A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury
2016

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Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events.

Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost.

A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.

Additional materials

Press Release
Report Recommendations
Infographic
Public Release Slides
Recommendations
Introductory Slide and Report Cover
Infographic: Putting Trauma on the Map

Publication information

530 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-44285-0
ISBN Ebook: 0-309-44286-9
DOI: https://doi.org/10.17226/23511

Suggested citation

National Academies of Sciences, Engineering, and Medicine. 2016. A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury. Washington, DC: The National Academies Press.

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Front Matter i-xl
Abstract 1-4
Summary 5-34
Part I: Introduction, Overview, and Framework 35-36
1 Introduction 37-72
2 Overview of Contemporary Civilian and Military Trauma Systems 73-118
3 A Framework for a Learning Trauma Care System 119-146
Part II: Assessment 147-148
4 Generating and Applying Knowledge to Improve Trauma Outcomes 149-232
5 Creating and Sustaining an Expert Trauma Care Workforce 233-270
6 Delivering Patient-Centered Trauma Care 271-300
7 Leveraging Leadership and Fostering a Culture of Learning 301-336
Part III: Recommendations 337-338
8 A Vision for a National Trauma Care System 339-380
Appendixes 381-382
Appendix A: Case Studies 383-428
Appendix B: Committee Collective Analysis of Case Studies 429-436
Appendix C: MilitaryCivilian Exchange of Knowledge and Practices in Trauma Care 437-448
Appendix D: Military and Civilian Trauma Care in the Context of a Continuously Learning Health System 449-458
Appendix E: Public Committee Meeting Agendas 459-474
Appendix F: Committee Biosketches 475-490

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A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury (2016)

Chapter: Part II: Assessment

Part II

Assessment