1. Welcome The Trauma Audit & Research Network (TARN)

2. 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

3. 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

4. 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

6. 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

7. 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

8. 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

9. 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

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

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

12. 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

13. 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

14. 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

15. 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

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

17. Contact us
Phone-line:
Twitter
Website:
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/ :44.
SubmissionID is 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

18. Questions?