Report, Webinar Explore How to Push Trauma Care Forward

On June 17, the National Academies of Sciences, Engineering and Medicine released a report by the Committee on Military Trauma Care’s Learning Health System and its Translation to the Civilian Sector detailing ways in which trauma care can be improved in both the military and civilian sectors.

NASEM hosted a webinar on the day of the report’s release to summarize the report’s findings and recommendations.

Donald Berwick, MD, chair of the committee, says the report is dedicated to Dr. Norm McSwain, who died during its composition. Berwick says the report is coming at a time of great need for better trauma care in the civilian sector, especially with MCIs such as the Orlando nightclub shooting occurring.

“We are very mindful of the tragedy in Orlando, and it motivates us even further to make sure care for those who are injured is as good as it can be,” Berwick says.

Before presenting the summary, Berwick stressed the importance of trauma care in America. In civilian cases, Berwick says nearly 148,000 Americans died in 2015 from trauma-related incidents, and nearly 20% of those deaths were preventable with optimal trauma care. This comes out to about 30,000 preventable deaths after injury.

The committee set relatively strenuous goals for the report, including:

• Understanding the ways in which the military has made progress in trauma care and exploring how that progress was made;
• Examining opportunities to ensure advances in trauma care are sustained and built upon in both the civilian and military sectors;
• Finding ways to foster the transfer of information on trauma care practices between the military and civilian sectors most efficiently.

In the report, the committee presents its goal: zero preventable deaths after injury. 

“Zero preventable deaths may sound impossible, but it’s not,” Berwick says. “It might be a stretch, but it’s not impossible.”

The committee’s vision to achieve this goal hinges mainly on creating a national trauma care system focused on unifying civilian and military trauma systems. The national system would have shared aims, infrastructure, data, best practices and personnel.

The report presents 11 recommendations for how to create this system. One of the recommendations is to focus on the importance of prehospital care in relation to trauma care.

“Many, many preventable deaths happen before the patient arrives at the hospital,” Berwick says.

The goal of zero preventable deaths after injury simply cannot be completed without giving proper attention and improvement to the EMS system. The military and EMS have made big improvements in trauma care recently, and continued support via the exchange of best practices between EMS personnel and the military sector is essential, Berwick says.

Examining and recalibrating EMS policy to reflect how important the service is to society and rethinking at the ways we fund EMS are also recommended.

Some of the other recommendations Berwick and his team presented are:

• Allowing the White House to present the zero preventable deaths goal. This way, the goal becomes truly a national ideal, and progress is more likely.
• The White House should also lead the integration effort between military and civilian trauma care.
• Improving the collection, integration and use of data. Berwick acknowledged some limitations exist in this regard, but stressed having one data system would make progress come faster on a national scale.
• Creating a collaborative military-civilian research infrastructure. This facet would ensure funds are allocated to make sure trauma care is proportionately researched compared to other areas of medicine.
• Investing in a supportive regulatory environment. This would include setting rules to allow civilian and military trauma care providers to learn from real-time case studies.

The full version of the report and other resources concerning trauma care can be found on NASEM’s website.

To watch the webinar in full, click here.