW London Network St. Mary’s Hospital
SE London NetworkKings College Hospital
SW London NetworkSt. George’s Hospital
Sussex
London
East of England
East Midlands
Yorkshire & the Humber
North East
S. Cumbria & Lancashire
Greater Manchester
Merseyside & Cheshire
N.W. Midlands
Centre of England
Birmingham & Black Country
What has changed On scene patient triage: Positive
Direct to MTC (< 45 mins travel)
Indirect Transfer(>45 mins, time critical intervention)
MAJOR TRAUMA CENTREConsultant led trauma teamImmediate operating theatreAll specialties: neurosciencesImmediate CT scanInterventional radiologySpecialist critical care
Trauma UnitTrauma teamImmediate CT Resuscitate, Assess & ? Transfer
TARN
Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Additional payment made to Major Trauma Centres only
Based on Injury Severity
Moderate Trauma (ISS>8): £1,500
Major Trauma (ISS>15): £3,000
Payment conditional on Best Practice criteria being met
Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Level 1 (Moderate Trauma): Injury Severity Score >8
TARN data is completed and dispatched within 25 days of discharge/death.
Rehabilitation prescription completed for each patient & recorded on TARN.
Tranexamic acid (TXA) administered within 3 hours of injury for any patient receiving blood: Exclusions: Isolated Serious (Severity 3+) Head injuries
Non-emergency transfers: Patient must be admitted to MTC within 2 calendar days of referral from Trauma Unit
Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Level 2: (Major Trauma) Injury Severity Score >15Level 1 criteria and following additional criteria met:
Direct admissions or emergency (<12 hour) transfers: Patient must be seen by Consultant within 5 minutes of arrival
Direct admissions: Head CT performed within 1 hour of arrival for patients with SeeAIS1+ Head injury & GCS <13 in ED (or intubated pre-hospital)
Exclusions: patients requiring emergency surgery or interventional radiology within 1 hour of admission
Additional BPT fields added to TARN database
Web-based Trauma Data Collection
Electronic data collection & reporting system Secure on-line system through patient pathway Data Collection AND Reporting
TARN Reports Clinical Reports: Published March, July, November. Email notification to all users
Performance Comparisons: Updated March, July, November. Available to all.
Online Reports: Self produced reports
Ad Hoc analysis: Available any time
Separate Reporting
Training session
Questions?