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Trauma Services BC

Trauma Services BC is dedicated to ensuring all British Columbians have access to a high performing, comprehensive, integrated and inclusive provincial trauma system.

With a mission to ensure the optimal performance of BC’s trauma system, its long-term vision is for an integrated system of injury care, control and prevention strategies that results in BC having the lowest burden of injury in North America.

Our work

About trauma

Traumatic injury refers to physical injuries of sudden onset and severity which require immediate medical attention to prevent loss of life or limb. 

Major trauma is the principal cause of death for people under age 45 in Canada. Over 700,000 people are injured each year in BC and more than half of them seek medical attention. 

Of the 700,000 British Columbians injured each year, about 1,800 die, 9,000 suffer permanent disability, 27,000 are hospitalized and an estimated 41,000 potential years of life are lost. The yearly cost of injury exceeds $2.8 billion in BC and is close to $19.8 billion nationally.

Falls and motor vehicle-related injuries are the main causes of injury-related hospitalization in BC.

Trauma Services BC is responsible for ensuring the optimal performance of BC’s trauma system. It was formed in 2012 as a program of the Provincial Health Services Authority (PHSA) to provide high-level system oversight, strategic leadership and performance evaluation for major trauma care in BC.


Trauma Services BC aims to improve the quality of and access to trauma care in BC by integrating trauma services throughout the province. This ensures a flexible response to trauma cases from all health care facilities and providers that ensures standardized quality care for trauma patients. 


Trauma Services BC works with provincial health authority trauma leaders and provincial partners to ensure the delivery of comprehensive and inclusive trauma care to all BC residents, regardless of where they live in the province. 

Initiatives

Key activities include:

  • optimization of provincial trauma system performance
  • BC Trauma Registry data collection, reporting and support of research and quality initiatives related to trauma care
  • injury prevention support (specific to trauma data) 
  • standardisation of clinical practice guideline development
 

Trauma Services BC has operational oversight of the BC Trauma Registry. 


The BC Trauma Registry is designed to capture data on patients who require complex trauma care and are treated at all facilities in the province. There are two BC Trauma Registry datasets.


The minimum dataset contains information on all trauma patients in BC who have been sent by ambulance or have been in an emergency department, or who have been admitted to hospital. The minimum dataset is originally compiled from data available from other datasets in BC and then is enhanced by adding several additional trauma specific data elements.


The comprehensive dataset is not captured in other provincial or regional datasets. It contains a large number of clinical and administrative data specific to trauma on patients who meet any of the following criteria:

  • Are treated for moderate to severe injuries (injury severity score greater than or equal to 9)
  • Meet site trauma team activation criteria or have a trauma team response
  • Require coordinated care across facilities
  • Are included in specialized populations (pediatrics)
  • Expire in hospital following a traumatic incident

The registry’s primary purpose is to support improvement in the quality of care for BC trauma patients, and to reflect and facilitate system-level performance improvement. Many traumatic injuries are preventable, such as falls and motor vehicle accidents, so it is important to look at the data to determine how trauma-related injuries can be prevented. 


BC Trauma Registry analysts are present in each of BC’s 11 trauma-designated facilities to collect data for the comprehensive dataset. Each participating hospital has one (or more) health information registrars who code and abstract trauma information as per provincial standards. Data from the sites is transferred to a central registry, which contains all registry records from participating facilities. As of August 2016, the provincial trauma comprehensive data set contains over 190,000 patient records. 


Rigorous data quality checks and business rules are applied to the data received by the registry to ensure a high level of data integrity and consistency. The BC Trauma Registry provides data access for public-interest research purposes, surveillance, program delivery and evaluation.


BC’s Provincial Burn Registry also operates under the BC Trauma Registry with two participating sites: Vancouver General Hospital and BC Children’s Hospital. 


Contact: BCTraumaRegistry@phsa.ca

 

BC’s system of organized trauma care can be described as a collaboration of the regional health authorities and the pre-hospital system to streamline acute management of major trauma anywhere in the province. All acute care hospitals in the province are part of the system with an expectation of readiness to receive and redirect major trauma, based on resources and expertise. 


According to Accreditation Canada’s trauma distinction standards, BC currently has:


Three Level 1 provincial referral trauma centres (the highest level of trauma care)

  • BC Children’s Hospital – Vancouver (Provincial Health Services Authority)
  • Royal Columbian Hospital – New Westminster (Fraser Health)
  • Vancouver General Hospital (Vancouver Coastal Health)

Three Level 2 centres

  • Kelowna General Hospital (Interior Health)
  • Royal Inland Hospital – Kamloops (Interior Health)
  • Royal Jubilee Hospital & Victoria General Hospital – Victoria (Island Health)

Five Level 3 centres

  • Abbotsford Regional Hospital & Cancer Centre (Fraser Health)
  • Lions Gate Hospital – North Vancouver (Vancouver Coastal Health)
  • Nanaimo Regional General Hospital (Island Health)
  • St. Paul’s Hospital – Vancouver (Providence Health Care)
  • University Hospital of Northern BC – Prince George (Northern Health)

Two Level 4 centres 

  • Richmond Hospital (Vancouver Coastal Health)
  • Surrey Memorial Hospital (Fraser Health)

