1. Welcome The Trauma Audit & Research Network (TARN) Data Collection session

2. Today Background Inclusion criteria Identifying cases
Quality Assurance: Data Accreditation and Completeness
Data Entry
Injury scoring & calculating the ISS (Injury Severity Score)
Ps14 (Probability of Survival) & Hospital Survival rate (Ws)

3. TARN Largest European Trauma registry
Over 500,0000 injured patients with more than 46,000 injured children
Review and monitor processes of care & outcomes
Report to trusts & commissioners
Inform changes in practice: Improve Trauma Care

4. TARN Team Administrator/PA: Gemma Reed Coding team: Laura Blakeley
Naomi Brook
Paul Gembarski
Phil Hammond (Supervisor)
Corinne Tilley
Victoria Zagrodnik
Training & Audit Manager:
Laura White
Financial Accountant:
Jean Hodkinson
Projects Manager:
Victoria Phillipson
Registry Manager:
Tom Jenks
Systems Analysts:
Marisol Fragoso
Sophie Jones
Tom Lawrence
Mike Young
Medical Statistician:
Omar Bouamra
Executive Director:
Maralyn Woodford
Operations Director & Deputy to the Executive Director:
Antoinette Edwards

5. TARN Academic: University’s of Manchester, Sheffield and Leicester
Non Profit making
100% membership in England and Wales
Members in Southern Ireland, Denmark and Switzerland
Clinically led
BOARD and Executive Committees
Research and Audit Committees

6. TARN Research Committee
Director: Professor Fiona Lecky, Clinical Professor & Honorary Consultant in Emergency Medicine (EM) at ScHARR and Salford Royal NHS Foundation Trust
11 members including: Executive Director, Medical Statistician, Registry Manager, Data Analysts, Clinical Research Advisor, Research Fellows, Pre-hospital research advisor.
Meet Monthly to review:
Ongoing Research projects
New Research proposals
Meetings & teleconferences with researchers

7. Have you got a Research idea?
Complete Request form or

8. TARN Audit Committee
Director: Dr Dhushy Kumar, Consultant in Critical Care, Pre-hospital Care and Anaesthesia at University Hospital Coventry.
15 members - National representation: Clinicians, TNCs, Data Coordinators, Rehabilitation, TARN Executive Director, TARN Registry & Training Managers
Meet 6 times per year to discuss audit changes
Have you got an audit request?

9. The beginning
1988: Report by RCS: The Management of patients with Major Injuries
“Serious deficiencies in the management of severely injured patients”
Enhancing pre-hospital care, ensuring appropriate medical intervention
Rapid transfer to the best local facility
Assessing the use of helicopters
Adopting ATLS principles
Integrating trauma services within and between hospitals
Investing in rehabilitation services
System of Auditing & Research
TARN Established in 1989: Based Salford Royal Hospital

10. Major Trauma reports
2000: Joint report by RCS and BOA: Better Care for the Severely Injured
“Standards & outcome measures developed, against which institutions can audit the outcome of treatment”
2007: NECPOD: Trauma: Who cares?
“Given the importance of evaluation of processes and outcomes in the trauma patient, all units providing treatment for severely injured patients should contribute to the Trauma Audit & Research Network”

11. Major Trauma Network development
Public Accounts Committees March 2010
Chief Executive of NHS on public record as
Committing to development of Major Trauma Networks across England by end of 2011/12
Mandating TARN membership
Most Major Trauma Networks “live” April 2012

12. 17 Major Trauma Network and Major Trauma Centres (MTCs)
Greater Manchester Network
Salford Royal Hospital
Wythenshawe Hospital
Manchester Royal Infirmary
Royal Manchester Children’s Hospital
Merseyside & Cheshire Network
University Hospital of Aintree
Walton Centre for Neurology
Royal Liverpool University Hospital
Alder Hey Children’s Hospital
South Cumbria & Lancashire Network
Royal Preston Hospital
Northern
James Cook University Hospital
Royal Victoria Infirmary, Newcastle
North East
Yorkshire & Humber
Leeds General Hospital
Sheffield Teaching Hospital NHS Trust
Sheffield Children’s Hospital
Hull Royal Infirmary
S. Cumbria & Lancashire
Yorkshire &
the Humber
Greater Manchester
East Midlands Network
Nottingham University Hospital
Merseyside & Cheshire
East
Midlands
East of England Network
Addenbrooke’s Hospital
West Midlands Network
North West Midlands Network
Royal Stoke University Hospital
Centre of England Network
University Hospital of Coventry & Warwickshire
Birmingham and the Black Country Network
Queen Elizabeth Hospital, Birmingham
Birmingham Children’s Hospital
N.W. Midlands
Centre of England
East of England
Birmingham & Black Country
NE London Network
Royal London Hospital
NW London Network
St. Mary’s Hospital
SE London Network
Kings College Hospital
SW London Network
St. George’s Hospital
Thames Valley
London
Severn
Sussex
Peninsula
Wessex
Severn Network
Southmead Hospital
Bristol Royal Children’s Hospital
Peninsula Network
Derriford Hospital
Thames Valley Network
John Radcliffe Hospital
Wessex Network
Southampton General Hospital
Sussex Network
Royal Sussex County Hospital

13. On scene patient triage: Positive
What has changed
On scene patient triage: Positive
Direct to MTC
(< 45 mins travel)
TARN
Indirect Transfer
(>45 mins, time critical intervention)
MAJOR TRAUMA CENTRE
Consultant led trauma team
Immediate operating theatre
All specialties: neurosciences
Immediate CT scan
Interventional radiology
Specialist critical care
Trauma Unit
Trauma team
Immediate CT Resuscitate, Assess & ? Transfer

14. Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Additional payment made to Major Trauma Centres only
Based on Injury Severity
Moderate Trauma (ISS>8): £1,500
Major Trauma (ISS>15): £3,000
Payment conditional on Best Practice criteria being met

15. Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Level 1 (Moderate Trauma): Injury Severity Score >8
TARN data is completed and dispatched within 25 days of discharge/death.
Rehabilitation prescription completed for each patient & recorded on TARN.
Tranexamic acid (TXA) administered within 3 hours of injury for any patient receiving blood: Exclusions: Isolated Serious (Severity 3+) Head injuries
Non-emergency transfers: Patient must be admitted to MTC within 2 calendar days of referral from Trauma Unit

16. Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Level 2: (Major Trauma) Injury Severity Score >15
Level 1 criteria and following additional criteria met:
Direct admissions or emergency (<12 hour) transfers: Patient must be seen by Consultant within 5 minutes of arrival
Direct admissions: Head CT performed within 1 hour of arrival for patients with SeeAIS1+ Head injury & GCS <13 in ED (or intubated pre-hospital)
Exclusions: patients requiring emergency surgery or interventional radiology within 1 hour of admission
Additional BPT fields added to TARN database

17. Web-based Trauma Data Collection
Electronic data collection & reporting system
Secure on-line system through patient pathway
Data Collection AND Reporting

18. Separate Reporting Training session
TARN Reports
Clinical Reports: Published March, July, November. notification to all users
Performance Comparisons: Updated March, July, November. Available to all.
Online Reports: Self produced reports
Ad Hoc analysis: Available any time
Separate Reporting Training session

19. Questions?