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University Hospital Wishaw (UHW) was identified as a STAG mortality outlier for 2017 – 2019 inclusive.
As a result, a high-level multidisciplinary mortality review process of all trauma deaths was conducted. This is now established as an essential part of the UHW Major Trauma annual clinical governance process.
These annual mortality reviews identified three key areas for quality improvement initiatives due to the excess mortality demonstrated:
The quality improvement initiatives commenced during 2021 and coincided with the employment of the NHS Lanarkshire Major Trauma Coordinator who has driven them forward. The projects were supported by an extensive education programme for medical, nursing and AHP staff as well as continued ward support.
These interventions have led to significant improvements in mortality in both patient groups,
It is highly encouraging that in the STAG 2024 Annual Report, UHW were no longer Scottish mortality outliers for 2021 – 2023 inclusive. This sustained improvement in mortality demonstrated the case for an additional Major Trauma Coordinator to allow expansion of the service.
Introduction by National Clinical Lead
Annual report time arrives once again, and in this new style of presentation my superlatives for the work of all who support the continued work, development and improvements of the Scottish Trauma Network will be brief. This is just as well, as the resources of my thesaurus begin to abate.
It is now 5 years since we convened and commenced our program of work to build and implement an entirely new clinical network of acute care and long-term rehabilitation for Scotland’s most seriously injured. August 30th 2021 witnessed the completion of Phase I with delivery of the fully operational end product. At time of writing, we run smoothly and successfully in the best traditions of “National Collaborative Pragmatism”.
All of this achieved of course, against the backdrop of complications presented to us by the pandemic. A remarkable achievement now recognised and acclaimed at the highest levels of the NHS, the Scottish Government, and national and international media.
This hard-earned and well-deserved reputation requires stiffening of the sinews and strengthening of resolve to be maintained, for us to progress further as we contribute well beyond our remit to the Remobilisation of the NHS in Scotland.
Thus, now begins Phase II, where we plan to tell the story using data, to raise standards for the future, and to demonstrate the sustained improved outcomes for patients, their families, their communities and the nation as a return on the visionary investment of these past 5 years.
The full report can be seen here
Martin McKechnie
National Clinical Lead
Scottish Trauma Network
The eighth report by the Scottish Trauma Audit Group (STAG) since 2011 can be found on the Public Health Scotland website. Compliance with a subset of the Scottish Trauma Network Key Performance Indicators, case-mix adjusted mortality and Patient Reported Outcome Measures (PROMs) are within part one of the report. Part two and three provide a comprehensive summary of injuries and the patient journey for both adults and paediatrics respectively.
Introduction from National Clinical Lead
2020 – 21 has been variously difficult, challenging, interesting and rewarding across the many spheres of activity, development and progress for the Scottish Trauma Network (STN). This Annual Report sits alongside and complements the imminent publication of the Scottish Trauma Audit Group’s (STAG) Annual Report for the same period. They both reveal and explore much of the data, operational and patient-centred clinical stories around this past year’s extraordinary activity within the Network. Set against the pandemic backdrop, the strong message coming from these reports is one of resilience, maintained high-quality patient care and an above-and-beyond spirit of collaboration and pragmatism on a national scale. That key performance and outcome measures have been delivered, yet alone maintained and improved in several areas, is worthy of acknowledgment and appreciation. The reports further explore much of our presentation and discussion at the Scottish Parliament Health and Sport Select Committee in January 2021.
There are many examples to celebrate, but I take this opportunity to highlight and express admiration and gratitude to the Scottish Ambulance Service, the ScotSTAR and EMRS transport and retrieval arms, and the newer Advanced Paramedics in Critical Care red teams therein. Their relentless and complex work in supporting and enabling the pandemic response across trauma and all related critical care services has been inspiring. The STN and patients are thankful to them beyond words. These thanks are expressed in equal measure to all staff and services recruited in good faith and optimism to the STN, yet who found themselves redeployed and reallocated to support the response in other vital areas such as Emergency Departments, Trauma Wards which became Covid High Dependency Units and Critical Care areas, and Theatres.
More interesting still is what much of this tells us about the improved access we now have to data and patient-reported measures. These are the mainstays of why the STN does what it does. With STN Trauma and STAG coordinators now embedded in our hospitals, we are able to reach more broadly across and deeper into the care of trauma patients than ever before. The resulting information and its analysis will further “tell the story” as we move beyond delivery of Phase I later this year, with the opening of the Major Trauma Centres at the Queen Elizabeth University Hospital in Glasgow, and the Royal Infirmary of Edinburgh, and the operational delivery of the Regional Networks in the West and South East of Scotland. These final pieces of the jigsaw will complete the national picture alongside the MTCs at Aberdeen Royal Infirmary and Ninewells Hospital in Dundee opened in 2018, supporting all the component services within our Regional Networks.
It is to be hoped that by the time of next year’s report we will be able to reflect upon a time of challenge and change with a more secure feel for what the immediate and medium-term future holds for our service. This learning allows us to reenergise and reconvene with strength, determination and the confidence that comes from surmounting such a significant hurdle.
Every person and every collaborative and linked service involved, described and embraced within the following pages is deserving of the greatest of gratitude and recognition. We are indebted to you all.
The full report can be seen here.
Martin McKechnie
National Clinical Lead
Scottish Trauma Network
Registration Now Open!!
Online registration for the STAG Quality Improvement Workshop on 1st March 2019 is now open and can be accessed here.
In order to cover some of the cost, there will be a fee of £80 for Consultants and £40 for other delegates.
This workshop will be facilitated by Nancy Dixon who is the Director of Strategic Services at Healthcare Quality Quest. Nancy is a specialist in the subject of measuring and improving the quality and safety of healthcare services and leads the development and consultancy work at HQQ.
More information can be found on the registration page at the link above.
The innovative and novel app has been designed in collaboration with clinicians within the Queen Elizabeth University Hospital, Glasgow. The initial phases of Emergency Department (ED) care are critical to outcome and dependant on effective team working to deliver multiple often simultaneous critical interventions. New tools are required to integrate and align health care delivery within the complex systems within the ED. The development of the major trauma app will support clinicians to achieve three key aims:
1- Robust data collection to enable forensic analysis of clinical care processes
2- Cognitive aids to support and prompt clinicians during trauma care delivery
3- Provision of a reliable framework to deliver care aligned to the highest clinical standards to reduce variability
Daysix, the industry partner, has immersed themselves attending courses and simulation events developing a deep understanding of trauma care. NHS GG&C eHealth provided a critical role as the civic partner providing initial funding in conjunction with the Digital Health Institute, in addition to technical specialist advice and guidance on integration standards. Further funding secured from the STN will enable the app to be developed, integrated and deployed within the network. We are looking forward to demonstrating the impact of the app on clinical care by enhancing teams ability to deliver excellent care.
If you would like to find out more about the app, please contact David.Lowe@glasgow.ac.uk