2 - International Conference in Emergency Medicine and Public Health-Qatar Proceedings
  • ISSN: 1999-7086
  • EISSN: 1999-7094


The South West London & Surrey Trauma Network has one major trauma centre (MTC) and seven acute trauma units (TUs) over a wide geographical area. Seventy-five percent of the major trauma patients (injury severity score >15) were taken to MTC. However, many were admitted in trauma units. Available data indicates that there is a possibility that patients in TU rather than MTC may receive less than optimal care.

We would like to describe the development of a new system and process to review the management of ISS>15 cases under governance framework, assuring the delivery of safe and effective trauma care outside a MTC.

The standard operating procedure and flow chart process were developed for review of major trauma cases. TARN Office identified patients were reviewed using a proforma, with key trauma measures as quality indicators. The notes were initially reviewed by clinicians, and in due course by the MDT team for the whole patient journey from arrival to discharge.

The commonest age group is >65 years. Head injury is most common, resulting from a fall from standing height (64%) causing subdural haemorrhage (57%). Most arrive by blue-light ambulance (86%). There is evidence of specialist team involvement in 64% of the cases and multidisciplinary team involvement in 55% of the cases. However, there are issues with the quality of record keeping, Timely CT scans and incorporating rehabilitation prescriptions into discharge letters were done.

Issues with care were formally registered with hospital incident reporting system and registered in the trauma risk register. Findings were presented in the hospital audit study day, in the Trust Governance Committee and disseminated for development. This governance system has evolved with more concrete systems now in place.

Initiating a robust governance system and process will minimise substandard care and help standardise care across the network.


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  • Article Type: Research Article
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