1. The State Major Trauma Unit a new service Susanne Jenner 28 th August 2008

2. Index The State Major Trauma Unit (SMTU) Goals and Objectives Multidisciplinary Team Social Work Service Conclusion References

3. The State Major Trauma Unit Is part of a 40 bed unit completed 2008 Located level 3 north block RPH To accommodate: – State Major Trauma Unit – 25 beds – State Adult Burns Unit – 10 beds – with 5 either/or beds usually SMTU. In a disaster situation can be become one high acuity 40 bed unit.

4. Official Opening

5. Reception

6. Corridor (east view)

7. Single adjoining room

8. SMTU Goals and Objectives Provision of expert care of trauma patients To expedite patients from ED To improve flow of major trauma patients in all related clinical areas To expedite patients from ICU, HDA and Theatres/Recovery by providing “step down” facility. To provide an ongoing Education and Research environment for improved trauma management and patient outcomes.

9. Complex Trauma Patients All Multi-system trauma patients requiring input from more than one admitting specialty Single system injuries with complex co- morbidities. Exclusions – Patients who require advanced organ system support eg renal, ventilator or cardiac – Isolated spinal and neurosurgical injuries

10. Multidisciplinary Team Medical – Trauma Fellows 1.6 fte – RMO’s 5 fte Nursing 42.78 fte Case Manager 1 fte Clinical Psychologist 2 fte Social Work 1.6 fte level 7 Physiotherapy 3 fte – 1 level 8 and 2 level 4/6 for 7 day service

11. Multidisciplinary team cont’d Occupational Therapy 2.5 fte – 3 level 7s for 7 day service Speech 1fte Dietician 0.6 fte Pharmacy 1 fte Chaplaincy ? 0.4fte Administration personnel Researchers

12. Social Work Service Expectation – Provide Trauma specific SW service – 72 hour turnaround – See every patient incl ICU and HDU Action taken to develop the role – Literature search – Identify role – Develop Psychosocial assessment specific to trauma

13. Social Work role Prioritise (using traffic light system) Complete psychosocial assessment Documentation – Headings are used for assessment details – Action required – Plan including early discharge destination Handover – The medical notes are used as a social work handover.

14. Social Work role cont’d Sources of information contained in your assessment must be documented. The comprehensive psychosocial assessment is intended as a guide only and contains the information required by the SMTU and assist in efficient discharge planning. Intended outcome – Continuity of Social Work Service to the Unit

15. Psychosocial Assessment (headings) Family Cultural Employment Education Financial Residence History Trauma

16. Psychosocial Assessment cont’d Preliminary discharge plan Legal Pre-existing function Leisure interests Risk Factors Protective Factors Conclusion/Impression

17. In closing Research programs underway Lots of QI’s Some expected and unexpected outcomes Statistical spot light Important factor to remember The environment dictates service delivery ie how we work.

18. References State Major Trauma Unit, Operational Policy, January 2008 Brewin, Andres & Valentine, 2000 in Bonanno George A; Loss, Trauma, and Human Resilience; 2004; American Psychological Association Inc Vol.59, No 1, 20-28. Bonanno George A; Loss, Trauma, and Human Resilience; 2004; American Psychological Association Inc Vol.59, No 1, 20- 28. Australian Centre for Posttraumatic Mental Health; Australian Guidelines for the treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder; February 2007.