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A Systematic Approach for Regional Trauma System Development

Guixi Zhang, Gilberto Ka Kit Leung, Chung Mau Lo, Richard Kwong-Yin Lo, John Wong, Ronald V. Maier, Eileen M. Bulger, Joe King Man Fan*, Xiaobing Fu*

Background: International experiences have shown that trauma system development significantly reduces preventable deaths and disabilities. During the 9-year study, the aim was to find solutions for trauma system development in Shenzhen, China, so as to reduce trauma mortality and morbidity.

Methods: Introducing the Advanced Trauma Life Support^® (ATLS^®) program to mainland China was started in 2013. A geospatial analysis of traumatic incidents was conducted in 2015. A regional trauma center was illustrated as an example to be used as a reference. The trauma audit meeting was introduced as an approach to continuous trauma quality improvement. The Shenzhen Trauma Surgery Committee was established to finalize the plan for designation of trauma care hospitals. The American College of Surgeons Trauma System Development Guidelineswere translated into Chinese.

Results: ATLS^® provider course was held in Shenzhen and totally 221 doctors received training. A regional trauma center where adopted ATLS^® principles as the standard for trauma resuscitation and early trauma care, with results showing significant improvements in trauma team organization, trauma resuscitation, definitive trauma care and a significant reduction in mortality among major trauma patients. The trauma audit meeting was introduced to 8 hospitals. A new trauma system plan for Shenzhen was set up and a consensus was reached on trauma center designation. The American College of Surgeons' “Resources for Optimal Care of the Injured Patient” was translated into Chinese and published in November 2020. Six trauma networks are recommended combined with geospatial analysis technology and major trauma monitor system was establishedin November 2021.

Conclusion: The systematic approach for the development of a regional trauma system includes: trauma care training for providers, geospatial analysis of regional trauma accidents, development of standardized trauma center, designation of regional trauma center, development of trauma quality improvement program and establishment of major trauma monitor system. Shenzhen has been demonstrated as a successful example and this practical approach can be replicated in other countries or regions seeking to establish a trauma system.