Participants in the Achieving Zero Preventable Deaths conference. Front row, from left: Timothy C. Fabian, MD, FACS; Michael F. Rotondo,
MD, FACS, Medical Director, ACS Trauma Programs; Dr. Stewart; Dr. Winchell; Dr. Nathens; Dr. Bulger; and Jerry Jurkovich, MD, FACS.
A number of new recommendations for achieving
zero preventable deaths emerged from the meeting.
Eileen Metzger Bulger, MD, FACS, a member of the
COT Executive Committee, led a session on research
funding and direction. Session participants agreed
that to achieve zero preventable deaths in trauma, we
need to develop a well-defined research agenda and
priorities to support advocacy efforts. The trauma
community will need to tear down the internal silos
of “bone, blood, burn, brain” and speak with a united
voice to advocate for a national trauma research
action plan and engage the public and trauma survivors in these efforts as well.
We also need to rethink the trauma center verification process. At present, hospitals may self-select
for approval as Levels I or II trauma centers based on
financial incentives, rather than demonstrated need
in their region. Furthermore, the present system is
time-consuming, expensive, and labor-intensive, both
for COT surveyors and for trauma centers. Meeting
participants suggested moving to outcomes-based
verification using the quality measurement model
centered on structure (staff, physical resources,
policies); process (whether medicine was practiced
properly); and outcome.
Meeting participants also agreed that trauma professionals need to do a better job of collecting and
analyzing trauma care data. The importance of data
was heavily emphasized in a session led by Avery B.
Nathens, MD, PhD, FACS, FRCSC, another COT
leader and Medical Director, ACS Trauma Quality
Programs. Participants examined impediments to
data linkage across the continuum of trauma care.
Suggestions regarding how to overcome these barriers, including use of uniform trauma identification
bands, were offered. Speakers examined evidence-based information and suggested strategies for
establishing a national trauma system that incorporates clinical outcomes to reduce preventable injury
and disability in the trauma patient population. We
discussed methods for linking data and transitioning
patients between facilities, as well as the development
of a methodology to track trauma patients from injury
Speakers suggested the development of a National
Trauma Action Plan, which would articulate a unified
research agenda across the continuum of care, define
the “ask” for financial investment, set a strategy for