The Institute of Trauma and Injury Management (ITIM), in partnership with the NSW Ministry of Health, coordinates the monitoring of the NSW trauma system.
Monitoring the pre-hospital component
The pre-hospital component of the trauma system is monitored and evaluated by NSW Ambulance. NSW Ambulance reports to the NSW Ministry of Health on a range of agreed key performance indicators related to trauma, including compliance with the Protocol T1: Pre-Hospital Management of Major Trauma.
Monitoring the in-hospital component
NSW trauma services are responsible for monitoring in-hospital patient care. This is achieved through a performance improvement program that involves:
- patient care review through daily rounds
- monitoring of key performance indicators
- participation in the NSW Trauma Registry
- morbidity and mortality reviews
- multidisciplinary trauma committee meetings.
Monitoring at state level
The ITIM provides state-level monitoring of the NSW trauma system through the ITIM clinical review committee.
Trauma system monitoring is conducted on moderate to critically-injured patients (ISS >12) treated by NSW trauma services using data from the NSW Trauma Registry, and on an ad hoc basis for cases reported to ITIM by any of the NSW trauma services.
Trauma deaths are reviewed by NSW trauma services and local health district trauma committees. Possibly preventable and preventable deaths are reported to ITIM for review by the ITIM clinical review committee.
ITIM obtains the post-mortem reports from the NSW Coroner and Department of Forensic Medicine for the NSW trauma services, as requested.
Any case issues are followed up with the different agencies to obtain all the details of the case for review, and the outcomes are notified to the reporting trauma service.
ITIM is invited on an ad-hoc basis to participate in trauma root cause analysis by the local health district clinical governance units.