61 Level 5 centres located throughout the province

 
  • Major trauma is the principal cause of death for people under age 45 in Canada.
  • Over 700,000 people are injured yearly in BC. Of these, approximately 1,800 die, 9,000 suffer permanent disability, 27,000 are hospitalized and an estimated 41,000 potential years of life are lost. 
  • The yearly cost of injury exceeds $2.8 billion in BC.
  • The most common cause of injury in BC is falls.
  • Many falls – especially in older adults – result in minor injuries that require hospitalization.
  • Falls and transport-related (car, motorcycle, ATV, bike, boat, watercraft, plane crashes) are the main causes of moderate-to-severe injury hospitalizations in BC.
  • Fraser Health has the highest number of injuries related to falls in the province with nearly 6,500 recorded compared to the next highest at just over 4,300 in Interior Health (2014/15). 
  • Interior Health has the highest number of transport-related injuries in the province and has noted an increasing trend of morbidity and mortality associated with all-terrain vehicles (ATVs).
  • Island Health saw a 6.8 per cent increase in trauma-related injuries in 2014/15 over the previous year. Twenty-three per cent of its population is seniors and the region has the highest number of people aged 75 or older in the province.
 
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Who we are

Leadership

Led by Catherine Jones, executive director and Dr. David Evans, medical director, Trauma Services BC engages partner organizations through the Trauma Services BC council. 

The council consists of trauma leadership designates from all of BC’s six health authorities and partner organizations – such as BC Emergency Health Services, BC Coroners and Health Emergency Management BC. 


The council’s objectives include: 

  • Strategic planning to assure optimal performance of BC’s trauma system. 
  • Implementation of system-level performance evaluation strategy.
  • Implementation of an effective, secure and sustainable information management 
  • Overseeing the development and implementation of a provincial quality review process 
  • Supporting BC’s regional health authorities in the design and delivery of effective and efficient trauma care and injury management. 
  • Overseeing the implementation of a system of trauma centre designation, evaluation (verification) and accreditation, incorporating province-wide participation in Accreditation Canada’s trauma distinction program. 
  • Engaging and supporting BC Emergency Health Services in the design and delivery of effective and efficient strategies of pre-hospital care and the inter-facility transport of trauma patients. 

Trauma Services BC’s operational model ensures engagement and participation of regional trauma programs in setting provincial priorities through the Trauma Services BC’s council. 


In addition, it oversees working groups like the provincial performance improvement and patient safety committee, and specialist services committee to advance trauma management and monitor provincial performance through the registry. 


The BC government indirectly influences the province’s system of trauma and injury care management through the Ministry of Health by engagement and fiscal support of the health authorities, and the Ministry of Justice through oversight of public security, coroners services and provincial emergency management.


In consultation with the council and its partners, Trauma Services BC develops strategic plans which determine its operational focus. This consensus-based plan aligns with Ministry of Health, and provincial and regional health system priorities to further consolidate a comprehensive and accountable provincial trauma system for BC. 


Roles and responsibilities outlining collaboration with regional health authority trauma leadership are articulated through yearly service agreements. This formal agreement demonstrates transparency of funds and intentional alignment with the yearly strategic initiatives achievement. 


Trauma Services BC also provides a stipend for trauma registry support in designated trauma 

 

Who we work with
Trauma Services BC works with numerous provincial partners to ensure the delivery of comprehensive trauma care. BC’s system of trauma care is a collaboration between the regional health 
authorities and the pre-hospital system to streamline management of major trauma anywhere in the province.

BC health authorities

  • Fraser Health 
  • Interior Health 
  • Island Health 
  • Northern Health 
  • Providence Health Care
  • Provincial Health Services Authority - BC Children’s Hospital
  • Vancouver Coastal Health 

Emergency services

BC Emergency Health Services (BCEHS), a program of PHSA, provides pre-hospital emergency services and inter-facility patient transfers throughout the province. BCEHS oversees the BC Ambulance Service and the BC Patient Transfer Network.


Health Emergency Management BC (HEMBC) is a program of PHSA that provides emergency management leadership and support to BC’s health authorities.


BC's Mobile Medical Unit is a program of PHSA that offers health emergency response, business continuity, clinical education and health consultation services throughout BC.


External agencies & groups 

The BC Coroners Service is responsible for the investigation of all unnatural, sudden and unexpected, unexplained or unattended deaths. It advances recommendations to improve public safety and prevent death


The BC Injury Research & Prevention Unit and BC Injury Prevention Policy Advisory Committee bring together key partners in injury management and prevention to provide guidance and recommendations to influence the development of injury surveillance and prevention policies and programs.

 

Resources


See the Trauma Association of Canada for a list of conferences, scientific meetings and events on trauma-related topics. 
 
Accreditation Canada is an independent, not-for-profit organization that improves health quality through accreditation. It’s trauma distinction award recognizes trauma systems or networks that demonstrate clinical excellence and an outstanding commitment to leadership in trauma care.

Trauma distinction awards in BC

Vancouver Coastal Health (VCH), Providence Health Care (PHC) and PHSA were the first in Canada to be awarded ‘Distinction in Trauma Services’ by Accreditation Canada in April 2016.


Fraser Health was awarded Accreditation Canada’s ‘Distinction in Trauma Services’ in July 2016. It is the second health authority in Canada to receive this distinction.


BC’s other health authorities are working towards achieving trauma distinction status.

 
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SOURCE: Trauma Services BC ( )
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