The report is comprehensive and broad in scope, calling for the development of a national trauma care
system and highlighting 11 specific recommendations. These recommendations can be summarized
•The White House should set a national aim of
achieving zero preventable deaths after injury and
minimizing trauma-related disability.
• The White House should lead the integration of military and civilian trauma care to establish a national
trauma care system. This initiative would include
assigning a locus of accountability and responsibility that would ensure the development of common
best practices, data standards, research, and workflow
across the continuum of trauma care.
•The Secretary of Defense should ensure combatant
commanders and the Defense Health Agency (DHA)
Director are responsible and held accountable for the
integrity and quality of the execution of the trauma
care system in support of the aim of zero preventable deaths after injury and minimizing disability.
To this end:
Ȗ The Secretary of Defense also should ensure the
DHA Director has the responsibility and authority
and is held accountable for defining the capabili-
ties necessary to meet the requirements specified by
the combatant commanders with regard to expert
combat casualty care personnel and system support
Ȗ The Secretary of Defense should hold the Secretaries of the military departments accountable for fully
supporting the DHA in that mission.
Ȗ The Secretary of Defense should direct the DHA
Director to expand and stabilize long-term support
for the Joint Trauma System so its functionality can
be improved and used across all combatant com-
mands, giving players in the system access to timely
evidence, data, educational opportunities, research,
and performance improvement activities.
• The Secretary of the U.S. Department of Health and
Human Services (HHS) should designate and fully
support a locus of responsibility and authority within
the department for leading a sustained effort to achieve
the national aim of zero preventable deaths after injury
and minimizing disability. This leadership role should
include coordination with governmental (federal, state,
and local), academic, and private-sector partners and
should address care from the point of injury to rehabilitation and post-acute care.
• The Secretary of HHS and the Secretary of Defense,
together with their governmental, private, and academic
partners, should work jointly to ensure that military and
civilian trauma systems collect and share common data
spanning the continuum of care. Within that integrated
data net work, measures related to prevention, mortality,
disability, mental health, patient experience, and other
intermediate and final clinical and cost outcomes should
be made readily accessible and useful to all relevant providers and agencies.
• To support the development, continuous refinement, and
dissemination of best practices, the designated leaders of
the recommended national trauma care system should
establish processes for real-time access to patient-level
data from across the continuum of care and just-in-time
access to high-quality knowledge for trauma care teams
and those who support them.
• To strengthen trauma research and ensure that the
resources available for this research are commensurate with the importance of injury and the potential for
improvement in patient outcomes, the White House
should issue an Executive Order mandating the establishment of a National Trauma Research Action Plan
requiring a resourced, coordinated, joint approach to
trauma care research across the Department of Defense
(DoD), HHS (including the National Institutes of
OCT 2016 BULLETIN American College of Surgeons