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Source
J Trauma. 2010 Dec;69(6):1350-61; discussion 1361
Publication Type
Article
Date
Dec-2010
Author
Syed Morad Hameed
Nadine Schuurman
Tarek Razek
Darrell Boone
Rardi Van Heest
Tracey Taulu
Nasira Lakha
David C Evans
D Ross Brown
Andrew W Kirkpatrick
Henry T Stelfox
Dianne Dyer
Mary van Wijngaarden-Stephens
Sarvesh Logsetty
Avery B Nathens
Tanya Charyk-Stewart
Sandro Rizoli
Lorraine N Tremblay
Frederick Brenneman
Najma Ahmed
Elsie Galbraith
Neil Parry
Murray J Girotti
Guiseppe Pagliarello
Nancy Tze
Kosar Khwaja
Natalie Yanchar
John M Tallon
J Andrew I Trenholm
Candance Tegart
Ofer Amram
Myriam Berube
Usmaan Hameed
Richard K Simons
Author Affiliation
Research Committee of the Trauma Association of Canada, Calgary, Alberta, Canada. morad.hameed@vch.ca
Source
J Trauma. 2010 Dec;69(6):1350-61; discussion 1361
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Canada
Catchment Area (Health)
Health Services Accessibility
Humans
Questionnaires
Rural Population - statistics & numerical data
Trauma Centers
Travel
Abstract
Trauma is a leading cause of morbidity, potential years of life lost and health care expenditure in Canada and around the world. Trauma systems have been established across North America to provide comprehensive injury care and to lead injury control efforts. We sought to describe the current status of trauma systems in Canada and Canadians' access to acute, multidisciplinary trauma care.
A national survey was used to identify the locations and capabilities of adult trauma centers across Canada and to identify the catchment populations they serve. Geographic information science methods were used to map the locations of Level I and Level II trauma centers and to define 1-hour road travel times around each trauma center. Data from the 2006 Canadian Census were used to estimate populations within and outside 1-hour access to definitive trauma care.
In Canada, 32 Level I and Level II trauma centers provide definitive trauma care and coordinate the efforts of their surrounding trauma systems. Most Canadians (77.5%) reside within 1-hour road travel catchments of Level I or Level II centers. However, marked geographic disparities in access persist. Of the 22.5% of Canadians who live more than an hour away from a Level I or Level II trauma centers, all are in rural and remote regions.
Access to high quality acute trauma care is well established across parts of Canada but a clear urban/rural divide persists. Regional efforts to improve short- and long-term outcomes after severe trauma should focus on the optimization of access to pre-hospital care and acute trauma care in rural communities using locally relevant strategies or novel care delivery options.
PubMed ID
20838258 View in PubMed
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The electronic Trauma Health Record: design and usability of a novel tablet-based tool for trauma care and injury surveillance in low resource settings.

https://arctichealth.org/en/permalink/ahliterature105545
Source
J Am Coll Surg. 2014 Jan;218(1):41-50
Publication Type
Article
Date
Jan-2014
Author
Eiman Zargaran
Nadine Schuurman
Andrew J Nicol
Richard Matzopoulos
Jonathan Cinnamon
Tracey Taulu
Britta Ricker
David Ross Garbutt Brown
Pradeep Navsaria
S Morad Hameed
Author Affiliation
Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
Source
J Am Coll Surg. 2014 Jan;218(1):41-50
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
British Columbia
Databases, Factual
Developed Countries
Developing Countries
Electronic Health Records
Feasibility Studies
Health Resources
Humans
Internet
Mobile Applications
Pilot Projects
Population Surveillance - methods
Software Design
South Africa
Traumatology
User-Computer Interface
Wounds and Injuries - diagnosis - therapy
Abstract
Ninety percent of global trauma deaths occur in under-resourced or remote environments, with little or no capacity for injury surveillance. We hypothesized that emerging electronic and web-based technologies could enable design of a tablet-based application, the electronic Trauma Health Record (eTHR), used by front-line clinicians to inform trauma care and acquire injury surveillance data for injury control and health policy development.
