Major Trauma Audit summary report 201

The Major Trauma Audit (MTA) was established by the National Office of Clinical Audit (NOCA) in 2013. This audit focuses on the care of the more severely injured patients in our healthcare system, across 26 trauma receiving hospitals.</p

Major Trauma Audit paediatric summary report 2014-2019

The Major Trauma Audit (MTA) was established by the National Office of Clinical Audit (NOCA) in 2013. This audit focuses on the care of the more severely injured patients in our healthcare system, across 26 trauma receiving hospitals. </p

Major trauma in older adults summary report 2017-2021

The Major Trauma Audit (MTA) was established by the National Office of Clinical Audit (NOCA) in 2013. This audit focuses on the care of the more seriously injured patients in our healthcare system, across 26 trauma receiving hospitals.  </p

Major Trauma Audit Report focussed on older adults 2017-2021

This report from the Major Trauma Audit (MTA) is focused on older adults, defined as those aged 65 years and over, with major trauma injuries. It will explore an in-depth analysis of 11,145 episodes of care between 2017 and 2021.  The MTA is a clinically led audit established by the National Office of Clinical Audit (NOCA) in 2013. It focuses on the care of the more severely injured trauma patients in Ireland’s healthcare system. In 2016, the MTA became the first national clinical audit endorsed by the National Clinical Effectiveness Committee (NCEC) and mandated by the Minister for Health. The methodological approach for the MTA was provided by the Trauma Audit and Research Network (TARN), which was based in the University of Manchester, United Kingdom until March 2024. Due to a cyberattack on the University of Manchester in July 2023, the TARN audit ceased data entry for 10 months and has now been migrated onto the National Health Service (NHS) England’s Outcomes and Registries Programme with the new title of National Major Trauma Registry (NMTR). Data entry will recommence from during 2024.  Twenty-six eligible hospitals have been participating in the MTA, and data have been collected on more than 35,000 patients. While the system was offline due to the cyberattack, data collection continued at hospital level on paper, and this data will be uploaded to the system during 2024. As there were no new data forthcoming, the MTA Governance Committee decided a focused report on older adults (aged 65 years and over) during 2017–2021 would be important. This was also in keeping with the aims and objectives of the audit: “To promote the use of the data for reflective clinical practice”.  The focus of this report is timely due to the publication of the Trauma System Implementation Programme Clinical Guidance Document: Management of Major Trauma in Older Adults (HSE, 2024) from the National Office for Trauma Services, Health Service Executive. The guidance describes 12 core evidence-based principles which all healthcare workers should implement when managing major trauma in older adults. Throughout the data chapters in this report, some of the relevant core principles are highlighted alongside the MTA data. It is important to reflect on how our system is performing against these core principles.  Older adults are the fastest-growing cohort of major trauma patients. In addition to having major trauma injuries, many older adults included in this report have additional comorbidities that make managing a major trauma more challenging. As the reconfiguration of the trauma system is under way in Ireland following the publication of A Trauma System for Ireland: Report of the Trauma Steering Group (Department of Health, 2018), details about subgroups of the major trauma population are essential for service planning. It is vital that services are age attuned for older adult patients to ensure they receive the right care and rehabilitation for their injuries. The loss of function and independence for older people is at jeopardy if the health service does not get this right.  Data from previous MTA reports (NOCA, 2022; NOCA, 2023b) have shown that older adults with major trauma are less likely to be recognised as having major injuries and therefore less likely to be pre-alerted, received by a trauma team or have an early assessment and management by a senior clinician than those aged 0–64 years. Outcomes for older adults with major trauma are also poorer than for their younger counterparts.  This report includes data from the 26 participating hospitals. Unless otherwise specified, the term ‘older adult’ will be defined throughout this report as those aged 65 years and over, and the younger major trauma cohort as those aged 0–64 years.  As has been stated in previous reports, the leading cause of major trauma is from low falls. Findings from this report will extend the understanding of the range of injuries associated with such incidents in an older adult population.  Opportunities for injury prevention and safety awareness have been highlighted in previous reports. A multifaceted, multi-agency approach to falls prevention is required at the population level in a similar way to the Road Safety Authority campaign to improve road safety. It is hoped that the data from this and previous reports will continue to inform the need for better safety measures in our homes, which are the most common setting of incidents causing injury. Some materials are already available on the NOCA website, including a home safety infographic, and a home safety checklist.  Each hospital is encouraged to use MTA reports for continuous quality improvement. Without the constant leadership provided by the hospital clinical leads for the MTA and the dedication and hard work of the audit coordinators, this audit would not be possible. The NOCA Executive Team and the MTA Governance Committee wish to thank the clinical leads, audit coordinators and staff in the participating hospitals for their continued commitment to and engagement with this audit. </p

Major Trauma Audit national report 2021

This is the seventh national report from the Major Trauma Audit (MTA). Since 2016, 26 eligible hospitals have been participating in the MTA and data have been collected on almost 33,500 major trauma patients. This report focuses on processes that impact outcomes for patients who sustained major trauma during 2021. Chapter 6, The Patient Journey, includes a focus on major trauma patients who required blood products between 2017 and 2021. The process of reconfiguring Ireland’s trauma system began while this report was being written, following the publication of A Trauma System for Ireland: Report of the Trauma Steering Group (Department of Health, 2018). The commitment to developing an integrated trauma system is welcomed by the MTA. The ongoing work to ensure that facilities and services are coordinated for the delivery of care of major trauma patients in Ireland within standardised pathways is acknowledged.  This report includes data from only 22 of the 26 participating hospitals. The effects of redeployment when contending with a fourth and fifth wave of a global pandemic alongside further disruption associated with the cyberattack on the Health Service Executive (HSE) and vacant posts left unfilled have resulted in data coverage which is below the optimum standard of 80%. The data coverage for all 26 hospitals was 68%, which represents a further reduction from 73% in 2020 and 83% in 2019 (NOCA, 2022). As four hospitals had no data entered for 2021, the data coverage for the 22 hospitals is 76%. The goal for future reports is to provide hospital-level reporting in MTA to drive quality through enabling hospitals to benchmark against peer hospitals.  The MTA has consistently shown that injuries in the home, especially low falls, comprise the most common cause of major injuries. More needs to be done to keep our population safe; therefore, we continue to advocate the use of public health messages on this issue, which can be obtained via the website of the National Office of Clinical Audit (NOCA). The hyperlinked documents are highlighted in blue throughout the text. The Major Trauma Audit National Report 2018, (NOCA, 2020) featured a home safety infographic, the Major Trauma Audit Paediatric Report 2014–2019 (NOCA, 2021) featured an injury prevention infographic for children and the Major Trauma Audit National Report 2019 and 2020 (NOCA, 2021) featured a home safety checklist.  Each hospital is encouraged to use MTA reports for continuous quality improvement. Without the constant leadership provided by the hospital clinical leads for the MTA and the dedication and hard work of the audit coordinators, this audit would not be possible. The NOCA Executive Team and the MTA Governance Committee wish to thank the clinical leads, audit coordinators and staff in the participating hospitals for their continued commitment to, and engagement with, this audit.</p