Welcome The Trauma Audit & Research Network (TARN)

Background Largest: European Trauma registry: >680,0000 injured patients with >50,000 injured children Review and monitor process of care & outcome Report to Trusts & Commissioners Inform changes in practice: Improve Trauma Care 100% membership in England, Wales, ROI and Northern Ireland Members in Denmark and Switzerland 220 Hospitals submitting data Clinically led (BOARD and Executive committees), Academic, Independent

The beginning 1988: Report by RCS: The Management of patients with Major Injuries “Serious deficiencies in the management of severely injured patients” Enhancing pre-hospital care, ensuring appropriate medical intervention Rapid transfer to the best local facility Assessing the use of helicopters Adopting ATLS principles Integrating trauma services within and between hospitals Investing in rehabilitation services System of Auditing & Research TARN Established in 1989: Based Salford Royal Hospital

Major Trauma Network development Public Accounts Committees March 2010 Chief Executive of NHS on public record as ...... Committing to development of Major Trauma Networks across England by end of 2011/12 Mandating TARN membership Most Major Trauma Networks “live” April 2012

On scene patient triage: Positive What has changed On scene patient triage: Positive Direct to MTC (< 45 mins travel) TARN Indirect Transfer (>45 mins, time critical intervention) MAJOR TRAUMA CENTRE Consultant led trauma team Immediate operating theatre All specialties: neurosciences Immediate CT scan Interventional radiology Specialist critical care Trauma Unit Trauma team Immediate CT Resuscitate, Assess & ? Transfer

Major Trauma Centre: Best Practice Tariff Year (16-17) Additional payment made to Major Trauma Centres only Based on Injury Severity Level 1: Moderate Trauma (ISS>8): £1,500 Level 2: Major Trauma (ISS>15): £3,000 Conditional on ‘Best Practice’ targets being met & data correctly entered onto TARN database BPT worth 45 million per annum Last year 10.5 million in missed payments

Major Trauma Centre: Best Practice Tariff Year (16-17) Level 1 (Moderate Trauma): Injury Severity Score >8 TARN data is completed and dispatched within 25 days of discharge/death. Rehabilitation prescription completed for each patient & recorded on TARN. Tranexamic acid (TXA) administered within 3 hours of injury for any patient receiving blood: Exclusions: Isolated Serious (Severity 3+) Head injuries Non-emergency transfers: Patient must be admitted to MTC within 2 calendar days of referral from Trauma Unit

Major Trauma Centre: Best Practice Tariff (16-17) Level 2: (Major Trauma) Injury Severity Score >15 Level 1 criteria and following additional criteria met: Direct admissions or emergency (<12 hour) transfers: Patient must be seen by Consultant within 5 minutes of arrival Direct admissions: Head CT performed within 1 hour of arrival for patients with SeeAIS1+ Head injury & GCS <13 in ED (or intubated pre-hospital) Exclusions: patients requiring emergency surgery or interventional radiology within 1 hour of admission

Web-based Trauma Data Collection Electronic data collection & reporting system Secure on-line system through patient pathway Data Collection AND Reporting

Hospital Activity: News and Updates TARN Annual awards New: Report & Training calendar System update notification Report publications Press Releases Data Entry Advice

Hospital Activity Accessible to all secure users Activity Summary for each Hospital 90 days Calendar year Updates constantly, includes: Submission Summary ISS Breakdown MOI breakdown

Resources OUTCOME PREDICTION MODELLING: Injury Severity Score (ISS) Ps14 modelling detail Ps14 calculator TRAINING RESOURCES: Latest Procedures manuals: England & Wales, Republic of Ireland, Northern Ireland Analysing your own data Fracture definitions ICD10 codes list BOAST4 algorithm Chest Wall Trauma Screen guidance Anatomy guide

Resources FORMS & DOCUMENTATION Standards used in TARN reports Twitter Guidance Dashboard support documents CONTACTS LIST & DATA COLLECTION FORMS Coordinator contacts list Data collection pro forma BOAST4 pro forma Chest Wall Trauma screen pro form Links to: Data monitoring summary Annual reports: Severe injury in children (2 reports) Older person’s report – published April 17

Research Director: Professor Fiona Lecky Research publications: 1992 to date Including: 25 years of Trauma Audit – EMJ publication Blue hyperlink: downloadable Research enquiry form- submit to Research committee Meet Monthly: Ongoing projects & New proposals

Training Dates & venues Course content Delegate feedback Copies of Training slides Training videos

Contact us Phone-line: 0161 206 4397 Email: support@tarn.ac.uk Twitter account: @TARNaudit www.facebook.com/TARNaudit Website: www.tarn.ac.uk Largest European trauma registry > 500,0000 injured patients  Half a million patients. The particular patient was.......... a 74 year old man transferred to Stoke Mandeville after a fall (whilst on holiday in the Isle of Wight). He had sustained an odontoid fracture. The submission was coded and approved by Paul 16/04/2015 11:44. SubmissionID is 853400004202 if you want to have a look. Self funded through hospital membership fees - non profit making organisation Clinically led, Academic and Independent Provides the functionality for Best Practice Tariff payments

Questions?