Trauma System Agenda for the Future


What is Trauma

What is Trauma Systems

The Vision

Executive Summary


Comprehensive Trauma Care System: Fundamental Components of Trauma Care

Comprehensive Trauma Care System: Key Infrastructure Elements





Background and Objective of this Report

After three decades of evolution, the need for consensus regarding trauma system development has never been more evident. Over the past 20 years, a number of multidisciplinary groups have described the essential components and influenced the design of these systems. Focus has shifted from trauma centers to trauma systems, with an emphasis on inclusiveness. A research agenda has been established to strengthen medical evidence and draw conclusions regarding trauma care effectiveness. An international study recently has been undertaken to evaluate the cost-effectiveness of trauma care. And national experts in trauma care have gathered in a series of forums to analyze system needs and recommend strategies for improvement.

At one such meeting held in Skamania, Washington in July 1998, approximately 100 of the nation's leading trauma authorities convened to provide recommendations for improved trauma system performance and evaluation. One recommendation was that leaders from key stakeholder groups be gathered to create a trauma system agenda for the future.

Between 1999 and 2002, the National Highway Traffic Safety Administration (NHTSA), Health Resources and Services Administration (HRSA), and the American Trauma Society (ATS) coordinated development of this vision for a trauma system of the future. The process began in April 1999, when leaders representing hospital and trauma system administrators, state elected officials, EMS system managers, trauma surgeons, emergency physicians, trauma nurses, and public health professionals were convened as a steering committee. The committee met four times over two and a half years to deliberate the many issues surrounding trauma care and develop thoughtful recommendations to guide the future of trauma system development. The American Trauma Society (ATS) launched a complementary Rapid Design® process during their 2000 and 2001 Annual Meetings, during which more than 150 participants drafted a vision of trauma care in 2010.

This input was subsequently combined with that of the steering committee to produce this Trauma System Agenda for the Future, a powerful vision statement representing the perspectives and priorities of the full range of professionals involved in the prevention, treatment, and rehabilitation of trauma victims.

The design of high quality, cost efficient trauma systems for the United States in the 21 st century is an iterative process that will involve many organizations and individuals. This report has been prepared as an important first step. Together, the groups convened in this vision process represent a comprehensive range of trauma stakeholders. Their findings complement and strengthen one another, presenting a persuasive analysis of the needs, opportunities, and direction of trauma systems.

The report is organized around a framework that includes all components of a comprehensive trauma care system. It begins with a discussion of the fundamental components (injury prevention, prehospital care, acute care facilities, and post-hospital care) that are at the heart of the trauma care system. The report then examines the key infrastructure elements that are integrated across the continuum of care: leadership, professional resources, education and advocacy, information management, finances, research, technology and disaster preparedness and response.