The Commission has funded 12 scholarships to participate in a trauma quality improvement facilitator course, delivered by Ko Awatea in 2020.
The course began in March with a two-day workshop at Ko Awatea. Due to the impact of COVID-19 the course was put on hold from late March until July. The format of the course was adjusted for online delivery only and extended through until the end of February 2021, in consideration of the lost time due to COVID. As at early November, participants are now more than halfway way through the course and well into the testing phase with their quality improvement projects.
Applicants must have an active role in the management of trauma patients and be involved at a hospital or regional level in the organisation of multidisciplinary trauma care delivery.
During the 10-month course participants are taught quality improvement theory and be supported to practically apply that theory by completing a project. The project must be strategically important to their organisation and to their patients and communities, and related to one of the areas below.
The three areas of focus are:
- critical haemorrhage
- trauma rehabilitation
- severe traumatic brain injury.
On completion of the course, participants will have the skills and knowledge to be able to advise and guide improvement activities in their organisations, resulting in safer care for people and their whānau.
Visit the National Trauma Network website for more information.
Summary of projects
Questions about any of these projects can be sent to help@majortrauma.nz.
| Region | DHB location | Project name | Project aim | Key outcome/comment |
| Northern | Northland DHB | Reduce pain-related readmission rates of major trauma patients at Northern DHB | By February 2021 we will increase the days between major trauma patients representing for pain by 50 percent to a median of 100 days between representations | The main cause of unplanned representations for this patient group is uncontrolled pain. This is the cause of over 25 percent of all major trauma representations (2016–19) |
| Northern | Auckland DHB – Starship Hospital | Standardisation of concussion screening in children admitted and discharged over the weekend with head trauma at Starship Children’s Health | One hundred percent of children admitted and discharged over the weekend at Starship Children’s Health with head trauma receive concussion screening by February 2021 | Concussion can have significant impact on a child’s cognitive and emotional development. Screening and early detection enable correct rehabilitation services to be put in place to manage the condition appropriately |
| Midland | Waikato DHB | Improving the major trauma patient and whānau experience – transitioning between clinical areas at Waikato Hospital | Increase the instance of major trauma patients and their whānau reporting positive experiences by 50 percent when transitioning between clinical areas at Waikato Hospital by end February 2021 | To make major trauma patients and their whānau more confident, informed and involved when transitioning from one clinical area to another |
| Midland | Waikato DHB | Trauma reach clinic | One hundred percent of patients discharged from the Waikato trauma team straight home receive a follow up from the trauma reach clinic by February 2021 | The trauma reach clinic does not have a known inclusion criteria, structured template and evaluation to increase quality and utilisation of the service |
| Midland | Midland Trauma System, Waikato DHB | Safety net screening | One hundred percent of patients seen in Waikato DHB trauma reach clinic to receive safety net plan screening by February 2021 | All patients reviewed in the trauma reach clinics will receive support for potential/actual complications |
| Midland | Bay of Plenty DHB | Trauma community transition | Reduce the number of readmissions and improve satisfaction with transition home for Māori men aged between 18–40 who have experienced traumatic injuries by March 2021 | Having a case manager involved during a hospital admission assists with improved communication between patients, their whānau and the team and are a point of contact for the patient if they have any queries about their care or discharge plan |
| Central | Capital Coast DHB | Improving the management of blood product administration in major trauma haemorrhage | Decrease the percent of patients who die from complications related to not following best practice processes in haemorrhaging trauma patients from 45 percent to <5 percent by July 2021 | Decrease in avoidable mortality and complications related to non-compliance with processes in haemorrhaging trauma patients |
| Central | MidCentral DHB | Preventable death from haemorrhage in trauma patients | Decrease the yearly mortality rates of haemorrhage-related deaths from trauma by 33 percent (n=3) at Palmerston North Hospital by February 2021 | Trauma patients presenting with haemorrhage are dying unnecessarily from either direct haemorrhage or multi organ failure once admitted to hospital |
| South Island | Nelson Marlborough DHB | Chest injury pathway project | Project aims to improve blunt chest injury care for all patients admitted to Nelson Marlborough Hospital (NMH). The goal is to develop and disseminate a chest injury pathway for all blunt chest injured patients admitted to NMH | Introducing rib fracture scoring, consistent care for chest injured patients in line with international best practice. Outcomes include improved times for pain relief and regional anaesthetic blocks, improved time to chest physiotherapy (rehabilitation), and reduced length of stay in hospital |
| South Island | Canterbury DHB | Enhancing the trauma patient’s journey and recovery for traumatic brain injury and rehab | By December 2020 there will be a concussion assessment clinic aligned to the trauma and neurosurgical outpatient clinics. Staffed by occupational therapists who will conduct assessments on all patients discharged from ED and identify who requires concussion clinic follow up | Clinic process will identify 100 percent patients who have discharged from the emergency department who have and identified head injury on an ACC45. Patients will receive a phone call and phone assessment. From this the occupational therapist will determine who needs to be reviewed in clinic and who requires a concussion referral or another intervention |
| South Island | Southern DHB | Te Ara Matatea | One hundred percent of Māori traumatic brain injury patients on rehab wards will be offered support from Māori health providers prior to discharge by February 2021 | Māori traumatic brain injury patients report the transition home to be difficult to navigate. Māori health providers in our district offer navigation support as well as a range of other services to assist with transition home and recovery. Currently these providers do not receive referrals from Southern DHB rehab wards – rehab ward staff report they are not aware of these services and do not know how to refer |
| Central region | Wellington Free Ambulance | Project Crimson – improving pre-hospital management of major traumatic haemorrhage | By April 2021 paramedics will be adequately trained and equipped to treat greater than 95 percent of patients with major traumatic haemorrhage within the Greater Wellington Region with an appropriate bundle of care designed to reduce mortality | Paramedics will have greater confidence in their training and equipment with regards to treating major traumatic haemorrhage. Compliance with recommended interventions and treatments will ultimately decrease preventable death from major traumatic haemorrhage |
Summary of projects
Questions about any of these projects can be sent to help@majortrauma.nz.
