Speech notes to launch Midland Regional Trauma System

  • Tony Ryall

Thank you for the introduction, Dr Christey. 

Thanks for inviting me here today to attend the launch of the Midland Regional Trauma System.

It is largely due to Dr Christey that we are all here today launching the first organised system of trauma care delivery in New Zealand. 

Getting this far is due in large part to his efforts.

As Dr Christey has explained, trauma patients are a very vulnerable group with complex needs. 

Trauma injuries are the leading cause of death in the first 50 years of life.

To survive - with the best possible outcome - a major trauma victim  requires specialised and coordinated care. 

How it will work

Our hospitals and health professionals are exceptional - but the people behind the Midland Regional Trauma System believe we can do better for our major trauma patients.  

For example a young fellow crashes his car at high speed on a Saturday night.  

A tragic but common occurrence around New Zealand. 

The paramedics pick him up and admit him to ED.  He has serious head and internal injuries, and quite a few broken bones.

In a hospital without a trauma system, the doctors and nurses will give him the highest quality of care. No question about that.

He'll be admitted to the single organ subspecialty that will deal with his most prominent injury - and since our subspecialty services are of the highest quality - they will do that well.

But our crash victim has serious multiple injuries - he may have been transferred to a bigger hospital -  and he is particularly vulnerable to time delays and any deviation in best practice.  

In a hospital without a dedicated trauma system - where different teams are doing excellent work separately - our young crash victim may face delays and he may not receive optimal treatment for his other injuries.

A dedicated trauma team working to a system however, will make sure he gets the right treatment for all his injuries in the right place at the right time.

They'll organise that transfer without delay to another hospital if he needs it and make sure there are no delays.

They'll design a co-ordinated wrap-around treatment plan for him.

The customised plan will map out the appropriate, timely and seamless care he will receive for every inch of his journey to recovery and rehabilitation.

It will be monitored daily.

A trauma specialist nurse and a consultant with trauma expertise will work together in each DHB to support and advise staff daily where appropriate, and work with the clinical teams to make sure all the patient's needs are met. 

It will mitigate risks and resolve potential problems before they come up.

They'll be supported by the core trauma system group when required.

The guiding principle of Midland Trauma System throughout is that the patient and their family come first. 

The trauma nurse specialist will be a constant presence - acting as clinical expert, professional guide and advocate for the patient and his or her family.

All this will make a crucial difference to the patient's recovery and to his family during one of the worst times a family can go through.  

Longer Term Benefits

The Midland RTS will customise patient care, reduce waiting and transfer times and improve patient outcomes. 

But it'll also create longer term benefits.

As Dr Christey has described, the Midland RTS is an evidence-based approach. 

It is founded on sound principles that have been developed as trauma systems have steadily grown around the world.

In each of the five DHBs, the specialised nurses and doctors will observe , record and act on quality or care issues with each trauma patient.

They'll be supported in that by the Midland Regional Trauma System core group.

The detailed data on each patient will make a significant difference to that patient's recovery.   

It will also add to the Midland Regional Trauma System data registry.

That will be a valuable tool for resolving issues, improving quality and ultimately informing resource planning and preventative strategies across the region.  

Resolute Commitment

The Midland Regional Trauma System builds on the Emergency Care Coordinating Teams , including the Midland ECCT.

But it goes further. This is a major paradigm change in the care of complex patients.

It is going to require resolute commitment from DHBS to achieve the goals.

It is expected that DHBs will provide adequate support for the establishment of clinical trauma teams in each of their districts - and maintain them on an ongoing basis.

The Midland Regional Trauma System will be highly vulnerable to minor shifts in DHB Managers and budgets and DHBs should be vigilant.  

DHBs will also need to provide resources for the training courses and education which will be available to staff and others as required - especially during the start - up first two years.

The Government is committed to much greater regional collaboration. That is the way we can future proof vulnerable services and provide certainty for New Zealanders.

The Midland Regional Trauma System is such a collaboration.

It is a clinical programme that links multiple services across the region with a common goal: to provide the best care leading to the best outcomes for trauma patients and their families. 

Clinical Networks

This Government is also serious about re-engaging doctors and nurses in the running of front line health services, not just talking about it.

The Midland RTS is a good example of a collaborative clinical network making a difference.

Clinical networks strengthen clinical leadership and engagement, and improve service planning at district, regional and national levels. 

The Midland RTS will save or salvage the lives of seriously injured people across the region.

Cost and Life Saving

I am advised Waikato hospital has been operating under this system for several years already, and this has saved approximately 14 lives per year.

That is an excellent outcome.

The project is also expected to be cost effective with projected savings of $30,000 per life saved.

That is also good news.

Improving efficiencies means we will have more resources freed up to spend on improving other frontline services. 

This is an example of the Government's priorities of regional collaboration and clinical leadership at their best.

DHBs will be expected to demonstrate resolute commitment to the Midland RTS project in the short and long term so that regional objectives of comprehensive and cost effective care of trauma patients and their families be achieved for the good of all.

National system for Trauma Care

It is also to be hoped the system will provide a potential template for further regional systems, or for a national system of trauma care. 

Your experiences, and the lessons learnt will mean you will be some of the best people to look to for ideas and innovations on how to address the challenges of trauma.

At present, the National Health Board and ACC staff are working jointly with trauma specialists to provide advice on a proposal for the establishment of a national trauma service.  I'll be very interested to see the outcome of this work.

In closing, I would like to acknowledge the hard work that you do every day for your patients.  As we all know, trauma is an immensely challenging and high pressure specialty.

As Dr Christey told the Waikato Times  - this is not work for the faint hearted but " we don't give up". 

You haven't.

Thank you for your commitment and foresight in developing this system.  And thank you again for giving me the opportunity to speak to you here today.