The study was conducted in 3 phases: 1. Design of an electronic application capable of supporting clinical care and injury surveillance; 2. Preliminary feasibility testing of eTHR in a low-resource, high-volume trauma center; and 3. Qualitative usability testing with 22 trauma clinicians from a spectrum of high- and low-resource and urban and remote settings including Vancouver General Hospital, Whitehorse General Hospital, British Columbia Mobile Medical Unit, and Groote Schuur Hospital in Cape Town, South Africa.
The eTHR was designed with 3 key sections (admission note, operative note, discharge summary), and 3 key capabilities (clinical checklist creation, injury severity scoring, wireless data transfer to electronic registries). Clinician-driven registry data collection proved to be feasible, with some limitations, in a busy South African trauma center. In pilot testing at a level I trauma center in Cape Town, use of eTHR as a clinical tool allowed for creation of a real-time, self-populating trauma database. Usability assessments with traumatologists in various settings revealed the need for unique eTHR adaptations according to environments of intended use. In all settings, eTHR was found to be user-friendly and have ready appeal for frontline clinicians.
The eTHR has potential to be used as an electronic medical record, guiding clinical care while providing data for injury surveillance, without significantly hindering hospital workflow in various health-care settings.
PubMed ID
24355875 View in PubMed
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A population-based analysis of injury-related deaths and access to trauma care in rural-remote Northwest British Columbia.

https://arctichealth.org/en/permalink/ahliterature142241
Source
J Trauma. 2010 Jul;69(1):11-9
Publication Type
Article
Date
Jul-2010
Author
Richard Simons
Penelope Brasher
Tracey Taulu
Nasira Lakha
Nadine Molnar
Nadine Caron
Nadine Schuurman
David Evans
Morad Hameed
Author Affiliation
Department of Surgery, Trauma Services, Vancouver General Hospital, Vancouver, British Columbia, Canada. richard.simons@vch.ca
Source
J Trauma. 2010 Jul;69(1):11-9
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
British Columbia - epidemiology
Emergency Medical Services - statistics & numerical data
Focus Groups
Health Services Accessibility - statistics & numerical data
Humans
Patient Discharge - statistics & numerical data
Registries - statistics & numerical data
Retrospective Studies
Rural Population - statistics & numerical data
Trauma Centers - organization & administration - statistics & numerical data
Treatment Outcome
Wounds and Injuries - mortality
Abstract
Injury rates and injury mortality rates are generally higher in rural and remote communities compared with urban jurisdictions as has been shown to be the case in the rural-remote area of Northwest (NW) British Columbia (BC). The purpose of study was to identify: (1) the place and timing of death following injury in NW BC, (2) access to and quality of local trauma services, and (3) opportunities to improve trauma outcomes.
Quantitative data from demographic and geographic databases, the BC Trauma Registry, Hospital discharge abstract database, and the BC Coroner's Office, along with qualitative data from chart reviews of selected major trauma cases, and interviews with front-line trauma care providers were collated and analyzed for patients sustaining injury in NW BC from April 2001 to March 2006.
The majority of trauma deaths (82%) in NW BC occur prehospital. Patients arriving alive to NW hospitals have low hospital mortality (1.0%), and patients transferring from NW BC to tertiary centers have better outcomes than matched patients achieving direct entry into the tertiary center by way of geographic proximity. Access to local trauma services was compromised by: incident discovery, limited phone service (land lines/cell), incomplete 911 emergency medical services system access, geographical and climate challenges compounded by limited transportation options, airport capabilities and paramedic training level, dysfunctional hospital no-refusal policies, lack of a hospital destination policies, and lack of system leadership and coordination.
Improving trauma outcomes in this rural-remote jurisdiction requires a systems approach to address root causes of delays in access to care, focusing on improved access to emergency medical services, hospital bypass and destination protocols, improved transportation options, advanced life support transfer capability, and designated, coordinated local trauma services.
PubMed ID
20622573 View in PubMed
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