| Region | DHB location | Project name | Project aim | Key outcome/comment |
| Northern | Northland DHB | Reduce pain-related readmission rates of major trauma patients at Northern DHB | By February 2021 we will increase the days between major trauma patients representing for pain by 50 percent to a median of 100 days between representations | The main cause of unplanned representations for this patient group is uncontrolled pain. This is the cause of over 25 percent of all major trauma representations (2016–19) |
| Northern | Auckland DHB – Starship Hospital | Standardisation of concussion screening in children admitted and discharged over the weekend with head trauma at Starship Children’s Health | One hundred percent of children admitted and discharged over the weekend at Starship Children’s Health with head trauma receive concussion screening by February 2021 | Concussion can have significant impact on a child’s cognitive and emotional development. Screening and early detection enable correct rehabilitation services to be put in place to manage the condition appropriately |
| Midland | Waikato DHB | Improving the major trauma patient and whānau experience – transitioning between clinical areas at Waikato Hospital | Increase the instance of major trauma patients and their whānau reporting positive experiences by 50 percent when transitioning between clinical areas at Waikato Hospital by end February 2021 | To make major trauma patients and their whānau more confident, informed and involved when transitioning from one clinical area to another |
| Midland | Waikato DHB | Trauma reach clinic | One hundred percent of patients discharged from the Waikato trauma team straight home receive a follow up from the trauma reach clinic by February 2021 | The trauma reach clinic does not have a known inclusion criteria, structured template and evaluation to increase quality and utilisation of the service |
| Midland | Midland Trauma System, Waikato DHB | Safety net screening | One hundred percent of patients seen in Waikato DHB trauma reach clinic to receive safety net plan screening by February 2021 | All patients reviewed in the trauma reach clinics will receive support for potential/actual complications |
| Midland | Bay of Plenty DHB | Trauma community transition | Reduce the number of readmissions and improve satisfaction with transition home for Māori men aged between 18–40 who have experienced traumatic injuries by March 2021 | Having a case manager involved during a hospital admission assists with improved communication between patients, their whānau and the team and are a point of contact for the patient if they have any queries about their care or discharge plan |
| Central | Capital Coast DHB | Improving the management of blood product administration in major trauma haemorrhage | Decrease the percent of patients who die from complications related to not following best practice processes in haemorrhaging trauma patients from 45 percent to <5 percent by July 2021 | Decrease in avoidable mortality and complications related to non-compliance with processes in haemorrhaging trauma patients |
| Central | MidCentral DHB | Preventable death from haemorrhage in trauma patients | Decrease the yearly mortality rates of haemorrhage-related deaths from trauma by 33 percent (n=3) at Palmerston North Hospital by February 2021 | Trauma patients presenting with haemorrhage are dying unnecessarily from either direct haemorrhage or multi organ failure once admitted to hospital |
| South Island | Nelson Marlborough DHB | Chest injury pathway project | Project aims to improve blunt chest injury care for all patients admitted to Nelson Marlborough Hospital (NMH). The goal is to develop and disseminate a chest injury pathway for all blunt chest injured patients admitted to NMH | Introducing rib fracture scoring, consistent care for chest injured patients in line with international best practice. Outcomes include improved times for pain relief and regional anaesthetic blocks, improved time to chest physiotherapy (rehabilitation), and reduced length of stay in hospital |
| South Island | Canterbury DHB | Enhancing the trauma patient’s journey and recovery for traumatic brain injury and rehab | By December 2020 there will be a concussion assessment clinic aligned to the trauma and neurosurgical outpatient clinics. Staffed by occupational therapists who will conduct assessments on all patients discharged from ED and identify who requires concussion clinic follow up | Clinic process will identify 100 percent patients who have discharged from the emergency department who have and identified head injury on an ACC45. Patients will receive a phone call and phone assessment. From this the occupational therapist will determine who needs to be reviewed in clinic and who requires a concussion referral or another intervention |
| South Island | Southern DHB | Te Ara Matatea | One hundred percent of Māori traumatic brain injury patients on rehab wards will be offered support from Māori health providers prior to discharge by February 2021 | Māori traumatic brain injury patients report the transition home to be difficult to navigate. Māori health providers in our district offer navigation support as well as a range of other services to assist with transition home and recovery. Currently these providers do not receive referrals from Southern DHB rehab wards – rehab ward staff report they are not aware of these services and do not know how to refer |
| Central region | Wellington Free Ambulance | Project Crimson – improving pre-hospital management of major traumatic haemorrhage | By April 2021 paramedics will be adequately trained and equipped to treat greater than 95 percent of patients with major traumatic haemorrhage within the Greater Wellington Region with an appropriate bundle of care designed to reduce mortality | Paramedics will have greater confidence in their training and equipment with regards to treating major traumatic haemorrhage. Compliance with recommended interventions and treatments will ultimately decrease preventable death from major traumatic haemorrhage |
Last updated: 8th August, 2023
